Over-the-Counter Naloxone Shows Limited Uptake

WEDNESDAY, Sept. 17, 2025 (HealthDay News) — Sales of over-the-counter (OTC) naloxone increased in the United States after it was made available to the public then quickly declined, according to a research letter published online Sept. 15 in JAMA Internal Medicine.

Bradley D. Stein, M.D., Ph.D., from RAND in Pittsburgh, and colleagues examined first-year OTC naloxone sales trends and compared them to pharmacy-dispensed and program-distributed naloxone. The analysis included weekly retailer market-level NielsenIQ data from Sept. 2, 2023, through Sept. 28, 2024.

The researchers found that 136,239 OTC naloxone units were sold, with states averaging 396 OTC units per million residents but with substantial geographic variation. The unweighted mean price was $43.74 for counties with at least 75 units sold per million residents. State pharmacy-dispensed naloxone averaged 7,063 units per million residents in 2023, while state program-distributed naloxone averaged 12,015 units per million residents from August 2022 through August 2024. There was a peak of biweekly OTC sales of approximately 22.5 units per million from Sept. 16 to Oct. 21, 2023, decreasing to about 15 units per million in early December 2023. Through September 2024, sales remained between 11 and 15 units per million. For states in the first and fourth quartiles of program-distributed or pharmacy-dispensed naloxone, there was no significant difference in biweekly OTC sales in any period.

“While the FDA’s approval of over-the-counter naloxone was intended to facilitate access to this life-saving medication, we found there was only limited uptake for over-the-counter sales,” Stein said in a statement.

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