Over-the-counter Narcan available, but barriers still exist

While the opioid reversal medication is available without a prescription, buying it may not be as easy as it sounds.

In 2023, more than 1,300 people in Connecticut died of an overdose. The vast majority, or 84%, involved fentanyl. So far, 2024 is following that trend.

Naloxone, commonly known by the brand name Narcan, is designed to reverse the effects of an opioid overdose. It has been available over-the-counter since September, but an NBC News investigation found buying the medication may not be as easy as it sounds.

In February, NBC News visited 64 stores in 15 states, including Connecticut and Washington, D.C.

NBC CT Investigates found naloxone and Narcan for sale in most major drugstores and big-box store pharmacies. None of the convenience stores or gas stations we checked had it for sale.

At Beacon Prescriptions in New Britain, Narcan and generic naloxone are located behind the register in an area that customers can also access. A pharmacist told NBC Connecticut that so far, it’s not a big seller.

According to the Connecticut Department of Consumer Protection, any retailer licensed to sell other over-the-counter medications can carry Narcan. While a customer can grab pain relievers and allergy medicines right off the shelf, we found the same is not always the case for Narcan.

In many stores, Narcan was located behind the register or at the pharmacy, where customers have to ask an employee for assistance.

A spokesperson for Walgreens told NBC Connecticut, “The product’s placement behind the front register ensures it is highly visible and accessible to customers as they enter the store.”

A CVS spokesperson said, “In-store signage encourages customers to get NARCAN® at the pharmacy so our pharmacy teams can check the customer’s insurance plan for potential savings on the OTC product or determine if a prescription naloxone product may be more affordable.”

Fiona Firine, who lost her son Cameron to an overdose in 2018, would like to see naloxone on the shelves where customers can access it freely.

“The whole point of over-the counter is people do not want to have to ask for it,” Firine said, noting there’s a stigma attached with substance use.

Dr. Ben Oldfield, a physician at Fair Haven Community Health Center, agrees. He likens buying Narcan to buying condoms.

“If condoms are locked up or behind the counter, they're much less likely to be bought because there's stigma. There's embarrassment. There’s issues at stake with people asking for those as opposed to just putting it on the counter and paying for it,” he said.

“If we can get to that point where [naloxone] is more available on the shelf, doesn't require permission, a conversation, it's just like any other potentially life-saving medicine, that's where we need to get,” Oldfield said.

With an average price tag of $45 for two doses, the cost of the medication is another potential barrier.

Oldfield said naloxone is covered by most insurance plans, and there are organizations across the state that offer naloxone and training for free.

“I absolutely have it, yes. And I’ll never be without it,” said Paige Niver, whose daughter became addicted to opioids at age 14 after a serious bicycle accident.

Niver is active with the Manchester, CT HOPE Initiative, which is among the community groups sponsoring free Narcan training on June 13.

“It's having like another tool in your toolbox. If you've got it right in your house and you can administer it, you have an opportunity to potentially save a life,” she said.

Firine and Niver are among a small group of people who carry naloxone as a matter of course.

“One of the sort of interesting things about naloxone is that people don't use naloxone on themselves… you're generally buying it either to teach someone else how to use it or to use it on somebody else,” Oldfield said. “It’s not uncommon for people to want to make sure they have it on hand, and they may be among a community of people who is at risk for overdose. And naloxone can get used pretty frequently.”

A study from the Quinnipiack Health District and DataHaven looked at emergency naloxone use in New Haven and five surrounding towns from July 2021 to July 2023. Firefighters or EMS administered naloxone in 78% of suspected overdoses, while bystanders administered it in 16% of those cases.

According to the Connecticut Department of Public Health, most overdoses happen at a residence.

At the national level, data indicates potential bystanders were present, but unable to provide life-saving measures such as naloxone in nearly half of fatal overdoses in 2021.

You do not need medical training to give Narcan. The state of Connecticut has a free app called NORA (Naloxone + Overdose Response App) that gives step-by-step instructions for administering it.

All of the advocates we spoke with emphasized that it’s OK to give naloxone to someone, even if you’re not sure which drugs they’ve taken, because it only works on opioids.

“So if someone were to use naloxone who was not having an opioid overdose, they would probably just have no effect,” Oldfield said. “So one of the mantras that we usually use is when in doubt, use naloxone because the risks of using it are so low, and that’s why it’s becoming more and more available.”