It was a glimmer of hope amid America’s raging opioid epidemic. Narcan, the nasal spray that may nearly instantaneously reverse a doubtlessly lethal opioid overdose, was going to be out there over-the-counter in shops, simple to seek out and simple to purchase.With the proliferation of fentanyl within the unlawful drug provide, overdose deaths within the U.S. had reached alarming charges and most efforts to cease the disaster have been failing. Narcan wanted to be extra readily accessible for anybody who would possibly want it to save lots of a pal or perhaps a stranger.In a long-awaited transfer, the Meals and Drug Administration cleared the antidote for over-the-counter use in March 2023, and in September the $45 two-dose packing containers have been shipped throughout the nation. Previous to that, Narcan, or naloxone nasal spray, was distributed without spending a dime at group well being facilities and was additionally out there through prescription.Has the rollout lived as much as the early pleasure?NBC Information visited 64 shops in 15 states and Washington, D.C., over three weeks in February on the lookout for over-the-counter Narcan, together with main chain drug shops, impartial pharmacies, supermarkets, big-box chains, comfort shops and fuel stations.Shops across the nation stocked the bright-pink Narcan packing containers in several places: on show on the pharmacy counter; within the ache medicine aisle; behind the pharmacy counter; or behind the entrance register. Some have been simple to identify and entry. Different occasions, a buyer must hunt or ask for assist.In a CVS Pharmacy in a Goal outdoors of Pittsburgh, Narcan was noticed in a locked case on a shelf marked “Covid assessments.”In a Walgreens in Atlanta, it was on the highest shelf in a theft-resistant field, obscured by a big steel pole within the aisle.At a Publix pharmacy in Chattanooga, Tennessee, a Narcan show sat on the pharmacy counter, nevertheless it was almost obscured by a placard warning mother and father to lock up their medicines and pamphlets promoting “Pet meds for much less.”Most main drugstores and big-box retailer pharmacies NBC Information visited carried Narcan, however not one of the comfort shops or fuel stations did.“There’s an actual inconsistent rollout,” mentioned Maya Doe-Simkins, the co-director of Treatment Alliance, a bunch that distributes naloxone, the generic model of Narcan, to harm-reduction teams throughout the nation.Dr. Maryam Jowza, a persistent ache professional on the UNC Faculty of Drugs in North Carolina, mentioned not promoting Narcan in fuel stations and comfort shops was “a missed alternative.”“If one should buy kratom at a fuel station, why not Narcan?” Jowza mentioned, referring to the unregulated natural complement usually used for ache aid.Jacob Abraham, a pharmacist at Mineral Springs Pharmacy in rural Mineral Springs, North Carolina, mentioned he made positive to inventory over-the-counter Narcan when it turned out there final fall.“Then it sat on the shelf for therefore lengthy, we needed to ship it again, as a result of I’ve cash sitting on the shelf,” Abraham mentioned. Ultimately, somebody did are available and ask for it. Now, he mentioned, “I hold one on the shelf simply in case.”Alicia Home, government director of Steve Rummler HOPE Community, a hurt discount group in Minnesota, acknowledged that the rollout has been bumpy and that “it’s in all probability going to take a while” for consciousness concerning the over-the-counter model to construct.The necessity for Narcan on handWhen an individual overdoses on an opioid, the drug slows down their respiratory and coronary heart price. The individual can fall unconscious, change into unresponsive and go limp. Their lips, gums or fingertips might tackle a blue tinge. It’s attainable to choke on vomit, or to cease respiratory completely.Narcan, when given quickly after an overdose begins, reverses these results quickly: The individual will often get up inside one to 3 minutes, in line with the FDA. As a result of the results of Narcan don’t final lengthy, it’s important to additionally name 911.Dr. Steven Maher, an emergency drugs doctor on the Mayo Clinic in Rochester, Minnesota, mentioned that velocity is vital with regards to administering Narcan.”You begin getting mind harm or mind accidents inside six minutes of not respiratory very effectively,” Maher mentioned. “So usually the earlier, the higher.”Due to that, he added, already having Narcan readily available is essential. “Naloxone works exceptionally effectively,” mentioned Dr. Scott Hadland, an dependancy specialist at Mass Normal for Youngsters in Boston, utilizing the generic identify for the drug. “It acts inside minutes to reverse an overdose and save a life.”However “we have to broaden entry, which implies having it in additional individuals’s arms,” Hadland mentioned.Learn moreTo make certain, Narcan is promoting.For the reason that launch of the over-the-counter model final fall, the drug could be bought at greater than 32,000 mass, drug, grocery and on-line retailers