Siena Hapig-Ward: Narcan should be more accessible to those who need it

February 11, 2023. Winston-Salem Journal.

2022-23 NC Fellow Siena Hapig-Ward

Most of us, if given the chance, would save a life. Whether we donate blood, move a turtle off the road, perform CPR or volunteer at a soup kitchen, caring for our neighbors is at the core of our humanity. As a future emergency medicine physician, I will have undergone years of training to learn how to save lives — but not every scenario requires extensive training.

What if everyone could buy lifesaving medication — Naloxone (brand name Narcan) — over the counter at any pharmacy, thus, giving us yet another chance to save a life? It’s a nasal spray that could safely live in our purse or car, ready to use in the case of a medical emergency. Perhaps we also could provide a community education program that teaches how to safely administer this medication. This nasal spray, Narcan, is an opioid antagonist, meaning it reverses opioid overdose. Thus, Narcan saves lives.

The opioid epidemic afflicting Americans doesn’t discriminate — it attacks the rich and the poor, the blue collar and the white collar, and all ages, races and ideologies. According to the Centers for Disease Control and Prevention, from 2013 to 2019 the age-adjusted synthetic opioid death rate increased by 1,040%. In 2020, opioids were involved in 68,630 overdose deaths, which was 75% of all drug overdose deaths. While these numbers are staggering, there is good news: By making Narcan affordable and available to everyone, we can save lives.

As of January 2023, one doesn’t need a prescription to buy Narcan, but it is not available over the counter. In other words, it is not accessible to everyone and kept in a general area of the store. Currently, one can get Narcan from a pharmacist (“behind the counter”), so one must talk to a pharmacy staff member, physician, local health department, law enforcement agency or community organization. Essentially this means that anyone wanting Narcan must interact with another person, which immediately opens the door for judgment, embarrassment and possible harassment.

It’s important to note that Narcan is covered by most health insurance plans, so anyone with health insurance who is at risk of opioid overdose can obtain it from a trusted health care provider. It is also the responsibility of health care providers to identify their patients at risk of opioid overdose and counsel them (and their caregivers) on the importance of stocking Narcan and how to use it. Understanding the symptoms of opioid overdose — slow breathing, blue or cold skin, small pupils, and loss of consciousness or decreased alertness — and how to properly administer Narcan is how lives can be saved.

Both the American Pharmacists Association and American Medical Association support the approval of over-the-counter Narcan by the Food and Drug Administration (FDA). On Nov. 15, 2022, the FDA released a preliminary assessment that Narcan is safe and effective for nonprescription use. Despite this support, Narcan remains behind the counter, and difficult to obtain for those who need it most.

While many view Narcan and “illicit drug use” as synonymous, it is easy to forget that opioids are also used by our neighbors fighting aggressive cancers or chronic pain, by our aging grandparents whose bodies are slowly wearing down, and by those recovering from intensive medical interventions. It is a necessary medication for many people to prosper at their school or job, at home, and within society. However, ultimately, even if Narcan is synonymous with illicit drug use — the struggles each of our neighbors’ faces are unique and do not deserve judgment. What they do deserve is a fellow human to understand that, at some point in our lives, we are all in need of saving.

This is what Narcan can do — save lives. And each of us should be able to walk into our local neighborhood pharmacy and buy Narcan along with Tylenol, shampoo and gum. To find out more about Narcan, including where to obtain it and how to administer it, visit

Siena Hapig-Ward is a 2022-2023 N.C. Schweitzer Fellow at Wake Forest School of Medicine, Class of 2024.