Eagle County pharmacies begin offering Narcan over-the-counter

Narcan is a nasal spray that can be used to rapidly reverse opioid overdoses

After the FDA approved an over-the-counter Narcan, some Eagle County pharmacies have begun to sell the nasal spray, which can be administered to reverse opioid overdoses.
Emergent BioSolutions/Courtesy Photo

In March, the U.S. Food and Drug Administration approved Narcan — a nasal spray version of Naloxone used to rapidly reverse opioid overdoses — for over-the-counter, non-prescription purchases. And at the start of September, some local pharmacies began to sell the first shipments of this medication. 

Naloxone works to reverse opioid overdoses by blocking the effects of the opioids. When administered, it can quickly restore normal breathing to a person if their breathing has slowed or stopped due to an overdose. The FDA-approved version is sold in a pack that contains two, 4-milligram nasal sprays. Each spray is good for one use.

“Narcan is one of the most important tools to prevent overdose deaths. When coupled with other services to provide a more comprehensive approach, the combination of services can support the health of the individual, while also softening some of the community impacts,” said Heath Harmon, Eagle County’s director of public health.

“For example, this approach can reduce stigma, support testing for HIV or hepatitis C, offer peer support and connect people to other important services such as treatment or recovery resources. Research in harm reduction shows these to be successful strategies for reducing the risk of death and other drug-use-related diseases,” he added.

Many Eagle County pharmacies have already begun to sell the medication.

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The over-the-counter version became available about two weeks ago at Vail Health’s two pharmacy locations — Vail Health Hospital in Vail and the Shaw campus in Edwards — according to Sally Welsh, Vail Health’s director of public relations. The two-pack is available for approximately $55.

Marilee McInnis, representing Walmart’s corporate affairs, confirmed that the over-the-counter Narcan has been available at “virtually all stores” and online since the first week of September. It is also available at Walgreens in Avon, as well as at the City Market pharmacy locations in Vail, Eagle and Avon.

Increasing access, reducing stigma

Harmon says there are multiple benefits to Narcan now being more widely available for purchase without a prescription.

“Increasing access and availability of Narcan will save lives and is a key strategy in a comprehensive harm reduction approach to decreasing the community impact of opioid use,” Harmon said. “In rural communities, it can be difficult to access services and the resources are just not widely available. Having Narcan at local pharmacies will help improve access.”

The availability also serves another purpose in furthering the ongoing conversations, destigmatization and education around opioid use, fentanyl and overdoses.

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“Narcan’s availability at local pharmacies can help normalize access and increase community awareness. Both of which can help decrease stigma about accessing this life-saving medication, as well as seeking treatment or prevention services in the future,” Harmon said. “This is important now as more harm reduction services are planned to become available in the near future, but aren’t in place just yet.”

Prior to the over-the-counter Narcan becoming approved, Eagle County organizations and government entities have been working to increase community availability of Narcan. In addition to being carried by local law enforcement and first responders, many organizations have made efforts to improve access.  

Eagle County Paramedics started a program in 2021 to distribute Narcan to homes via its community paramedics program. High Rockies Harm Reduction, which was started in Carbondale, provides education, support services and harm reduction tools for free across mountain communities. 

Ahead of the 2022-23 school year, the Eagle County School District announced it would include the medication in its first aid kits at all of the district’s schools. In June of this year, Starting Hearts, an Avon-based nonprofit, announced that it had placed Narcan in publically accessible indoor AED cabinets in the county.

Starting Hearts and Eagle County Paramedics Services both have Narcan on hand for members of the public.

Having Narcan available in these ways, suggests “wide community acceptance of having Narcan available, which may indicate some reduction in stigma and improved awareness already,” Harmon said.

Narcan is one of the primary harm reduction efforts in the fight against the opioid epidemic.
Matt Rourke/AP File

A larger dialogue

Drug overdoses continue to persist as a public health issue across the country as well as locally. The FDA reported that there were more than 101,750 reported fatal overdoses occurring between October 2021 and October 2022 in the U.S. These were primarily driven by synthetic opioids like fentanyl, it added.

In Colorado, there were 1,799 deaths attributed to drug overdoses in 2022, according to data from the Colorado Department of Public Health and the Environment, a number that has only risen in recent years. Of these, 1,160 are attributed to an opioid and 920 to synthetic opioids mentioning fentanyl.

“Colorado typically sees higher substance use than the rest of the U.S. across the board. This has been and continues to be a significant challenge in Colorado and Eagle County, whether we are talking about opioid use or alcohol use,” Harmon said, adding that this is one reason mental and behavioral health are continuing to be prioritized in the county.

However, “overdose data is hard to come by currently,” Harmon said.

And while the local public health department is working with regional partners to create a regional dashboard to track them, current data is more often just “anecdotal or word of mouth,” he added.

With that, Harmon noted that “Eagle County has been averaging 3 to 4 overdose deaths involving opioids each year over the past half-decade,” often with “a combination of substances.”

Harm reduction — including education and access to Narcan and fentanyl test strips — has come into the national and statewide conversation as the prevalence of opioids, fentanyl and overdoses continue to rise. Advocates for harm reduction measures see it as a more viable option for reducing overdoses as it embraces education and risk mitigation.

In addition to growing local efforts in this realm, there is also an ongoing regional effort with Lake, Summit, Eagle, Garfield and Pitkin counties to “address the impacts of the opioid epidemic within our communities,” Harmon said.

This effort is funded by settlements from major opioid drug distributors, with municipalities receiving their first funds last fall. The regional effort is governed by a regional opioid abatement council and has identified its first three priorities, according to Harmon. These priorities are currently being worked on by the group.

This includes “developing an anti-stigma and education campaign; increasing access to harm reduction services, like Narcan, as well as safe syringe access, peer support, and drug testing supplies across the entire region; and developing a data dashboard to improve access to local and regional data that can better inform priorities and strategies for prevention in the future,” he added.

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