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FDA approves over-the-counter Narcan. Here’s why CT doctors say that’s a good thing

NARCAN nasal spray is distributed upon request at the Greater Hartford Harm Reduction Coalition mobile RV site in Hartford on August 11, 2020.
Joe Amon
Connecticut Public
Narcan nasal spray is distributed upon request at the Greater Hartford Harm Reduction Coalition mobile RV site in Hartford on Aug. 11, 2020.

The Food and Drug Administration (FDA) on Wednesday approved selling Narcan, a leading naloxone product, without a prescription. The nasal spray rapidly reverses the effects of an opioid overdose and is well-tolerated, doctors say.

Connecticut was among the first states to expand access to naloxone by training pharmacists as prescribers.

But the FDA approval is effective in a way the state law wasn’t, said Dr. Kathryn Hawk, an associate professor at the Yale School of Medicine.

That’s because the majority of pharmacists in Connecticut did not obtain a license to be able to prescribe Narcan, Hawk said.

“My assumption is [that] it was really less than 5 to 10%,” she said. “I know there were one or two within the New Haven region that had it, so we could reliably refer patients to [them]. There was not wide uptake among pharmacists.”

One of the challenges in the state policy, Hawk said, is that it is centered on whether pharmacists take the training, whether they're available 24 hours a day and whether individuals who need naloxone know to ask for it when they walk in the door.

“At the end of the day, those pieces just did not all fall into place to really widely increase access to naloxone throughout the state of Connecticut,” she said.

Hawk said that she’s excited by the FDA’s approval and that it represents progress in increasing access to naloxone to help address overdoses.

“This is something that harm reduction organizations have been lobbying for decades,” she said.

Doctors are advising many people to purchase Narcan, including family members of people with substance use disorder, good Samaritan bystanders and even those who consume marijuana, which is increasingly laced with fentanyl.

“The main concern is still around maintaining access to people who would benefit from having access to naloxone, either as an individual or as a community member, or friend or family member,” Hawk said.

According to the Connecticut Department of Public Health, there were 102 drug overdose deaths in 2023 as of mid-February. Approximately 86.3% of these deaths involved fentanyl. The data is subject to change due to pending cases.

Dr. Christopher Moore, an ER physician at Yale New Haven Hospital, said his hospital is seeing more patients show up after consuming what they think is marijuana, not knowing it was laced with fentanyl.

Moore warned that while naloxone can be lifesaving, people who overdose are still at risk after receiving a dose.

“Naloxone can wear off faster than the opioids do,” he said. “So you can think you're out of the woods, but then somebody can essentially re-overdose.”

Moore advises calling 911 after administering Narcan.

Sujata Srinivasan is Connecticut Public Radio’s senior health reporter. Prior to that, she was a senior producer for Where We Live, a newsroom editor, and from 2010-2014, a business reporter for the station.
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