Will Over-The-Counter Naloxone Help The Opioid Epidemic?

Opioid related deaths have been rising since the early 2000s and unfortunately, overdose has only grown exponentially. In recent years, the opioid crisis has become so prolific that it was declared a public health emergency in 2017. While there are many schools of thought for how to reduce opioid related deaths, it is well known that the drug naloxone is vital to reversing an opioid overdose.

Recently, the FDA approved a new form of the drug that would make it the first over-the-counter version of naloxone available. This new form of over-the-counter naloxone comes as a nasal spray and is said to be released to the public sometime early this summer. Additionally, the drug was approved on the basis that it could be administered without any guidance from healthcare professionals. As such, the nasal spray will be made available outside of pharmacies, in supermarkets, convenience stores, and potentially even vending machines.

Although there is much excitement and praise that comes with this medical advancement, concerns have arisen as well. There is little known about the cost of the over-the-counter nasal spray, and some believe the price may outweigh the benefit of wider access. Additionally, there are skeptics that wider availability without medical regulation will actually have any benefits. Of course, with anything new in healthcare, there is always going to be wide ranging opinions. Keeping this in mind, we asked the Figure 1 community for their thoughts on this new over-the-counter naloxone nasal spray.

Here is what more than 875 healthcare professionals had to say.

Will This Help Combat Overdose Deaths?

We asked the Figure 1 community if they thought the approval of this nasal spray would help to reduce the amount of opioid overdose deaths. Most of our respondents, 53%, said they believe that it would help. This left 32% who said it would not help and 15% undecided.

One respondent had mixed feelings about this suggesting, “The question was if availability of nasal naloxone will save more lives from opioids, the answer is yes. But it will promote more addiction by inciting a false security blanket to addicts.” Many seem to agree with this school of thought that yes, more availability will save lives but may also, inadvertently, put more lives at risk.

Can It Be Used Properly?

One of the largest concerns was that instructions on proper use may be unclear and the product could be confusing to use and therefore administered improperly. Despite these concerns, the over-the-counter naloxone made its way to approval. Some HCPs are still concerned about this issue, but it is only a minority. Of our surveyed members, 55% were not concerned about proper use of the product, while only 37% showed some concern, and 8% remained unsure.

What’s the cost?

The company that developed the product has not made any official statement about pricing for the nasal spray. However, Alex Bennett, director of the Opioid Overdose Prevention Program at the NYU School of Global Public Health stated “the high cost ($60-90) of the intranasal formulation will remain a barrier for many people in comparison to the much more affordable injectable formulation, which did not receive the over-the-counter designation.” 

When asked, 79% of our surveyed members believe there should be a low-cost price cap for this nasal spray alternative. This left only 13% saying no, there should not be a price cap, and 8% remaining unsure.

What is the impact?

There are many different thoughts on how over-the-counter naloxone will impact the opioid crisis. Some believe it is exactly what is needed, others think it will only do harm. But most agree that it will not promote nor stop addiction.

Published May 8, 2023

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