Facts to Know: FDA-Approved Narcan Nasal Spray Over the Counter

Posted on April 5, 2023 by myMatrixx

By Phil Walls, R.PH, myMatrixx Chief Clinical Officer

The Food and Drug Administration (FDA) has made significant strides to make Narcan, a name brand nasal spray version of the generic drug naloxone, available over the counter (OTC) on a national level. Due to the ongoing dangers posed by opioids in workers’ compensation, wider availability of Narcan is a welcome step with a high potential to save lives.

Our goal at myMatrixx is to educate claims professionals about Narcan, provide helpful, accurate information on this important drug and explain what this means for the workers' compensation industry.

What is Narcan?

Narcan is a brand name for naloxone, a medication used to reverse the effects of an opioid overdose. It comes in two forms: an injection or a nasal spray. When someone is experiencing an opioid overdose, Narcan can quickly restore their normal breathing and potentially save their life. It's considered safe and effective by the FDA and has been instrumental in combating the opioid epidemic.

The Opioid Crisis Lingers On

Despite significant gains in overcoming opioid misuse in both workers’ compensation and general prescribing, the opioid crisis remains a major health and safety concern. In 2022 alone, 110,236 drug overdose deaths occurred in the general population, although the overwhelming majority were related to illicit, not prescription use. And while the CDC reports opioid prescriptions in workers’ compensation being cut nearly in half between 2012 and 2022, opioids are still a safety issue for injured workers.

Opioids and related dangerous drugs that constitute the biggest dangers to injured workers include:

  • Fentanyl is 50 to 100 times more potent than morphine and used for severe chronic pain. The synthetic analogues of fentanyl (acetylfentanyl, carfentanil, etc.) raises concern for illicit use and a growing contribution to drug overdoses.
  • Prescription opioids are generally recommended for short-term pain relief, but when used long-term it increases a patient’s risk of tolerance and addiction.
  • Prescription opioids used in combination with other potentially dangerous substances such as gabapentinoids and benzodiazepines increases the risk of overdose.

FDA Approves Narcan for OTC Purchases

In addition to new CDC opioid prescribing guidelines to help guide physicians in making safer prescription decisions for patients, the federal government has begun taking steps to increase access to opioid antidotes such as naloxone. In February, a committee of advisors voted unanimously to recommend making Narcan nationally available after reviewing a briefing document submitted by Emergent, the manufacturer of the drug. On March 29, 2023, the FDA formally approved Narcan to be sold over the counter for widespread purchase.

States have their own laws regarding Narcan and naloxone, with many making it available OTC in some form, but this is an opportunity to streamline the process and reduce barriers to access due to the relative safety and lack of side effects for the drug. In workers’ compensation, claims professionals may continue to see Narcan prescriptions as part of a workers’ compensation claim now being available OTC.

What to Know About Narcan OTC Availability

Narcan has been found to be generally safe, with no effect in the absence of opioids and no side effects. OTC Narcan is designed to be administered quickly and with no previous medical training. The health care and pharmacy community should be prepared to provide education and direction on responding to an opioid overdose and administering Narcan:

  • Check for signs of an opioid overdose, including unresponsiveness, slow or absent breathing, and pinpoint pupils
  • To administer Narcan, position individual on back, insert tip of spray bottle into either nostril and press plunger
  • After administering Narcan, call 911 immediately
  • Use caution: Individuals coming out of an opioid overdose following a Narcan dosage are immediately thrown into withdrawal and may be combative. Many people providing assistance have been injured by the person they are helping
  • Narcan only works for an opioid overdose and is ineffective in any other overdose situation

myMatrixx’s Commitment to Getting Injured Workers Safely Back to Work and their Lives

There is a very high correlation between mental and behavioral health disorders, chronic pain, and substance misuse problems. Addressing this high comorbidity requires a comprehensive behavioral care approach to ensure that at-risk patients dealing with one or both issues receive the care they require.

As part of the Evernorth family, we at myMatrixx are committed to ensuring injured workers receive the support they need to get back to fulfilling and productive activity. Our goal is to provide clinical value, innovative technology and actionable data analytics — all squarely focused on workers’ compensation patient advocacy.

Ask your myMatrixx pharmacist if you have any questions regarding the change to OTC status for Narcan. You can also reach the myMatrixx clinical team at clinical@myMatrixx.com.