Patient EducationSep | 25 | 2023
Vinod Rao, MD, PhDNarcan becoming available over the counter is definitely an important development in the evolution of how we can address the opioid epidemic.
The opioid epidemic is wide-reaching. Over 150 thousand people have died of an opioid overdose in the last two years, 29 million people are struggling with opioid use disorder, and 43 million Americans are impacted by a close friend or family member’s use — those this last figure is thought to be underreported.
Earlier this year, the Food and Drug Administration (FDA) approved the first over-the-counter naloxone nasal spray, Narcan, and it is expected to be available in store shelves this month, which is also National Recovery Month. In July, the FDA approved a second naloxone nasal spray for over-the-counter use as well. With the approval, this mitigating tool is in nearly everyone’s reach.
“The US is not the first country to make naloxone available over the counter,” says Vinod Rao, MD, PhD, Medical Director of the West End Clinic in the Department of Psychiatry at Massachusetts General Hospital. “The FDA approving Narcan for over-the-counter sales is a piece of the puzzle when it comes to doing everything we can to address the opioid crisis.”
An overdose of opioids, especially in combination with alcohol, blocks the activity of the brainstem, which normally keeps us breathing without us having to think about it — and that’s when an overdose can occur. Naloxone is nasally administered, providing a direct and quick route to the brain to knock opioid molecules off the receptors in the brain to restart breathing. It temporarily reverses the overdose, giving time for medical care and saving lives.
With Narcan becoming available for over-the-counter sales, anyone could purchase it at a pharmacy and carry it. It may be more likely that a person who uses opioids or the friends and family of someone suffering from opioid use disorder carries Narcan on a regular basis. Emergency personnel always carry it in the case that someone calls 911 to report a possible overdose they can respond and administer it quickly.
Individuals can carry and administer Narcan, there’s no special training needed and instructions for how to do so are widely available. Narcan won’t harm someone who isn’t overdosing, but of course, people can always dial 911 instead of administering it themselves. Most states (including Massachusetts) have ‘Good Samaritan’ laws in place that prevent a person from being prosecuted when administering Narcan in good faith to someone appearing to have overdosed.
“Most people need to cope with stress at some point or another in their life and we cope in a variety of ways, some people turn to opioids, others drink, others run, the list goes on and on,” says Dr. Rao. “There’s a large biological component to substance use disorder, but I’ve found in my work that people come to cope from an honest place, seeking support in a time with more social challenges and less social supports. Empathy is critical.”
There are a lot of different approaches depending on individual preferences and styles. Families and friends can engage and encourage treatment while also keeping themselves safe. Below are some different resources and approaches for handling this topic with your loved one:
Congratulations. This is an important first step in your path to recovery. There are resources below to help guide your immediate next steps.
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