Over-the-counter Narcan hits shelves soon. Here’s how you can find it in Pennsylvania now

A landmark decision from the U.S. Food and Drug Administration will pave the way for stores across the country to sell an overdose-reversing nasal spray over the counter later this year.

The FDA’s ruling, issued March 29, approved over-the-counter sales of Narcan, a version of the drug naloxone, which blocks opioids’ effect on the brain and can save the lives of those who overdose on opioid-based drugs like oxycodone, heroin or fentanyl. The agency expects Narcan to be widely available in pharmacies, convenience stores and other retailers by late summer.

“Today’s approval of OTC naloxone nasal spray will help improve access to naloxone, increase the number of locations where it’s available and help reduce opioid overdose deaths throughout the country,” FDA Commissioner Robert Califf said in a statement published following the ruling. “We encourage the manufacturer to make accessibility to the product a priority by making it available as soon as possible and at an affordable price.”

Here’s what you need to know about Narcan.

What does Narcan do?

Put simply, Narcan can save lives. The naxolone-based medication can reverse an overdose by blocking the effects of opioids on the brain and restoring breathing within two to eight minutes, according to the Pennsylvania Department of Health. For more than 40 years, naloxone has helped treat overdoses, which are the largest cause of accidental death in the U.S.

Naloxone’s only function is to reverse the effects of opioids on a person’s brain and respiratory system to prevent death. While treatments do not guarantee someone will avoid a fatal overdose, they significantly increase the chances of survival. A 2022 Penn State study found people were at least nine times more likely to survive an overdose after receiving at least one dose of naloxone.

Notably, naloxone treatments do not hurt those who take other drugs, but it is effective for only those with opioids in their systems. Naloxone drugs like Narcan are not addictive, cannot be used to get high and will not harm someone who is overdosing.

How should I use Narcan?

A box of Narcan contains two palm-size nasal spray plunger devices, each containing 4 milligrams of naloxone. Narcan is the recommended brand of naloxone because the 8-milligram dosage of its competitor, Kloxxado, is typically much higher than is necessary for the average overdose incident.

According to the U.S. Centers for Disease Control and Prevention, signs of an overdose include slow and shallow breathing, limp limbs, pale or cold skin, constricted pupils, slow or irregular heartbeat and a person falling asleep or becoming unconscious. If you are carrying Narcan or another naloxone treatment, watch for the signs of an overdose and be prepared to intervene.

To use Narcan, gently tilt back the person’s head and insert the spray tip into one nostril until both fingers are against the nose. Then, push the plunger to release the full dose.

In most cases, a single dose is enough to prevent an overdose. However, if the person has not started to wake up after a few minutes, apply the second dose into the other nostril. This is critically important for instances in which the person used a stronger opioid, like fentanyl, the DOH says.

Those who have a physical dependence on opioids may exhibit withdrawal symptoms within minutes of receiving naloxone treatments, the National Institute on Drug Abuse says. Withdrawal symptoms might include headaches, changes in blood pressure, rapid heart rate, sweating, nausea, vomiting and tremors.

“While this is uncomfortable, it is usually not life-threatening,” the NIDA says. “The risk of death for someone overdosing on opioids is worse than the risk of having a bad reaction to naloxone.”

Be sure to call 911 for emergency medical services if you witness and overdose, even if you successfully use a naloxone treatment. Thanks to Pennsylvania’s “good samaritan” laws, those who seek medical attention or administer naloxone to someone experiencing a drug-related overdose receive legal protection, or immunity, from risk of arrest, charges or prosecution for drug-related crimes.

Why do I need Narcan?

Keeping Narcan or another naloxone-based treatment in your home or on your person can equip you to intervene when an overdose occurs. Even if those chances are slim, preparations can help you save a life.

The FDA recommends the following people carry naloxone:

• People who are prescribed to opioid pain relievers

• People who are prescribed medicines to treat opioid use disorder

• People who are at an increased risk of opioid overdose, such as those who also use alcohol or other drugs, including benzodiazepines, a class of depressant drugs

• Caregivers of those who are at risk of an opioid overdose

“We want naloxone in the hands of the friends, family members and caregivers of people taking opioids,” Marta Sokolowska, Ph.D., the deputy center director for substance abuse and behavioral health at the FDA, said in a statement.

Where can I get Narcan?

Narcan and other naloxone-based products are already widely accessible through a standing order in Pennsylvania that authorizes licensed pharmacists to dispense naloxone without requiring an individual prescription. Anyone can access naloxone from their pharmacy by either getting a prescription from their doctor or using the standing order, which is kept on file at many pharmacies and available to download online.

Naloxone prescriptions can be filled at most pharmacies, but medications may not be available for same-day pickup, the state DOH says. Prescriptions are usually filled within a day or two of each order.

Narcan prices are highly variable, and costs are expected to increase once the drug hits shelves and becomes available for over-the-counter purchases. Two doses of Narcan can cost up to $50, PBS reports. Pennsylvania maintains a copay assistance program that could reimburse up to $75 for commonwealth residents who purchase naloxone out of pocket.

Additionally, Narcan and intramuscular naloxone are available for free through the mail in Pennsylvania thanks to partnerships between the commonwealth, harm-reduction programs across the country and NEXT Distro, an online platform that works to reduce drug overdose deaths and drug-related health issues.

To get started, visit nextdistro.org/pachoice. There, you will need to watch a training video, answer a short quiz and provide enrollment information to qualify for mail-based naloxone distribution.

Narcan and other naloxone-based treatments are carried by most police departments throughout Pennsylvania. In Centre County, Bellefonte, State College, Ferguson Township, Spring Township and Patton Township police carry naloxone, as well as Penn State’s police department. The Centre County Sheriff’s Department, as well as the county’s EMS departments, are also equipped with naloxone, the county government says.

Locally, other resources are available to help address opioid crises. The Centre County Heroin and Opioid Prevention and Education (HOPE) initiative works to eliminate substance abuse, drug overdoses and drug overdose deaths in the county through outreach and educational efforts, as well as annual events. Learn more online at centrecountypa.gov/2085/about-HOPE.