Naloxone

Naloxone is a medication that can reverse an overdose that is caused by an opioid drug (i.e., prescription pain medication, heroin, or illicit fentanyl). When administered during an overdose, naloxone blocks the effects of opioids on the brain and restores breathing within 2 to 3 minutes. Naloxone has been used safely by medical professionals for more than 40 years and has only one function: to reverse the effects of opioids on the brain and respiratory system in order to prevent death. As of August 1, 2023, the Food and Drug Administration (FDA) has approved three naloxone products for over the counter (OTC) use. As of September 2023, naloxone is now available over the counter. Products approved by the FDA for sale over the counter include:

Narcan™ 4mg naloxone nasal spray, manufactured by Emergent BioSolutions
Generic naloxone 4mg nasal sprays equivalent to the branded Narcan® spray, manufactured by multiple pharmaceutical companies
RiVive™ 3mg naloxone nasal spray, manufactured by Harm Reduction Therapeutics

Availability of these products may vary by store.

Naloxone Frequently Asked Questions

Pharmacies: Pennsylvanians can now purchase some naloxone products over the counter (OTC). OTC naloxone can be sold anywhere other common medications like ibuprofen are available, such as grocery stores, convenience stores, or gas stations. If you cannot find naloxone on the shelves of your pharmacy, speak with your pharmacist.

Prescription naloxone can also be purchased at a pharmacy by using the standing order(opens in a new tab).

Individuals at risk of an opioid overdose and their family and friends are encouraged to purchase and carry naloxone. Although the medication may not be available for same day pick up, it can often be ordered and available within a day or two. Check with your insurance provider for more information about naloxone coverage.

Some pharmacies will also sell naloxone online. Please visit their websites or speak with a pharmacist if you are interested in this option.

Commercial Insurance: Insurance companies vary in their coverage of naloxone. Check with your insurance provider to find out whether naloxone is a covered benefit under your policy, what forms of naloxone are covered, and any cost-sharing amounts that may apply. Your Health Savings Account (HSA) or Flexible Savings Account (FSA) may also be used to purchase naloxone.

Medical Assistance: The Medical Assistance Fee-for-service program and managed care organizations will pay for naloxone for Medical Assistance beneficiaries only. Pharmacists can treat the standing order as a verbal order for Medical Assistance beneficiaries to comply with the requirements of 55 Pa Code, Chapter 1121 – Pharmaceutical Services - §1121.52. Prior authorization is not required. There is no limit to how many times naloxone can be purchased through Medical Assistance.

Community-Based Organizations: Some community-based organizations (CBO) will provide naloxone to the public free of cost through the Pennsylvania Overdose Prevention Program.

Co-Pay Assistance: Pennsylvania residents who purchase naloxone may be eligible to receive reimbursement for out-of-pocket costs for naloxone through the Pennsylvania Department of Aging's Copay Assistance Program.

Mail-to-Home Naloxone Program (Individuals): Since 2020, PCCD and DDAP have provided Narcan® to support a statewide mail-to-home naloxone program for individuals to request medication for personal use through a partnership with Prevention Point Pittsburgh and NEXT Distro. More information about the program, including how to request a no-cost kit, is available here. If you have questions or would like more information about this program, please contact Prevention Point Pittsburgh’s Alfred DiRosa at alfred@pppgh.org.

Two of the most common ways that naloxone is administered are intra-nasal and intra-muscular. However, not all pharmacies stock both forms and insurance coverage may vary depending on the type of medication being purchased and each individual insurance plan. Check your insurance prescription formulary or call your benefits manager to determine if the medication is covered by your particular plan or if your purchase of the medication will be an out-of-pocket cost.

For more information about the different types of naloxone, view the naloxone product fact sheet(opens in a new tab).

In addition to talking to your healthcare provider or the pharmacist about how to use naloxone, individuals giving this medication to someone should take the online training ahead of time. Training is available at the Department of Health's website TRAIN PA. While it is not necessary to obtain a training certificate to purchase naloxone, learning these important details will help you respond properly in the event of an overdose. For more information, view the following resources: How to Use Naloxone Flyer, How to Use Injection Naloxone Flyer, How to Use Injection Naloxone Infographic

If you see someone overdosing, call 911 immediately, and then administer naloxone. If the person overdosing does not respond within 2 to 3 minutes after administering a dose of naloxone, administer a second dose of naloxone. Lay the person on their side to prevent choking and stay with them until emergency workers arrive.

Pennsylvania's naloxone standing order is a prescription written for the general public issued by Pennsylvania's Acting Secretary of Health. It can be used for prescription naloxone products, or depending on your insurance policy, may be used for insurance coverage of over-the-counter naloxone products. It is kept on file at many pharmacies or may be downloaded here.

Community-based organizations can use the standing order to purchase naloxone to provide to people at risk of overdose, and their family and friends.

First responders can use a standing order specific to them when leaving behind naloxone kits after providing EMS services.

Drug and alcohol treatment is available. You can find out more by calling the county drug and alcohol office where you live. For more information or to get the contact information for your local office, visit the Get Help Now website(opens in a new tab) , the Treatment Atlas website(opens in a new tab) or call 1-800-662-HELP (4357).