Narcan is now available over-the-counter, but how much will it cost?

Dr. Ximena Sanchez-Samper

Ximena Sanchez-Samper, MD is a Board- Certified Addiction Psychiatrist who obtained her degree as a psychiatrist at the Mayo Clinic in Rochester, MN and completed her Addictions Fellowship through the combined Massachusetts General Hospital, McLean Hospital / Brigham and Women’s Hospital Addictions Fellowship program in 2004.

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The opioid overdose reversing medication can now be sold over-the-counter without a prescription.

The recent approval the opioid overdose reversing medication Narcan for over-the-counter sales, is good news for people with substance use disorders, their family and friends, for drug addition specialists and even for bystanders. With overdoses on the rise, access to the life-saving medication is more urgent than ever before. It remains to be seen, however, how impactful the change will be.

Earlier this year the federal Food and Drug Administration approved the 4-milligram nasal spray version of Narcan for purchase without a prescription. But Narcan is already available in Massachusetts at pharmacies through a standing prescription established through the Department of Public Health with insurance covering most of the cost. At this time, pricing for over-the-counter Narcan has not yet been announced, and there is concern that it will be prohibitively expensive for uninsured folks, who may be the ones who need it most.

According to the National Centers for Disease Control and Prevention, more than 100,000 people in the U.S. died from drug-involved overdoses in 2021, including illicit drugs and prescription opioids. Nearly 75 percent of overdose deaths in 2021 involving heroin also involved synthetic opioids. The number has risen every year since 2015. With fatal overdoses on the rise in much of the U.S., due to the addition of the synthetic opioid fentanyl to heroin and other street drugs, easy access to Narcan has become more urgent.

How and when to use Narcan for an opioid overdose

Narcan is the brand name of naloxone hydrochloride, which blocks the effect of opioids in the brain and other areas of the body, reversing symptoms of an overdose, such as slowed breathing, low blood pressure and unconsciousness.

How To Use a Narcan Or Naloxone Kit For Opioid Overdose – YouTube

Overdoses can happen when drugs are taken intentionally, accidently or during the course of medical treatment. Some happen when a person leaves drug treatment. Someone taking prescription opioid medication could accidentally overdose by drinking alcohol or taking other sedating medication. If a person is suspected of being in an overdose situation and is not responding to their name or showing blue fingertips, clammy skin, and making snoring or choking sounds, 911 should be called, and Narcan administered. Since Narcan is short acting, a second dose may be necessary. There is no health risk associated with administering Narcan to someone who is not overdosing.

How much is Narcan over the counter?

The cost for over-the-counter Narcan has not yet been announced, according to the FDA. Generic naloxone can cost between $20 and $40 per dose, while Narcan can cost around $130 to $140 for a kit that includes two doses, according to information provided by, an online pharmaceutical encyclopedia.

How to get Narcan without a prescription

Those who are insured through MassHealth can already obtain Narcan free of charge from pharmacies across the state. Other insurers also cover the cost of Narcan, but coverage varies by provider, and co-pay costs may still apply.

While it remains to be seen whether or not over-the-counter Narcan will make a dent in the overdose numbers, it may go a long way toward addressing the stigma associated with substance abuse disorders. The FDA’s decision sends the right public health message, and may reduce stigma and increase access, but only if people can afford to pay for it.

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Other Links

FDA approves over-the-counter Narcan to reduce drug overdoses – ABC News

How do I get free Narcan emergency kits? (

Narcan is poised to be sold over the counter. But the price tag is unknown : NPR