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The opioid overdose reversal drug Narcan has been approved for sale over the counter

JUANA SUMMERS, HOST:

The opioid overdose-reversal drug Narcan will now be available over the counter. The Food and Drug Administration decided to make the nasal spray available without a prescription earlier today. It's a first for the life-saving drug. NPR pharmaceuticals correspondent Sydney Lupkin joins us now with the latest. And, Sydney, this feels like a really big step toward combating the opioid crisis.

SYDNEY LUPKIN, BYLINE: You know, absolutely it is. Opioid deaths have basically quadrupled in the last decade. They went from around 21,000 in 2010 to 80,000 in 2021. And these are deaths from heroin, prescription opioids and fentanyl, which is highly potent and has become widely available. But Narcan, which is the brand name for naloxone, is a nasal spray that reverses opioid overdoses, and it can be used by health care providers, first responders, family members. It binds to opioid receptors to reverse the overdose and restore breathing. Here's Dr. Brian Hurley, an addiction physician and president-elect of the American Society of Addiction Medicine.

BRIAN HURLEY: I think the fact that we're in the worst overdose crisis in American history sort of underscores the importance of making sure that every family has access to naloxone because you never know when somebody's going to experience an overdose.

LUPKIN: The FDA's decision paves the way for Narcan to become much easier for people to get.

SUMMERS: And, Sydney, if this is such an important life-saving drug - important solution, why are we only seeing access over the counter to Narcan now?

LUPKIN: Well, a drugmaker had to give it a try and go through the time-consuming process of gathering the safety data and seeking the FDA's over-the-counter approval. They said it can be used safely and effectively without the supervision of a doctor or other health care provider. So the drug maker, Emergent BioSolutions, applied for Narcan to have OTC approval in December, and then things moved pretty quickly after that. Last month, the FDA held a meeting of its advisers - these are doctors and other experts outside the agency - and they voted unanimously to approve Narcan for use without a prescription. So since the FDA went along with the committee's vote and did the approval, Narcan could be sold in gas stations, convenience stores and online - sold, really, just about anywhere.

SUMMERS: So, I mean, at a practical level, how soon could someone get Narcan over the counter?

LUPKIN: It's a great question. So not right away. The FDA says the timeline is really up to the manufacturer - that's Emergent BioSolutions - but it will take a few months to make the switch from prescription to over the counter. Emergent says the rollout will happen by late summer, but how much it will cost is up in the air. It's unclear now what the over-the-counter price will be. A box with two sprays available now with a prescription can run from around $30 to up to $100 or more, depending on the pharmacy.

SUMMERS: Well, I mean, is there anything people can do right now to get their hands on Narcan?

LUPKIN: So actually, there are many places where you can get Narcan without a prescription thanks to, basically, a patchwork system of workarounds. In many places, public health officials have done what's called a standing order, basically a prescription that covers their entire jurisdiction, and that allows cities like Philadelphia and Chicago to provide free Narcan - in public libraries, for example. But because it's a patchwork system, there are going to be places where you can't get it as easily. You need to get it from behind the counter. And steps like that are tricky because there's stigma. And, you know, what the new over-the-counter approval really is going to do, it's going to remove additional barriers across the country.

SUMMERS: That was NPR pharmaceutical correspondent Sydney Lupkin. Thank you.

LUPKIN: You bet. Transcript provided by NPR, Copyright NPR.

Sydney Lupkin
Sydney Lupkin is the pharmaceuticals correspondent for NPR.