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A major drug maker has applied to sell Narcan over the counter


There's a breakthrough in the fight to bring down the soaring number of drug deaths in the U.S. For the first time, a pharmaceutical company plans to sell a nasal spray over the counter that quickly reverses opioid overdoses. Some drug policy experts say it could save tens of thousands of lives. NPR's addiction correspondent Brian Mann reports.

BRIAN MANN, BYLINE: Here's what typically happens when a person is caught up in opioid addiction, whether it's pain pills, fentanyl or heroin. That's the drug used by China Darrington for 16 years.

CHINA DARRINGTON: When you overdose on heroin, you just kind of drift off. We call it going on the nod.

MANN: Overdoses are common, especially now with more powerful opioids like fentanyl on the street. During a severe opioid overdose, people stop breathing and die. Darrington was lucky. One medication saved her life.

DARRINGTON: If it wasn't for Narcan - and, again, I've experience being Narcaned (ph), I want to say, about a half a dozen times in my life that kept me alive long enough. You've got to give people a chance to stay alive.

MANN: Narcan, which is one name brand for the drug naloxone, quickly reverses the harmful effects of opioids. It works fast. It's easy to use. People start breathing again. But right now naloxone is often really hard to get. Dr. Rahul Gupta, head of the White House Office of National Drug Control Policy, points out that last year alone, 80,000 Americans died from opioid overdoses. With naloxone, many of those deaths would have been avoided.

RAHUL GUPTA: There is today no excuse absolutely for not having it everywhere available when we know that that's one medication that can save tens of thousands of lives right now.

MANN: Access to Narcan and other forms of naloxone is complicated by a dizzying patchwork of federal and state laws. Now a drug company called Emergent BioSolutions is seeking regulatory approval to sell Narcan over the counter, making it available without all the muddle, without even needing a prescription.

BOB KRAMER: We see this as a significant step forward for Narcan and naloxone products.

MANN: Bob Kramer is the company's CEO. He says the Food and Drug Administration has agreed to fast-track its review with an answer expected by the end of March. Kramer says the goal is to have Narcan so widely available that it's everywhere, ready in people's purses, in school classrooms, in shops and businesses whenever someone overdoses.

KRAMER: It's very easy to administer. You place the device in the nostril, and you deploy it with a puff.

MANN: Drug policy experts contacted by NPR agree making Narcan widely available is an important next step to reduce drug deaths. But they also raised one fear.

NABARUN DASGUPTA: I am very concerned about the price.

MANN: Nabarun Dasgupta is a drug researcher at the University of North Carolina. Emergent BioSolutions hasn't yet set a price for the nonprescription version of Narcan. Dasgupta says if it's too expensive, many people using drugs on the street just won't buy it.

DASGUPTA: If we have this resource scarcity mentality that this is an expensive product, this is a special product, then people will not take enough kits to do what they need to do.

MANN: In much of the country, governments, insurance companies and nonprofit groups subsidize naloxone distribution. It's not yet clear how that system will affect price once this drug is on pharmacy shelves. China Darrington, who's been in recovery from heroin for more than a decade, points out opioid use is far deadlier now because of fentanyl. She believes if naloxone is more widely available and affordable, it will save a lot of lives.

DARRINGTON: I think it's a wonderful thing. The potency of the drugs nowadays is just - it's so unfair. So naloxone has got to be around. People have got to have access to it.

MANN: The FDA has signaled it plans to approve over-the-counter naloxone sales and is urging other companies to apply for approval to sell their versions of the drug without a prescription.

Brian Mann, NPR News. Transcript provided by NPR, Copyright NPR.

Brian Mann
Brian Mann is NPR's first national addiction correspondent. He also covers breaking news in the U.S. and around the world.