On March 29, 2023, the FDA approved Narcan spray for opioid abuse and overdoses for sale over the counter without a prescription. This change will help provide access to potentially lifesaving treatment. It will allow people access to buy 4-milligram nasal sprays in pharmacies, grocery stores, vending machines, gas stations, and convenience stores.
What Is This Change Helpful?
This change is helpful because it makes the potentially lifesaving treatment of Narcan more accessible and affordable. People can purchase it over the counter without a prescription, making it easier to obtain in comparison to having to get a prescription or wait for emergency medical technicians to arrive.
Additionally, this will help reduce barriers for people who need access to this medication, especially those living in rural areas where there may not be easy access to immediate medical care. Furthermore, making Narcan available in places like vending machines, gas stations, and convenience stores could make it easier for people who find themselves in an emergency situation without the time to wait for emergency responders.
How Bad Is the Opioid Crisis?
The opioid crisis is a nationwide public health emergency. According to the CDC, there were 69,000 deaths in 2020, amounting to an average of 189 deaths every day from an opioid overdose. Both prescription opioids and illicit drugs like heroin and fentanyl caused opioid overdoses. They have increased in availability over the past decade.
This has led to a significant increase in unintentional drug overdoses, as well as increases in related health problems such as addiction, chronic pain, depression, anxiety, and suicide. The CDC estimates more than 2 million Americans are currently addicted to opioids or misusing them each year. By making Narcan nasal spray accessible without a prescription, it could be helpful in reducing deaths from accidental overdoses. It could also help those struggling with opioid addiction get access to overdose treatment sooner rather than later.
How Does Narcan Help Opioid Overdoses?
Narcan is an opioid antagonist that works by binding to the same receptors in the brain as opioids, blocking their effects and reversing an overdose. It does not create a “high” for users but instead allows them to remain conscious enough to seek medical help if needed.
Family members or friends can even administer Narcan at home with little training required when they have access to the nasal spray. This could potentially save lives since those in need can quickly access it before emergency services arrive on the scene.
Why Was Narcan Not Approved Sooner?
The FDA had resisted approving Narcan for over-the-counter use since it was first developed in the 1970s. The main reason for this resistance was concern that making Narcan more widely available would lead to increased misuse of opioids. Another reason is the belief that people should use naloxone (a generic form of Narcan) instead.
However, this decision had consequences, such as delays in getting Narcan to those who needed it and limited access to the medication in many areas due to its high cost and prescription requirement. This change is significant because it means that people who need access to potentially lifesaving drug treatment can now get it more quickly and easily than before.
It is worth noting the FDA has been considering making naloxone available without a prescription since last November. Many people anticipate that they will approve naloxone at some point in the near future.
How Is Narcan Administered?
Narcan is available in both nasal spray and injection form. The nasal spray is the easiest way to administer Narcan, as it only requires one dose of 4 milligrams per nostril. This is why the FDA approved it over-the-counter sales.
Packages will include two nasal spray devices consisting of 4 milligrams each. When someone needs it, they should first administer it in one nostril as soon as possible. Then if the person remains unresponsive, someone should administer the second dose in about two minutes in the other nostril.
Over-the-Counter Narcan Is Not a Replacement for Medical Care
Even after administering Narcan, it is still important to call 911 immediately. This is because Narcan only reverses the effects of opioids for a short period. Moreover, the person may need to give someone multiple doses to keep them awake or breathing.
Furthermore, certain opioids can require large amounts of Narcan to reverse the effects of an overdose. For example, fentanyl can require additional doses every two to three minutes until restoring breathing and consciousness. Due to the potency of fentanyl, more than one or two doses are often necessary.
Additionally, other medical complications may be related to the overdose that requires further treatment by paramedics or doctors. As such, calling 911 should always be done as soon as possible in an overdose situation after Narcan has been administered.
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