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Written by: Lucy Connery MPH

The U.S. Food and Drug Association (FDA) has approved Narcan’s 4mg naloxone hydrochloride nasal spray as an over-the-counter (OTC) medication! This will greatly improve overall access to live-saving naloxone and reduce the risk of opioid overdoses across the country.

Special thanks to the Washington Post for including MATTERS CMO Dr. Joshua Lynch in this important discussion.

The Science

When an individual takes opioids, the drug ‘attaches’ to opioid receptors in the brain. This elicits the human response to opioids, which can include decreased pain, slowed breathing, nausea/vomiting, and unconsciousness. When an individual overdoses, the flow of oxygen throughout the body slows down and puts the individual at an increased risk of injury or death.

Naloxone (commonly referred to as Narcan) is an opioid antagonist medication, meaning it reverses the effects that opioids have on the body. Narcan “knocks” the opioids off of the opioid receptor in the brain, which can help restore the flow of oxygen to the body.

There are different ways to administer naloxone: inhaled as a spray, injected as a “shot”, and through an intravenous (IV) injection. This legislation applies to the inhaled version of the medication.

Improving Access

Some states like New York have a standing order for naloxone at pharmacies, meaning individuals do not need a prescription to access Narcan, but this has not been consistent across state lines. This new FDA legislation will expand access access to naloxone across the entire United States by making the medication more readily available.

In the short-term, access to and cost of Narcan will vary; the FDA will  to work with Narcan manufacturers and regional stakeholders to add the medication to pharmacies across the U.S. Some states offer programs to reduce the cost of naloxone for individuals. For example, the New York State Naloxone Co-payment Assistance Program (N-CAP) will cover an individual’s co-pay for naloxone up to a $40 value.


Narcan is safe to use, simple to administer, and saves the lives of individuals at risk of an overdose. As time goes on, access to this life-saving medication will continue to improve.

The MATTERS Network now offers FREE Narcan Trainings for individuals and organizations across New York State – participants receive a free supply of Narcan upon completion of this training.

MATTERS will be introducing 15 harm reduction vending machines across New York State in 2023. These vending machines will be equipped with naloxone, fentanyl test strips, xylazine test strips, and clean syringes – at no-cost to individuals!

Keep an eye out for the expansion of our Harm Reduction Vending Machine Program this year – for questions or concerns, call 765-MATTERS.