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“Over the Counter” Naloxone Access

posted on Wed, Oct 11 2017 2:11 pm by Network for Public Health Law

In an attempt to reverse the unprecedented increase in preventable overdose deaths, all fifty states and the District of Columbia have now modified their laws to increase access to naloxone, a drug that is administered to people in order to reverse the effects of an overdose of heroin or other opioid painkillers. Although naloxone is a prescription drug, it is not a controlled substance and has no abuse potential. It is regularly utilized by medical first responders and can be administered by ordinary citizens with little or no formal training.

The Network was recently asked about the number of states in which naloxone can be purchased “over the counter”. 

Every state has made naloxone more available, but it's not available “over the counter” anywhere, although there are those who are advocating for the F.D.A. to make naloxone available without a prescription. While the federal government has the exclusive authority to determine whether a drug requires a prescription, states have the power to determine who can issue prescriptions, the form those prescriptions must take, and who can dispense prescription medications.

In roughly 46 states it's legally possible for a person to buy naloxone in a pharmacy without first seeing a doctor or other prescriber via prescription protocols like standing orders, which allow naloxone to be dispensed to any person who meets criteria specified by the prescriber without the prescriber and the patient ever meeting. In a few states there are additional barriers (such as a required training), however because states have enacted various prescribing protocols in order to increase access to naloxone, in most states a person can walk in and request it.

This blog post on the Network’s website explains the importance of this legal distinction and this Network resource provides more information on naloxone laws across the U.S.


Network attorneys are available to answer questions on this and other public health topics at no cost to you, and can assist you in using law to advance your public health initiatives. Contact a Network Attorney in your area for more information.

The legal information and assistance provided in this document does not constitute legal advice or legal representation. For legal advice, readers should consult a lawyer in their state.