Community-Originated Research to Identify Access Gaps in Over-the-Counter Naloxone Availability in Connecticut Pharmacies

Abstract Background Naloxone, a life-saving medication that reverses opioid overdoses, was available in the United States only by prescription until March 2023, when the federal government approved nasal-spray formulations for over the counter sales to expand access. We assessed the availability of...

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Main Authors: Katherine Hill, Peter Canning, Zoey Canning, Cameron Breen, Liz Evans, Mark Jenkins, Mark Nickel, Ken Plourd, Robert Heimer
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Harm Reduction Journal
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Online Access:https://doi.org/10.1186/s12954-025-01268-y
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author Katherine Hill
Peter Canning
Zoey Canning
Cameron Breen
Liz Evans
Mark Jenkins
Mark Nickel
Ken Plourd
Robert Heimer
author_facet Katherine Hill
Peter Canning
Zoey Canning
Cameron Breen
Liz Evans
Mark Jenkins
Mark Nickel
Ken Plourd
Robert Heimer
author_sort Katherine Hill
collection DOAJ
description Abstract Background Naloxone, a life-saving medication that reverses opioid overdoses, was available in the United States only by prescription until March 2023, when the federal government approved nasal-spray formulations for over the counter sales to expand access. We assessed the availability of naloxone in a sample of pharmacies across the state of Connecticut. Methods Between September 15 and November 24, 2024, trained community-based volunteers surveyed a convenience sample of pharmacies throughout the state, focusing on naloxone signage, availability, cost, and in-store location. Pharmacies were categorized into three groups: chain pharmacies, pharmacies within grocery stores, and independent pharmacies. Summary statistics for the full sample and the three subgroups were tabulated, and differences between groups were analyzed using Fisher’s exact tests. Results A total of 162 pharmacies across all Connecticut counties were evaluated. While naloxone was available in most pharmacies, it was predominantly kept behind the pharmacy counter (n = 111, 73.5%) or the general checkout counter (n = 46, 30.5%). Fewer than 20% of pharmacies (n = 29) had naloxone easily accessible on an aisle shelf. Pricing was often high (≥ $60), particularly in independent pharmacies (n = 7, 22.6%; p < 0.001). Additionally, fewer than 20% of pharmacies (n = 31) displayed signage related to naloxone availability, and all signage was exclusively in English. Conclusions Despite widespread availability, naloxone access was restricted by its in-store location, high cost, and inadequate signage. This highlights a notable discrepancy between naloxone availability and accessibility, suggesting a lag in the effective implementation of policy in intended settings.
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spelling doaj-art-9a142045bb41473eb1880a6394d52cf82025-08-20T03:04:31ZengBMCHarm Reduction Journal1477-75172025-07-012211610.1186/s12954-025-01268-yCommunity-Originated Research to Identify Access Gaps in Over-the-Counter Naloxone Availability in Connecticut PharmaciesKatherine Hill0Peter Canning1Zoey Canning2Cameron Breen3Liz Evans4Mark Jenkins5Mark Nickel6Ken Plourd7Robert Heimer8Department of Epidemiology of Microbial Diseases, Yale School of Public HealthEmergency Medical Services, University of Connecticut John Dempsey HospitalNorthwest Catholic High SchoolLiberation ProgramsLiberation ProgramsCT Harm Reduction AllianceCross Sector Consulting, LLPCross Sector Consulting, LLPDepartment of Epidemiology of Microbial Diseases, Yale School of Public HealthAbstract Background Naloxone, a life-saving medication that reverses opioid overdoses, was available in the United States only by prescription until March 2023, when the federal government approved nasal-spray formulations for over the counter sales to expand access. We assessed the availability of naloxone in a sample of pharmacies across the state of Connecticut. Methods Between September 15 and November 24, 2024, trained community-based volunteers surveyed a convenience sample of pharmacies throughout the state, focusing on naloxone signage, availability, cost, and in-store location. Pharmacies were categorized into three groups: chain pharmacies, pharmacies within grocery stores, and independent pharmacies. Summary statistics for the full sample and the three subgroups were tabulated, and differences between groups were analyzed using Fisher’s exact tests. Results A total of 162 pharmacies across all Connecticut counties were evaluated. While naloxone was available in most pharmacies, it was predominantly kept behind the pharmacy counter (n = 111, 73.5%) or the general checkout counter (n = 46, 30.5%). Fewer than 20% of pharmacies (n = 29) had naloxone easily accessible on an aisle shelf. Pricing was often high (≥ $60), particularly in independent pharmacies (n = 7, 22.6%; p < 0.001). Additionally, fewer than 20% of pharmacies (n = 31) displayed signage related to naloxone availability, and all signage was exclusively in English. Conclusions Despite widespread availability, naloxone access was restricted by its in-store location, high cost, and inadequate signage. This highlights a notable discrepancy between naloxone availability and accessibility, suggesting a lag in the effective implementation of policy in intended settings.https://doi.org/10.1186/s12954-025-01268-yNaloxoneNarcanPharmacy
spellingShingle Katherine Hill
Peter Canning
Zoey Canning
Cameron Breen
Liz Evans
Mark Jenkins
Mark Nickel
Ken Plourd
Robert Heimer
Community-Originated Research to Identify Access Gaps in Over-the-Counter Naloxone Availability in Connecticut Pharmacies
Harm Reduction Journal
Naloxone
Narcan
Pharmacy
title Community-Originated Research to Identify Access Gaps in Over-the-Counter Naloxone Availability in Connecticut Pharmacies
title_full Community-Originated Research to Identify Access Gaps in Over-the-Counter Naloxone Availability in Connecticut Pharmacies
title_fullStr Community-Originated Research to Identify Access Gaps in Over-the-Counter Naloxone Availability in Connecticut Pharmacies
title_full_unstemmed Community-Originated Research to Identify Access Gaps in Over-the-Counter Naloxone Availability in Connecticut Pharmacies
title_short Community-Originated Research to Identify Access Gaps in Over-the-Counter Naloxone Availability in Connecticut Pharmacies
title_sort community originated research to identify access gaps in over the counter naloxone availability in connecticut pharmacies
topic Naloxone
Narcan
Pharmacy
url https://doi.org/10.1186/s12954-025-01268-y
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