FDA Clears Narcan nasal spray for Over-the-Counter Use to Reverse Opioid Overdoses.

Lives will be saved, thanks to a new policy just announced.

The US Food and Drug Administration announced that for the first time it will permit a nasal spray that immediately treats opioid overdoses to be sold without a prescription. The treatment (nasal naloxone, brand name Narcan) is powerful enough to reverse almost any opioid overdose, if given in time.

This is important news and I applaud the FDA for this move. The new policy will save lives. Medicine only works when people have access to it. This change will make the treatment easier to access.

Narcan (or something like it) should be in every place where people gather, just like fire extinguishers are. Nasal naloxone should be packaged with every automated defibrillator device. It should be in public restrooms. It should be on all airline medical kits. It should be in the pocket of every first responder, be it police, fire, or EMS. Citizens should have it in their purses and backpacks.

Narcan should be everywhere—so much a part of the fabric of life that we can actually ignore its presence, any yet easily find it in a moment of need.

Narcan is safe, easy to administer, and easy to know when to use. If you find a person who is not breathing, just assume that they have had an opioid overdose. Put the device up a nostril and squirt. The effect is just about instantaneous.

Everyday people carrying Narcan can save lives and at no risk to themselves. The idea that one can overdose just by touching someone who has overdosed on fentanyl (or touching or just breathing near the substance itself) is a deadly myth. The only risk that someone giving Narcan might encounter is that the spray works so well that it can cause opioid withdrawal, which can make some patients agitated. (It does not cause symptoms in people who are given the spray even though they did not take an opioid; the withdrawal comes from the effects of the opioid being displaced off of the receptors.) But patients who have been given Narcan rarely do anything other than yawn a lot and thank the person who just saved their life. You want to be that person.

I once got into a public disagreement about Narcan with some economists who had concluded (based on shoddy methods, at best) that the availability of this antidote did not save lives—but merely delayed deaths. These economists also clutched pearls over the notion of “moral hazards”—that is, with decreased consequences comes increased risk taking.

My general response (in Slate) to this was straightforward. First, delaying deaths is the entire premise of medicine! We don’t aim to make people immortal. We aim to make them mortal for longer. Second, having personally treated more than zero opioid patients (i.e., the scorecard for those economists), I can assure you that none of my accidental overdose patients thought they were anywhere close to dying from an overdose that day. Either their use had increased in ways that they had not realized (or acknowledged), or the composition of the drug they used was stronger than they thought.

The idea is to keep patients alive long enough to get treatment. As my friend and Harvard colleague Dr. Alister Martin said in that Slate piece, “We can’t give patients opportunities to access other evidence-based opioid therapies if they’re already dead.”

By allowing Narcan to be available without a prescription, the FDA is making it easier for Good Samaritans to save lives, starting now.