Where you can still get Narcan for free (instead of over-the-counter for $44.99)

By Virginia K. Smith

For something health experts want every person to have, Narcan can be surprisingly hard to get your hands on. Or in some cases, surprisingly hard to keep your hands on.

As the opioid overdose crisis continues to spiral across the U.S., naloxone — an easy-to-use overdose reversal medication more commonly known by its brand name, Narcan — has become one of the key tools in the fight against overdose deaths. Public health officials now encourage all citizens to carry the medication as a matter of course, whether you personally use drugs or not. Having lost enough friends to overdoses already, I took a virtual training in winter 2021 and have made a habit of tossing Narcan in my bag ever since.

Not everyone has gotten the message, however. To wit: last April on my way into an event at Schimanski, a Williamsburg mega-club favored by Mayor Eric Adams, a pair of confused but zealous security guards confiscated the Health Department-issued emergency overdose kit from my purse on the way in. (Trying to tell them, “This is the opposite of drugs!” got me exactly nowhere.)

At that point, the general guidance was that Narcan was available for free at city pharmacies, but when I went to my neighborhood Rite Aid to re-stock, I had to wait half an hour, hand over my insurance information, explain why I wanted it (I got a bewildered, skeptical stare when I said, “Isn’t everyone supposed to carry it at this point?”) and check “yes” or “no” on a digital questionnaire about counseling. At my next appointment with my primary care doctor, I discovered that the pharmacy had somehow entered naloxone into my chart’s roster of “regularly taken medications.”

Not exactly a smooth or de-stigmatizing process for getting your hands on emergency overdose meds.

“I don’t think it’s as common a misconception anymore but it would be great to put out there that it’s totally legal to carry and distribute Narcan,” said Dan Knitzer, assistant director of communications at Alliance for Positive Change, an organization with community centers in all five boroughs, including the Lower East Side Harm Reduction Center.

“CDC best practices are to flood the streets with Narcan," he said. "Everyone and anyone should have it.”

To that end, the Department of Health and Mental Hygiene issued a new advisory this week citing the grim statistic that 3,026 overdose deaths were recorded in New York City in 2022, a 12% increase from 2021 and the highest number on record. Health Commissioner Dr. Ashwin Vasan said in a statement, “This crisis is killing a New Yorker every three hours and is impacting every individual and family in our city and in our nation. No one is spared, even if you think otherwise.”

The health department’s top recommendation? “First, everyone should carry naloxone, get trained to use it and to recognize the signs of overdose,” per the advisory.

Earlier this month, the opioid overdose reversal medication became available over-the-counter, meaning you can pick it up at the drugstore or pharmacy without a prescription — and without a conversation with the pharmacist. That ease of access comes with a high price tag, however; two-dose boxes are generally retailing for $44.99.

“The majority of people that we serve would probably not be able to afford Narcan at that over-the-counter price,” Knitzer told The Groove. “They’ve come to us [when they need] more. If anything, we’ve distributed more Narcan in the past few months.”

We’re all for opening up every avenue for people to get their hands on life-saving medication, but we’re also all for people being able to get these things for free. Luckily, there are still plenty of options for that too.

Where to get it, and what else to know

A Health Department spokesperson told The Groove via email that Naloxone is available through trainings and Public Health Vending Machines, and “can also be accessed for free (along with fentanyl test strips) at an Opioid Overdose Prevention program." More specifically:

• A full list of Opioid Overdose Prevention Programs in all five boroughs is available here, including contact information and what kind of medications, supplies and trainings are available.
• The city also offers virtual naloxone trainings and will mail participants an Overdose Response Kit following the training. Upcoming dates can be found online here, and questions can be directed to naloxone@health.nyc.gov.
• Certain participating pharmacies (full list here) still offer free supplies if you go to the pharmacy and request an “Emergency Overdose Rescue Kit.”
• That aforementioned Public Health Vending Machine program offers supplies including Naloxone, Fentanyl test strips, and safer sex kits cost-free; information and location data can be found here. The program is very much in its early stages, though, and as of press time there’s only one PHVM up and running, at 1676 Broadway in Brooklyn, with “additional machine locations to come.”
  

There’s also a fairly robust online ecosystem of organizations offering free naloxone trainings and kits (Next Distro has a database for New York City as well as a broader one for New York State).

And while it’s not an option for re-stocking your own personal supplies, in case of an immediate emergency, a growing number of bars and restaurants keep Narcan on hand along with other standard medical supplies. (In some cases bars themselves are becoming community harm reduction training hubs as well; just this week C’Mon Everybody in Bed-Stuy hosted its first ever “Harm Reduction Happy Hour” in conjunction with the Brooklyn Harm Reduction Outreach Cooperative, which did not immediately respond to a request for comment.)

Many organizations that distribute Narcan also offer fentanyl testing strips as well as testing strips for xylazine, a highly dangerous animal tranquilizer often referred to as "tranq" that’s more recently been making its way into the drug supply.

“People are definitely wary of xylazine’s presence, and that’s leading more people to invest in harm reduction,” Knitzer said. “People who use drugs and people who don’t are coming to us for xylazine test kits, fentanyl test kits, and while they’re at it, Narcan.”

One crucial thing to note: “Narcan doesn’t work on xylazine overdoses,” Knitzer said. “[But] even though Narcan does not respond to xylazine (that we know of), it should be administered in all overdoses, because — with an unregulated drug supply — it’s impossible to know in the moment if the cause of the overdose is xylazine, fentanyl, another, non-fentanyl opioid, or a mix."

In lieu of a Narcan equivalent for xylazine, organizers are distributing test strips, Knitzer said, as well as offering other emergency training.

“We’ve taught people to do rescue breathing,” he said. “And we’ve heard from our program participants that it’s saved people’s lives. At agencies like ours we encourage everyone — active drug users, friends of active drug users and just the general population — to come get trained.”