Stores across Minnesota are selling Narcan over the counter. Here’s what to know

Naloxone, also known by the name brand Narcan, is a medication that rapidly reverses the effects of opioids and can save someone from a fatal overdose. Using naloxone is the standard treatment for opioid overdose and can be administered by anyone. It comes in two forms: nasal spray and injectable solution.

In March the Food and Drug Administration approved Narcan nasal spray for use without a prescription, and as of early September it can now be found on shelves and purchased over the counter across the country. Many states including Minnesota already had Narcan available without a prescription, but now it’ll be accessible beyond pharmacies and in places like grocery stores, convenience stores, gas stations and online.

An estimated 82,000 people in the nation died last year from overdoses involving opioids, including prescriptions (i.e. Vicodin, OxyContin, Percocet), heroin and synthetic opioids like fentanyl, according to the FDA.

In Minnesota, opioid-involved overdose deaths increased by 44 percent from 2020 to 2021, to an all-time high of 978 deaths in 2021, according to the state health department.

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Below are common questions about naloxone, how it works and where to find it.

Where can I purchase Narcan in Minnesota?

CVS, Walgreens, Walmart and Target all carry over-the-counter nasal Narcan spray in stores across the state and online. Costco, Hy Vee and Kroger are also selling it in stores. Many big-box retailers have store locators on their websites or apps where you can see if stores near you are carrying it. It’s worth checking before you go, as not all locations have it in stock.

These stores aren’t the only places you can purchase Narcan — now that it’s over the counter, it can be sold by any business that wants to sell it.

In 2014, Minnesota passed a law expanding access to Narcan, but this should make it even easier to get.

Where do I find Narcan in the store?

It depends on the store. Stores can display Narcan directly on the shelf in medication aisles (possibly near pain care), at pharmacy counters and by front registers. You might instead find a slip of paper that you bring to the pharmacist requesting Narcan. And some stores might still be keeping it “behind the counter,” which requires asking the pharmacist for it, even though you don’t need a prescription. Think about it as similar to buying Sudafed, which is also “behind the counter.”

You can also use the state’s naloxone finder by entering your zip code and seeing which places near you carry it.

How much does it cost?

Narcan spray’s suggested retail price is $44.99 for a pack with two doses, although businesses can charge more.

Is it covered by insurance?

Most major insurance providers at least partially cover nasal Narcan, but it’s not yet clear whether that will continue now that it’s available over the counter. Have a pharmacist check your individual insurance plan to see what’s covered.

Where can I get Narcan for free?

Minnesotans can find Narcan for free at any syringe exchange program. The health department keeps a directory of syringe service programs all around the state with locations and hours.

Because of the high cost of nasal Narcan, most programs are more likely to instead offer injectable Narcan, which is much cheaper but not available over the counter.

Southside Harm Reduction Services in Minneapolis has intramuscular Narcan kits that contain four doses opposed to the common nasal spray packaging of two. People can have multiple kits from Southside at no cost.

“Programs like ours don’t have the funding,” said Shannon Clancy, Southside’s education and overdose prevention lead. “We can purchase intramuscular Narcan in bulk 50 times more than we can with nasal spray.”

Sometimes syringe exchanges get donations of nasal Narcan to distribute, but it’s not a guarantee they’ll have it.

Should I get Narcan?

“Carrying Narcan is like knowing how to do CPR,” said Clancy. “You never know when you’re going to come across a medical emergency, and the more tools you have in your toolbelt the better.”

Many health care, government and social service institutions encourage particular groups of people to carry naloxone and keep it at home. That includes people who take opioids in any amount for any reason; people who use drugs like cocaine or methamphetamines that can be contaminated with fentanyl; and people who know or are around anyone in these categories, including people living or working in areas with high rates of opioid use.

It’s not always obvious when someone is using opioids. Sometimes people struggling with substance use hide it from their loved ones.

“With substance use being so stigmatized, you don’t always know when [overdose] is going to happen,” Clancy said. “So just having it is important. What we try to do at Southside is normalize [naloxone] as a necessary medicine to have on you.”

How can I learn how to use Narcan?

Hennepin County keeps a calendar of virtual and in-person naloxone trainings.

Clancy said that training videos can sometimes be “weird and clinical to watch,” but recommends this one from a pharmacy group in Seattle for learning how to use injectable naloxone, and this one from the American Medical Association for learning how to administer the Narcan nasal spray.

Is there a limit on how much Narcan you can purchase?

No, there is no limit on the amount of Narcan you can purchase or have.

Are there age restrictions to buy or carry Narcan?

There are no federal restrictions on who can purchase or carry non-prescription Narcan.

As of July, school districts and charter schools are required to have at least two doses of nasal naloxone on-site, to respond to “rising youth and adult opioid overdoses.”