States offering naloxone without a prescription

Naloxone the Silver Lining for Opiate Abuse

While there aren’t many silver linings to the dark cloud of opiate abuse, one of them is a drug called naloxone. Categorized as an “opiate antagonist,” naloxone acts to quickly reverse the effects of an opiate overdose by blocking the chemicals in heroin or prescription painkillers from binding to receptors in the brain. Doctors, pharmacists, and public health officials hope that distributing naloxone directly to opiate users and their friends and family will help curb the epidemic of overdose deaths sweeping the country.

Since naloxone is a prescription drug, there are thorny legal issues to expanding access to people without a prescription. Currently, there is a patchwork blanket of access laws that differ state-to-state. Further, the legislative landscape is rapidly changing. According to the National Association of State Alcohol and Drug Abuse Directors, only six states had laws allowing distribution of naloxone without a prescription in 2013—this shot up to 28 states by 2015.

In order to obtain naloxone without a prescription, your state must have what’s called a standing order law, which permits a doctor to write a prescription that allows a third party to distribute naloxone to individuals who do not have a prescription themselves. These third-party providers can include first responders, community health groups, and critically, pharmacies.

33 States Currently Have Standing Order Prescriptions

In order for this to happen, however, your local pharmacy has to apply for and obtain a standing order; not all pharmacies in states that have standing order laws actually participate. According to data compiled by Corey Davis at LawAtlas, 33 states have laws on the books permitting standing order prescriptions. On the participation side, retail pharmacy giants Walgreens and CVS participate in a large number (but not all) of these states. To further complicate things, Walgreens and CVS have hammered out arrangements with state licensing boards even in some states without formal standing-order laws to enable them to distribute naloxone without a prescription in those states. These, too, are rapidly changing; CVS and Walgreens announced expansions of their naloxone programs in February and March of this year, respectively.

This leaves the landscape a bit murky. On paper, only eight states have no standing order law and do not have naloxone available at CVS or Walgreens: Alaska, Arizona, Florida, Iowa, Hawaii, Kansas, Michigan, and Missouri. Five states have standing order laws but have yet to garner participation from national pharmacy chains—Delaware, Georgia, Nevada, South Carolina, and West Virginia. In these states, smaller pharmacies or community health organizations might have secured standing order prescriptions, but the large national chains have yet to roll out a program. If you live in one of these states, check with your doctor or local health group for more information. For all other states in the country (plus the District of Columbia), naloxone is available without a prescription at CVS, Walgreens, or both.

Seriously Consider Naloxone for Yourself or a Loved One

If you or someone you care about is suffering from prescription painkiller or heroin addiction, you should seriously consider obtaining naloxone from your local pharmacy if it’s available. If it’s not, talk to a healthcare professional about other options; some states have laws allowing a doctor to write prescriptions for friends or family members of an opiate user. Naloxone is non-addictive, safe to use, and comes with educational material on how and when to administer it. It might not be pleasant to think about the consequences of an overdose, but that’s not an excuse to be unprepared.