Welcome access for Narcan, a tool to thwart overdose deaths

Opinion editor's note: Editorials represent the opinions of the Star Tribune Editorial Board, which operates independently from the newsroom.

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Seconds and minutes matter in a medical emergency. Being prepared to render assistance before first responders arrive can save a life.

That's why so many people voluntarily take cardiopulmonary resuscitation (CPR) classes. Or, if their loved ones suffer life-threatening allergies, have an EpiPen or a device like it on hand. It's also the reason employers, sports arenas and retailers frequently keep automated external defibrillators (AEDs) within reach in case a heart stops.

A recent move by the U.S. Food and Drug Administration has commendably eased access to another tool that can empower bystanders to thwart death. It's a medication called Narcan (or generically, naloxone) that can reverse a potentially fatal opioid drug overdose. It should become as commonplace as epinephrine injectors, AEDs and people certified in CPR as deaths from opioid drugs overdoses make up a continuing public health crisis across the nation.

Narcan is not a new medication. It has been available before now by prescription as an injectable and as a nasal spray. The milestone step FDA took in late March is to make the nasal spray available without a prescription.

This is the first time any naloxone product has been available over-the-counter, according to the agency's March 29 announcement. The move isn't a panacea but it is a pragmatic response to dangerous abuse of prescription painkillers or illicitly manufactured versions.

The trend in Minnesota is also alarming. "From 2020 to 2021, opioid-involved overdose deaths increased by 44%, to an all-time high of 978 deaths in 2021. Fentanyl, a highly potent synthetic opioid, was involved in the majority of the deaths," the Minnesota Attorney General's Office reports.

One data point especially makes clear the importance of having immediate access to Narcan. "Nearly 40% of opioid and stimulant overdose deaths occurred while a bystander was present," according to the U.S. Centers for Disease Control and Prevention (CDC).

Medical experts reacted favorably. Dr. Charles Reznikoff, an addiction doctor and internist with Hennepin Healthcare, said the FDA's move is safe and appropriate. In an interview, he cited research showing that for every 11 Narcan doses distributed to people with opioid addiction, one life will be saved.

That the nasal spray was the first to be cleared for general consumer use is sensible. Bystanders will likely feel more comfortable administering it because no needle is involved.

So who should consider having Narcan on hand? Not everyone carries an EpiPen, for example, but typically those who do have loved ones at risk of a severe allergic reaction. The same principle holds for Narcan.

Employers, retailers and public venues should also have it on hand, just as they now have AEDs on site.

While insurance typically covers Narcan available by prescription, consumers seeking it over the counter likely will have to shoulder the cost. The New York Times recently reported that a two-dose box could cost $35 to $65 (not including retail markup).