To be sure, Narcan is selling.
Since the launch of the over-the-counter version last fall, the drug can be purchased at more than 32,000 mass, drug, grocery and online retailers and e-commerce sites, Paul Williams, a senior vice president at Emergent BioSolutions, the maker of Narcan, said in a statement. In 2023, the company distributed more than 20 million doses of the antidote, both over-the-counter and prescription, in the U.S. and Canada, he said.
In the fourth quarter of last year, Emergent reported $111 million in Narcan sales, a 22% increase from the year prior. The increase was mainly driven by sales of the over-the-counter version, the drugmaker said.
Dennis Cauchon, president of Harm Reduction Ohio, a nonprofit group that distributes Narcan for free, said it’s still too early to gauge the impact the over-the-counter version is having on the opioid crisis.
Hadland knows of at least one case where a patient used Narcan bought over the counter to save a friend.
“People are recognizing it as something that everyone should consider carrying with them,” he said. “I think it will save lives.”
Matt Blanchette, a spokesperson for CVS Health, declined to share sales data for over-the-counter Narcan, but said the stores have “ample supply” of the product, located at the front store registers and near the pharmacy.
All CVS pharmacists, Blanchette added, are trained on how Narcan works and can provide counseling to people before they buy it. People can also buy the product at CVS.com.
Overcoming the stigma
For a product like Narcan, anonymity is part of access.
The stigma of walking into a brightly lit store and asking the pharmacist or another employee for Narcan behind the counter may be the biggest hurdle.
“They may ask all these invasive, detailed questions like, ‘What’s your name? What do you do? How old are you?’” House said. “Putting it out front, not having it being prescribed, is just taking down more of those stigmas and barriers.”
A Walgreens spokesperson said Narcan is placed behind the front register to ensure it is highly visible to customers. There are also pull cards on shelves in the pain relief aisle. The company, the spokesperson added, is “continually communicating with our field teams to ensure a consistent and proper placement of the product.”
At 16 Walgreens locations in 11 states plus Washington, D.C., NBC News spotted it behind the pharmacy counter, on display by the pharmacy and on the shelf in the pain relief aisle, in addition to behind the front register.
The cost barrier
Nearly all stores visited by NBC News priced over-the-counter Narcan at around $45, a lot for many people who use opioids.
As of late February, a handful of stores — including four Publix locations in Florida and one in Chattanooga, Tennessee — priced the product at $49.99. Two Walgreens locations, one in Maryland and one in Florida, sold Narcan for $49.99.
The Walgreens spokesperson said the company was communicating with stores about consistently pricing the product at $44.99.
Publix did not respond to multiple requests for comment.
Independent pharmacies may sell the drug at an even higher price, Cauchon said.
To really make a difference, the two-dose packs need to be priced at around $5, he said.
“There are very few reports of people going in and buying” Narcan in Ohio, he said.
“In theory, it’s good. In retrospect, we’ll be happy that this happened as an event in history,” Doe-Simkins said of Narcan’s arrival in stores. “Right now, it’s distracting.”
Hadland said he expects the people who will buy over-the-counter Narcan will be family members of people who use opioids.
“I’ve especially seen this among parents who increasingly want to keep Narcan at home, almost like a fire extinguisher in case of an emergency,” he said.
NBC Bay Area, NBC South Florida, NBC Connecticut and NBC affiliates KTAL (Shreveport, Louisiana), WBAL (Baltimore), WDTN (Dayton, Ohio), WFLA (Tampa, Florida), WIS (Columbia, South Carolina), WOWT (Omaha, Nebraska), WRAL (Raleigh, North Carolina) and WRCB (Chattanooga, Tennessee) contributed reporting.
