With the opioid crisis in the United States continuing to kill thousands of people every year, many are touting the benefits of a potentially life-saving drug: Narcan, which can prevent overdose deaths if administered quickly. But in recent months, getting your hands on a vial of Narcan has been easier said than done.
Narcan, also sold as the generic medication naloxone, can reverse the effects of opioid overdoses — including heroin, fentanyl and prescriptions — when given in time. It is sold as a two-pack of nasal spray, and unlike other overdose-reversing medications, has been approved for over-the-counter sales at drugstores. However, this also means that Narcan is susceptible to supply chain issues that can plague nationwide chains.
Narcan is already commonplace in medical settings. But anti-drug activists have long pushed for the medicine, and other versions of naloxone, to be more readily available in public places in the event of an overdose emergency. Why, then, is Narcan becoming more difficult to find, and how can its accessibility be improved?
Why is Narcan so hard to find?
Part of the issue, experts say, is that the rollout has been problematic — and different at locations across the country. Some stores stock Narcan “on display on the pharmacy counter; in the pain medication aisle; behind the pharmacy counter; or behind the front register,” NBC News said. Sometimes, the medicine was “easy to spot and access. Other times, a customer would have to hunt or ask for help.”
NBC investigated the rollout in greater detail and found that Narcan was often kept in haphazard locations at these stores. At a CVS pharmacy near Pittsburgh, it was “spotted in a locked case on a shelf marked ‘Covid tests,'” NBC said, while at a Publix pharmacy in Tennessee, it was “nearly obscured” by “pamphlets advertising ‘Pet meds for less.'”
And these were just the pharmacies that had Narcan in stock. A recent Rice University study into the availability of naloxone near Houston found that “of the 156 pharmacies they contacted, 71% of the Houston pharmacies [still] kept it behind the pharmacist’s counters or were entirely out of the product,” the Texas Tribune said.
And for addicts that do not live near a drugstore, finding Narcan can be even more difficult, if not impossible. While most major drugstores carry the drug, “none of the convenience stores or gas stations” that NBC visited did, the outlet said. Not selling Narcan in gas stations and convenience stores, which are typically ubiquitous, is a “missed opportunity,” Dr. Maryam Jowza, a chronic pain expert at the UNC School of Medicine in North Carolina, said to NBC. If someone “can buy kratom at a gas station, why not Narcan?” Jowza said, referring to a pain supplement sold in the U.S. despite being unregulated.
Even those who can find the drug might not be able to purchase it due to rising costs. At most retail stores, a “two-dose box of nasal naloxone can run $47 to $100,” the Kansas City Beacon said, while name-brand Narcan “could cost as much as $146 for a two-pack.” Some insurances cover the drug — but not all, the Beacon said, meaning that “even someone with health insurance might have a hard time affording” Narcan.
How is this affecting the battle against opioid abuse?
Even as the drug has been approved for over-the-counter sales, many in the medical field have expressed skepticism that Narcan would put a dent in the opioid crisis. The Narcan approval is “not by any means a game changer,” said Shoshana Aronowitz, a nurse practitioner and professor at the University of Pennsylvania, per the Philadelphia Inquirer.
The approval is a “tiny, tiny baby step that does not deserve a round of applause,” Aronowitz said. When it comes to buying Narcan over-the-counter, stigmas remain that could “especially deter people who use drugs,” said Lewis Nelson, the chair of the Department of Emergency Medicine and director of the Division of Medical Toxicology at Rutgers University, per the Inquirer.
“For those who don’t have substance use concerns, they might go in and just ask for the product and not be concerned about what the other person’s thinking,” Nelson said. But for someone with an opioid addiction, that is a “mental state that’s very hard for most of us to put ourselves into if we don’t live the life of somebody with the stigma and the marginalization that is so associated with substance use.”