As the overdose-reversing drug naloxone becomes available over the counter this summer without a prescription, recovery organizations and pharmacies look to the change as a step in the right direction — but not the end of the road.

The drug, also known by the brand name Narcan, can halt overdoses of opioid drugs such as heroin, fentanyl and oxycodone. It previously was available through distributions at recovery centers and through standing-­order purchases at pharmacies.

The FDA approval for over-the-counter Narcan should take effect this summer, according to the manufacturer.

It’s a move that makes potentially lifesaving treatment more available but doesn’t completely solve the problem of access, said Richard Jones, interim executive director at Sage’s Army, a recovery organization with locations in Greensburg and Irwin.

“We are very proud of all the work of all the recovery advocates and everybody involved. This was a very positive development in terms of fighting the opioid epidemic,” Jones said. “It’s the right thing to do. But it’s nowhere close to the end-all-be-all.”

When Narcan becomes available over the counter, it still will carry a consumer price tag. Today, without insurance, Narcan can range from $70 to $100, which can be cost-prohibitive, especially for people who are using drugs, he said. Free distribution still will be important in the future.

“The majority of folks needing Narcan are people who use drugs actively. … It’s not just family and friends; it’s people using drugs who are saving each other,” Jones said. “There are a lot of people out there who aren’t necessarily going to be able to pay for over-the-counter Narcan. Even though this is a fantastic development, we still advocate for free Narcan as well, because some people simply aren’t going to be able to pay for this.”

If free distributions don’t continue after naloxone is available over the counter, it would be “a step back,” he added.

“It’s a fantastic day for those of us in the recovery movement, but I just hope that it doesn’t bounce the free Narcan that has been available and is available,” he said. “Increased access is always a wonderful thing.”

Making Narcan available

At Town & Country Pharmacy in New Kensington, pharmacist Nicholas Roperti is planning how he will let people know that Narcan can be purchased without a prescription. Right now, when patients are prescribed prescription opioids, the pharmacy also lets them know Narcan is available in case of an emergency.

“Once it becomes available, I will probably make a sign and put it up in the pharmacy so that people know it’s available,” he said. “I don’t really know if I am expecting to see an increase in interest or not, until more people become aware.”

He plans to keep Narcan behind the counter initially so he can explain to customers how it works before they buy it.

“We can counsel patients on how to use it instead of them just buying it and not knowing,” he said.

Roperti doesn’t yet know how much Narcan will cost, but he says the price without insurance is sometimes a deterrent.

“It’s up to the manufacturer when they will be able to distribute it and what price they want to make it,” he said. “The generic one is around $80 to $90. The brand Narcan is over $100 without insurance. I also think that that is a deterrent for people. Luckily, we are able to get some generic ones that are less than $100.”

Making naloxone available over the counter means it may be sold in places other than pharmacies, such as grocery stores or convenience stores, noted Tim Phillips, director of the Westmoreland County Drug Overdose Task Force. However, price still might be a barrier to access.

“Are people going to be able to afford it? We don’t know that yet,” he said. “The cost is going to be set by the pharmaceutical company.”

Phillips also hopes free Narcan distribution continues.

“Not everyone can afford it, so we need to make it available to anyone,” he said. “Saving lives is the ultimate end that we need to do — save every life no matter what. Everybody should have Narcan equipped.”

Even if a person doesn’t use drugs themselves or know someone who does, Phillips says carrying naloxone is a good idea.

“You never know when you are going to come across someone who may be overdosing,” he said. “I have known of cases where people have gone into a convenience store restroom and saw someone overdosing. It’s an opportunity to save a life, no matter what, and there’s no risk involved with having it. It’s just a smart move to make sure that everyone has it.”

Fighting stigma, increasing access

Dr. VonZell Wade, director at Lost Dreams Awakening in New Kensington, says the rule change for naloxone is “going to help people.”

“Anytime we can provide more access to something that’s lifesaving, you can’t go wrong with that,” he said. “That’s a good thing.”

While he also would like to see the price of naloxone decrease, he is glad to see a victory of any sort.

“Of course, we want it to be at a reasonable price. But while we’re advocating for that, people are dying,” he said. “You take what you’ve got to work with, and you get it out there and you educate people, and you distribute it.”

Seeing naloxone become less of a financial barrier is still a goal for recovery advocates, he said.

“That’s going to take the health care community coming together and uniting and being one voice, and really advocating for that,” Wade said.

Lost Dreams Awakening currently distributes Narcan to people who use drugs, and trains them and their community and family members on how to use it at monthly “talking circle” events.

“It brings everyone together, and we talk about the benefits of naloxone. We do the training, and then we distribute it. It’s a beautiful way of really getting dialogue around it,” he said.

“When it comes to decreasing stigma around it, we believe the best approach with that is dialogue and sharing and giving people the opportunity to hear real-live stories,” Wade added. “We’re trying to kill two birds with one stone — really educate and distribute but also beat down stigma.”

Training sessions are important to Jennifer Bloodworth, administrator at Onala Recovery Center in Pittsburgh. The nonprofit holds regular Narcan training sessions and distributions.

Bloodworth shares the concerns about cost with other recovery experts and noted that what happens after you give someone naloxone is just as important as knowing how to administer it.

“I hope people still participate in training and that people continue to educate themselves,” she said. “The steps following a revival from an overdose are really critical.”

Calling an ambulance is especially important, she said, because naloxone doesn’t last as long as opioids, meaning a person could have a second overdose once the naloxone wears off.

“It’s a stopgap, very much like (emergency) medicine,” she said. “This is to keep this person alive until they get into proper care.”

Overall, she looks forward to naloxone being available over the counter, especially because the approval is at the federal level.

“I want as much Narcan on the street as possible,” she said. “I just think the educational piece is so important, and there’s resources for that.”

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