On Friday, the Alabama Department of Public Health (ADPH) announced that the U.S. Food and Drug Administration (FDA) had approved the Narcan®4 mg nasal spray medication for over-the-counter nonprescription use. Narcan is designed to help reverse the effects of an opioid overdose in minutes.
Other options remain prescription only. In addition to Narcan, naloxone is available in an injectable form and other doses. The other formulations and dosages of naloxone will remain available by prescription only. ADPH said that the standing order by State Health Officer Dr. Scott Harris would remain in place for naloxone and does not expire. The standing order allows pharmacists to dispense naloxone formulations and dosages that are prescription only. Medicaid patients can access naloxone through prescription.
Louise Jones is the Chief Executive Officer of the Alabama Pharmacy Association.
“The Alabama Pharmacy Association applauds the FDA’s decision to make this life-saving drug available without a prescription to anyone who needs it,” said Jones. “Only the Narcan 4 mg nasal spray version has been approved for over-the-counter (OTC) use. The Alabama current statewide standing order issued by the state health officer will remain in place as the injectable version will still require a prescription. It should be noted that Alabama Medicaid recipients have coverage for the nasal spray, but Medicaid requires a prescription for OTC products. In collaboration with the Alabama Department of Public Health and Alabama Medicaid, APA has worked to maintain access for our state’s most vulnerable population.”
Narcan nasal spray is the first naloxone product approved for use without a prescription. In the next few months, Narcan can be sold directly to consumers in locations such as drug stores, convenience stores, grocery stores, and gas stations, as well as online.
“Pharmacists and pharmacy practices across Alabama who have participated in the Naloxone Statewide Standing Order have been, and will continue to be, instrumental in helping patients get access to naloxone and other supportive therapies to help reduce the risk of an opioid-related overdose,” Jones said. “Pharmacies are highly accessible, critical access points that allow patients, caregivers, and families to connect with their trusted pharmacist to learn more about naloxone and the risk associated with opioid medications.”
NPR’s A Martinez on Friday spoke with pediatrician and addiction specialist Scott Hadland about the FDA’s decision. The nasal spray could be on store shelves and ready to buy without a prescription by late summer.
“We’re at a point right now in this overdose crisis where since the turn of the century, we’ve had more than a million overdose deaths and where these are increasing,” Hadland said. “We’re now at a point where more than 100,000 people die every year. Narcan is a medication that is safe. It’s effective. It has virtually no downside to administering it. And there really is no reason that it shouldn’t be widely available to save the lives of the so many people who die each year.”
“What happens when somebody overdoses is that opioids – and in this day and age, it’s most commonly fentanyl that’s getting into people’s systems – opioids bind to receptors in the body and make it so that a person stops breathing, and that’s what ultimately ends up killing a person,” Hadland explained. “And so what Narcan is doing is it’s getting in, and it’s releasing the fentanyl or other opioids from those receptors and essentially in just seconds or even just minutes reversing that overdose and saving a person’s life. And since Narcan is a medication that’s sprayed up the nose, it’s very easy to administer. Almost anybody can do it with very little training needed.”
Cost remains a concern.
“It’s one thing to make it available. It’s another thing to make it affordable to people,” Hadland said. “And as somebody who works with families that have been affected by this overdose crisis every day, I know that if the price is too high, many families and patients just simply won’t buy it.”
“Yeah, according to GoodRx, 130 bucks for an average price of a two-dose box,” Martinez said. “I know if you make something more expensive, it makes it harder to get, and also, people might want to do something terrible to try and get it.”
Drug use among high school students is on a historic decline, but the drugs they use are more dangerous than ever before, resulting in overdose deaths tripling in recent years. Fentanyl is the causative agent, and often the drugs are laced with fentanyl.
Only a tiny amount of fentanyl is needed to kill a person, especially someone younger and inexperienced with drugs. Most teenagers who overdose on fentanyl likely did not know it was in the drug they were taking.
To connect with the author of this story or to comment, email brandonmreporter@gmail.com.
