Drug that can reverse effects of opioid overdoses soon available over the counter in the US

NEW YORK: A drug that reverses the effects of an opioid-related overdose will soon be available for over-the-counter sale in the United States. 

The prescription nasal spray Narcan, a naloxone-based drug, is expected to become widely available later this year, but its cost could be a limitation.

Observers said the move also does not address the deeper issues at the root of the opioid crisis in the US, which sees record numbers of drug overdose deaths reported each year.

THE US’ OPIOID EPIDEMIC

Naloxone is a life-saving medication that can reverse the effects of an overdose from opioids, including heroin, fentanyl, and prescription opioid medications. 

Outreach groups said fentanyl, a synthetic opioid up to 50 times stronger than heroin, has saturated the drug supply.

“Fentanyl is in the powdered cocaine, the crack cocaine, it’s in the compressed pills and it’s in the heroin,” said Mr Hiawatha Collins, community and capacity building manager at the National Harm Reduction Coalition. 

“Now, the danger is you have added Xylazine to that mix which, if people don’t know, is an animal tranquiliser not meant for human consumption.”

Many critics blame major pharmaceutical companies and some doctors overprescribing prescription painkillers for contributing to the country’s opioid epidemic.

In 2021, there were more than 2,500 fatal overdoses in just New York City, the most seen in at least 20 years. Officials believe this figure was likely even higher in 2022. 

Nationwide, opioid overdoses have now killed more than 100,000 people in each of the past two years. 

To help buck that trend, around 17 million naloxone doses were distributed in 2021 alone. 

“Everybody needs to have and know about naloxone,” said Mr Collins. 

“But it needs to be in the hands of predominantly drug users, and friends and family of drug users, because they’re going to be the ones to be first on the scene if or when someone overdoses so they can use it right there.”

APPROVED TO BE SOLD OVER THE COUNTER

The naloxone nasal spray Narcan was approved as a prescription drug by the US Food and Drug Administration (FDA) in 2015.

Now, it has been given the green light to be sold over the counter. By late summer, Narcan will be available for purchase online, in gas stations, supermarkets and other major retailers. 

The FDA said this is a move to address a dire public health need.

Narcan is already distributed widely by healthcare professional and community outreach groups, but advocates hope the sale over the counter will help normalise its use among the broader population.

“Before someone calls 911, if they see someone on the street, if it’s a friend, a loved one, someone on a bus with them or a ferry, having Narcan available is really very, very important,” said Dr Joseph Conte, executive director at the Staten Island Performing Provider System. 

Meanwhile, the maker of Narcan said it hopes the out-of-pocket cost for the drug will be under US$50. 

Some fear that sticker shock will be a deterrent. 

MORE THOROUGH SOLUTIONS NEEDED

“We really need to think about saturating communities with naloxone, saturating it and making it available in low threshold settings where there are no barriers,” said Research Associate Professor Alexander Bennett of New York University’s School of Global Public Health. 

“If you put up barriers, people are not going to access the medication. So if you stigmatise people, discriminate against people or charge them with a lot of money, people are not going to access the medication.”

Some observers argued that the wider availability of Narcan is a positive step, but stressed that broader action and more thorough solutions are needed.

“We need to have mass awareness and prevention campaigns, we need to get people into treatment even if they don’t want it, we need to figure out ways to get them into treatment,” said Foundation for Drug Policy Solutions president and chief executive officer Kevin Sabet. 

“So there’s a lot of things we need to do that are frankly a lot harder, a lot more expensive but would have a lot more of an impact.”

While critics noted that over-the-counter Narcan is no magic bullet to reverse the opioid crisis, its advocates believe the broader availability is crucial to help prevent thousands more lives from slipping away.