When you wander down the aisles at a Walgreens store these days, you can grab some cough syrup, paper towels, or a bag of candy.
While you’re there, you can also pick up a nasal spray used to reverse opioid overdoses.
Walgreens recently announced that all its pharmacies would stock Narcan, an inhalant form of the drug naloxone.
Most states don’t require a doctor’s prescription to buy Narcan, so this improves the chances that the life-saving drug may be available when it is crucially necessary.
Walgreens joins CVS Pharmacy, which this summer increased access to Narcan for its customers.
Phil Caruso, Walgreens media relations representative, told Healthline that the announcement is part of the company’s efforts to make it easier for people to obtain the drug.
“For an opioid overdose victim’s family member or caregiver, having the medicine on hand could make the difference,” Caruso said. “We hope it’s the first step on the road to recovery.”
Some restrictions apply
Buying Narcan is not as simple as buying aspirin, however.
Narcan is a prescription drug, so it’s not available over the counter.
Nonetheless, 49 states and the District of Columbia have enabled workarounds such as statewide standing prescription orders from doctors and allowing pharmacists to prescribe.
“Narcan is a behind-the-counter drug,” Thom Duddy, executive director of communications for Narcan manufacturer Adapt Pharma, told Healthline. “In most states, you can go to the pharmacy and buy Narcan without an individualized prescription. As with getting a flu shot, there is a prescription attached, but you don’t need someone to write a prescription for you to buy it.”
In California, for instance, the pharmacist on duty can prescribe Narcan to anyone who requests the drug.
Dispensing pharmacists are required to provide instructions to individuals who purchase Narcan, including how to recognize an overdose, steps for administering the drug, and calling 911.
A recent purchase of a two-dose kit at a CVS Pharmacy in Foster City, California, took about 20 minutes to complete. The buyer’s healthcare insurance covered all but a $25 co-pay.
Who buys Narcan
According to Duddy, early market reports indicate that a typical purchaser of Narcan is someone who cares for someone with a risky high-dose opioid prescription.
But as the opioid epidemic continues to claim victims, access to naloxone is becoming more mainstream.
“There are three populations that should have access to naloxone,” Dr. Scott Weiner, MPH, director of the Comprehensive Opioid Response and Education Program at Brigham and Women’s Hospital in Boston, told Healthline. “One, active users of illicit opioids, either injecting or taking pills not prescribed to them, acquired illegally, or by diversion. Two, family members of people using drugs like that. And three, people using opioids as prescribed, but on a high dose — 50 mg or more of morphine or its equivalent.”
According to a study done in Massachusetts, naloxone is 93 percent effective in reversing an opioid overdose.
However, Weiner recently coauthored a report estimating that 1 in 10 of those who are saved from death in this manner suffer a drug-related death within a year.
Nevertheless, communities with access to Narcan have fewer overdose deaths than those with limited access to the drug.
“The more people that have it the better,” Weiner said. “If you’re in an area with a high incidence of overdose, you may be a candidate to have it.”
What to do when someone overdoses
An opioid overdose causes respiratory arrest, where the victim’s breathing slows or stops.
They can become somnolent, even blue, and can quickly die.
Naloxone inhibits the effects of the opioid, effectively blocking the opioid from acting on the brain’s receptors and thus reversing the overdose.
Administering Narcan involves confirming that the overdose victim is unresponsive, assembling a simple atomizing device, spraying a puff of the drug into each nostril, and then calling 911.
Medical attention is necessary, although overdose victims sometimes refuse to be taken to the hospital.
According to Dr. Michael R. Brumage, MPH, FACP, executive director and health officer of the Kanawha-Charleston Health Department in West Virginia, an overdose victim may wake up and not realize they had been close to death.
“A lot of people don’t like being brought out of their high,” Brumage told Healthline. “They don’t even know they’ve overdosed. They just know that someone’s taken them out of their euphoria. They immediately go into withdrawal. Sometimes they get combative.”
A trip to the hospital, though, can be a teachable moment for the opioid abuser and could lead to treatment and recovery.
Buprenorphine and methadone, drugs that prevent withdrawals and block cravings, can be effective at keeping addicts off opioids.
“We need to get them into treatment so they can live the long and healthy life they deserve,” Weiner said. “You can’t recover someone if they’re dead.”
“I am alive because of Narcan,” Mike-Alison Burke of Florida, told Healthline. “Heroin was not my drug of choice, but one day I decided to snort some to take the edge off. I woke up being wheeled out of my hotel room and into the meat wagon. It was my first and hopefully last O.D. I’m completely clean now.”
There are calls to allow naloxone to become an over-the-counter medication and further widen the market for people who can buy it.