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Moving Naloxone Over the Counter Is Necessary but Not Sufficient

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ANNALS OF INTERNAL MEDICINE
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AMER COLL PHYSICIANS
DOI: 10.7326/M23-0852

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Naloxone plays a crucial role in preventing death from opioid overdose, but its accessibility remains limited. The recent approval of an over-the-counter formulation of naloxone provides an important opportunity to increase distribution, but careful steps must be taken to ensure it doesn't hinder overall access. This includes ensuring a sustainable supply at affordable prices, prioritizing comprehensive distribution methods, and investing in harm-reduction strategies such as supervised consumption spaces.
Naloxone is an opioid antagonist that is available in numerous formulations and can be easily administered to avert death from opioid overdose. Amid a historic overdose crisis in the United States, naloxone has a crucial role in stemming the loss of life. However, it remains largely inaccessible to the public. Recently, the U.S. Food and Drug Administration announced the approval of the first over-the-counter formulation of naloxone. Although this historic change provides an important opportunity to increase distribution of naloxone, we must take careful steps during this transition so that it does not paradoxically threaten overall access to this life-saving medication. Specifically, we must ensure that a larger supply of naloxone will meet the newly increased demand at a sustainable price for consumers who are most in need. We must also continue to prioritize comprehensive methods of distribution, such as overdose education and naloxone distribution programs, that serve as important tools to reach the most vulnerable populations. In addition, simultaneous investment in harm-reduction strategies, such as supervised consumption spaces, is critical to ensure that naloxone is available in settings where its life-saving potential can be most fully realized.

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