and e-commerce websites, Paul Williams, a senior vp at Emergent BioSolutions, the maker of Narcan, mentioned in an announcement. In 2023, the corporate distributed greater than 20 million doses of the antidote, each over-the-counter and prescription, within the U.S. and Canada, he mentioned.Within the fourth quarter of final 12 months, Emergent reported $111 million in Narcan gross sales, a 22% enhance from the 12 months prior. The rise was primarily pushed by gross sales of the over-the-counter model, the drugmaker mentioned.Dennis Cauchon, president of Hurt Discount Ohio, a nonprofit group that distributes Narcan without spending a dime, mentioned it’s nonetheless too early to gauge the influence the over-the-counter model is having on the opioid disaster.RecommendedHadland is aware of of at the very least one case the place a affected person used Narcan purchased over-the-counter to save lots of a pal.“Persons are recognizing it as one thing that everybody ought to take into account carrying with them,” he mentioned. “I feel it’s going to save lives.”Matt Blanchette, a spokesperson for CVS Well being, declined to share gross sales information for over-the-counter Narcan, however mentioned the shops have “ample provide” of the product, situated on the entrance retailer registers and close to the pharmacy.All CVS pharmacists, Blanchette added, are educated on how Narcan works and might present counseling to individuals earlier than they purchase it. Folks may purchase the product at CVS.com.Overcoming the stigmaFor a product like Narcan, anonymity is a part of entry.The stigma of strolling right into a brightly lit retailer and asking the pharmacist or one other worker for Narcan behind the counter often is the largest hurdle.Barrier to entry: Narcan in an Atlanta Walgreens was behind a big steel pole.J.J. McCorvey / NBC Information“They could ask all these invasive, detailed questions like, ‘What’s your identify? What do you do? How outdated are you?’” Home mentioned. “Placing it out entrance, not having it being prescribed, is simply taking down extra of these stigmas and obstacles.”A Walgreens spokesperson mentioned Narcan is positioned behind the entrance register to make sure it’s extremely seen to prospects. There are additionally pull playing cards on cabinets within the ache aid aisle. The corporate, the spokesperson added, is “regularly speaking with our subject groups to make sure a constant and correct placement of the product.”At 16 Walgreens places in 11 states plus Washington, D.C., NBC Information noticed it behind the pharmacy counter, on show by the pharmacy and on the shelf within the ache aid aisle, along with behind the entrance register.The price barrierNearly all shops visited by NBC Information priced over-the-counter Narcan at round $45, so much for many individuals who use opioids.As of late February, a handful of shops — together with 4 Publix places in Florida and one in Chattanooga, Tennessee — priced the product at $49.99. Two Walgreens places, one in Maryland and one in Florida, bought Narcan for $49.99.The Walgreens spokesperson mentioned the corporate was speaking with shops about persistently pricing the product at $44.99.Publix didn’t reply to a number of requests for remark.Unbiased pharmacies might promote the drug at an excellent increased worth, Cauchon mentioned.Hiding in plain sight? At a Publix pharmacy in Chattanooga, Tenn., a Narcan show sat on the pharmacy counter, nevertheless it was almost obscured by placards and pamphlets.Heather Holley / NBC NewsTo actually make a distinction, the two-dose packs have to be priced at round $5, he mentioned.“There are only a few studies of individuals getting into and shopping for” Narcan in Ohio, he mentioned.“In principle, it’s good. Looking back, we’ll be completely happy that this occurred as an occasion in historical past,” Doe-Simkins mentioned of Narcan’s arrival in shops. “Proper now, it’s distracting.”Hadland mentioned he expects the individuals who will purchase over-the-counter Narcan will likely be relations of people that use opioids.“I’ve particularly seen this amongst mother and father who more and more wish to hold Narcan at residence, nearly like a fireplace extinguisher in case of an emergency,” he mentioned.NBC Bay Space, NBC South Florida, NBC Connecticut and NBC associates KTAL (Shreveport, Louisiana), WBAL (Baltimore), WDTN (Dayton, Ohio), WFLA (Tampa, Florida), WIS (Columbia, South Carolina), WOWT (Omaha, Nebraska), WRAL (Raleigh, North Carolina) and WRCB (Chattanooga, Tennessee) contributed reporting.Sara G. Miller is the well being editor for NBC Information, Well being & Medical Unit. Berkeley Lovelace Jr. is a well being and medical reporter for NBC Information. He covers the Meals and Drug Administration, with a particular deal with Covid vaccines, prescription drug pricing and well being care. He beforehand lined the biotech and pharmaceutical business with CNBC.Alicia Victoria Lozano, Minyvonne Burke, Patrick Martin, Akshay Syal, M.D., Erika Edwards, John Torres, M.D. and J.J. McCorvey contributed.