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FDA approves the overdose-reversing drug Narcan for over-the-counter sales


Drug overdoses continue to be one of the leading causes of accidental deaths in the U.S. But yesterday's FDA approval of the nasal spray Narcan, an overdose-reversing drug, could change that. So far, Narcan nasal spray has been available as a prescription drug, but soon Americans will be able to access it in convenience stores, vending machines or even online. Dr. Scott Hadland is a pediatrician and addiction specialist at Mass General Hospital for Children and Harvard Medical School in Boston. At the FDA panel last month, he testified as an independent expert in favor of the approval. Doctor, you work with children and teens. Why did you support this?

SCOTT HADLAND: Well, it's a really - an easy decision. We're at a point right now in this overdose crisis where since the turn of the century, we've had more than a million overdose deaths and where these are increasing. We're now at a point where more than 100,000 people die every year. Narcan is a medication that is safe. It's effective. It has virtually no downside to administering it. And there really is no reason that it shouldn't be widely available to save the lives of the so many people who die each year.

MARTÍNEZ: So if someone takes Narcan just by itself, it's fine.

HADLAND: That's right. It's a medication with basically no adverse effects. And so it's very safe to administer.

MARTÍNEZ: So then explain to us how the drug works on someone who has overdosed.

HADLAND: What happens when somebody overdoses is that opioids - and in this day and age, it's most commonly fentanyl that's getting into people's systems - opioids bind to receptors in the body and make it so that a person stops breathing, and that's what ultimately ends up killing a person. And so what Narcan is doing is it's getting in and it's releasing the fentanyl or other opioids from those receptors and essentially in just seconds or even just minutes reversing that overdose and saving a person's life. And since Narcan is a medication that's sprayed up the nose, it's very easy to administer. Almost anybody can do it with very little training needed.

MARTÍNEZ: So now that the FDA approval has happened, how worried are you that costs may prevent access to many who need it?

HADLAND: This is really the central worry right now, is that, you know, a key step - and we celebrate this step, that the FDA has made this medication now widely available. We're anticipating that starting in probably the summer, Narcan will be available all across the United States. So this is huge. Unfortunately, many of us are still worried about the cost of this medication. It's one thing to make it available. It's another thing to make it affordable to people. And as somebody who works with families that have been affected by this overdose crisis every day, I know that if the price is too high, many families and patients just simply won't buy it.

MARTÍNEZ: Yeah, according to GoodRx, 130 bucks for an average price of a two-dose box. I know if you make something more expensive, it makes it harder to get, and also people might want to do something terrible to try and get it.

HADLAND: That's right. And, you know, I've seen some of my patients who, when I prescribe them medication and they have to pay a co-pay, even if their insurance requires a co-pay for Narcan that's 20 or $30, some of my patients and families will just say, hey, that's too expensive for me. That's not something I can afford right now, and then they won't have it when they need it.

MARTÍNEZ: There's a lot of stigma, doctor, attached to drug users. I'm sure you know that. When you testified for the FDA, you talked about the need to change public perception. How do you think that can happen?

HADLAND: Well, I think that making Narcan available reflects the fact that almost everybody in this country at this point is aware of the overdose crisis. Many of us have family or friends or in my case patients who, you know, have been personally affected by this crisis. We've lost loved ones. Even when we haven't lost loved ones, we've watched as people have struggled with addiction, and we've worried about them. And so what this FDA approval does is it makes the availability of Narcan all over the country normalized. It tells us all that this is something that we should all have with us, that we should make available in our communities and that we should use to save the lives of people who might use drugs.

MARTÍNEZ: Doctor, what would you say to someone who says that if Narcan is easier to get, that no one will fear the danger of an overdose?

HADLAND: This is an unfortunately common argument, and I refute it. If - you know, there are many examples in public health of situations like this where people worry that if we make a safety measure available, it will make people behave in a different way. So, for example, in the 1980s when we talked about making seatbelts mandatory for people when they're driving, people made the argument that maybe that would drive people to be more reckless when they drive their cars, and that just hasn't been borne out. And in countless public health examples, this isn't what happens. And so I have personally watched as people use Narcan to keep themselves safe and not in a way that results in them using more drugs.

MARTÍNEZ: Dr. Scott Hadland is a pediatrician and addiction specialist at Mass General Hospital for Children and Harvard Medical School in Boston. Doctor, thanks.

HADLAND: Thanks for having me. Transcript provided by NPR, Copyright NPR.