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Narcan Over-the-Counter Now: a Leap in Combating Opioid Overdoses

Zena Hassoun

Written by Zena Hassoun

Zena Hassoun

Zena Hassoun

Zena earned her M.S. in Medical Health Sciences from Touro University, California and has a background in Psychology. She is passionate about increasing access to healthcare, de-stigmatizing mental health treatment, and improving health equity.

Mari Carlo Manzana, MD

Reviewed by Mari Carlo Manzana, MD

October 12, 2023 / Read Time 3 minutes

The fight against the opioid crisis received a significant boost, as the U.S. Food and Drug Administration (FDA) has approved the sale of Narcan and RiVive, another form of naloxone spray, over-the-counter.1,2 This monumental decision means you no longer need a prescription for this life-saving medication.

What is Narcan?

Narcan, a 4 mg naloxone hydrochloride nasal spray, is the go-to treatment for opioid overdoses. Its rapid action reverses the effects of an opioid overdose, making it a crucial tool in the fight against the current public health crisis.

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Why is Narcan OTC Important?

According to recent data, a staggering 101,750 fatal overdoses were reported in the U.S. within 12 months ending in October 2022.1 This move towards making Narcan OTC widely available can save thousands of lives by ensuring quicker access to the antidote in critical moments.

The FDA Commissioner, Dr. Robert M. Califf, highlighted the significance of this decision, stating, "[the] approval of OTC naloxone nasal spray will help improve access to naloxone, increase [its availability,...] and help reduce opioid overdose deaths throughout the country."1

RiVive: Another Key Player in Opioid Overdose Treatment

Following the U.S. Food and Drug Administration's (FDA) green light for over-the-counter Narcan, they approved a second option for over-the-counter naloxone, RiVive. RiVive is a 3 mg naloxone hydrochloride nasal spray available without a prescription. This move further expands consumer access to vital life-saving medication without a prescription.

Recent data paints a grim picture; in the 12 months leading up to February 2023, the U.S. witnessed over 105,000 reported fatal overdoses, with a significant number attributed to synthetic opioids like illicit fentanyl.2 This reality underpins the urgency of making treatments like Narcan and RiVive readily available.

How to Use Narcan

If you or someone you know is struggling with opioid overdose, Narcan and RiVive nasal sprays can help. These medications are designed to quickly reverse the effects of opioid overdose, allowing the person to breathe normally again. It's important to use them properly, so follow the instructions that come with the medication, and always consult your physician for customized medical advice. However, here’s a general guide from Narcan that can help.

  • Identify the signs: First, it’s crucial to recognize the symptoms of an opioid overdose, including shallow breathing, pinpoint pupils, blue lips and nails, unconsciousness, and a slow or absent pulse.

  • Administration: Lay the person on their back. Hold your thumb on the bottom of the nasal spray’s plunger and put your first and middle fingers on each side of the nozzle. Tilt the person's head back slightly and insert the nozzle into one nostril until your fingers touch the bottom of the nose. Press the plunger firmly to release the first dose.

  • Aftercare: Turn the person onto their side after giving them the medication. If they don't show signs of waking up, consider giving them another dose in the other nostril. It's key to watch them closely and stay with them until emergency medical help arrives.


It is important to immediately call 911 or seek emergency medical attention after the first dose, as these treatments are only temporary solutions, and the person may require further medical assistance.

To make sure you know how to use naloxone safely during emergencies, it is recommended to receive training on proper usage. Our doctors can provide you with more information on properly administering naloxone.

  1. 1

    Book on our free mobile app or website.

    Our doctors operate in all 50 states and same day appointments are available every 15 minutes.

  2. 2

    See a doctor, get treatment and a prescription at your local pharmacy.

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    Use your health insurance just like you normally would to see your doctor.

Where Can You Get Narcan Without a Prescription?

Now, Americans will find Narcan readily available at local drug stores, convenience stores, grocery stores, gas stations, and even online. You will still need a prescription for other forms of naloxone.

Initially approved in 2015 as a prescription drug, Narcan underwent rigorous evaluation by the FDA to ensure its safe and effective use as an over-the-counter medication. As with any drug, it's vital to understand its effects and how to administer it correctly. Opioid-dependent individuals who use Narcan may experience withdrawal symptoms.

Thus, while having Narcan over-the-counter is a blessing, awareness about its correct use is key. Book an appointment to learn more about the availability and use of Narcan over-the-counter.

This FDA decision is a monumental step forward in the battle against opioid overdoses. With easier access to Narcan, many more lives can be saved.

Read More About Narcan OTC:

Sources:

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  1. U.S. Food and Drug Administration (FDA). FDA Approves First Over-the-Counter Naloxone Nasal Spray. Accessed on September 21, 2023 at https://www.fda.gov/news-events/press-announcements/fda-approves-first-over-counter-naloxone-nasal-spray.

  2. U.S. Food and Drug Administration (FDA). FDA Approves Second Over-the-Counter Naloxone Nasal Spray Product. Accessed on September 21, 2023 at https://www.fda.gov/news-events/press-announcements/fda-approves-second-over-counter-naloxone-nasal-spray-product.

  3. NARCAN®. NARCAN® NASAL SPRAY - ANYONE CAN SAVE A LIFE. Accessed on September 21, 2023 at https://narcan.com/.

  4. California Department of Public Health (CDPH). Over-the-counter (OTC) Naloxone. Accessed on September 21, 2023 at https://www.cdph.ca.gov/Programs/CCDPHP/sapb/Pages/Over-the-Counter-(OTC)-Naloxone.aspx.

  5. RiVive. NOW APPROVED: Easy-to-use, over-the-counter RiVive (TM) (naloxone HCl nasal spray 3 mg) for the emergency treatment of opioid overdose. Accessed on September 21, 2023 at https://rivive.com/.

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