Where to get naloxone
Q: Where can I get naloxone in MA?
A: Anyone in Massachusetts can use insurance or cash to purchase naloxone through a pharmacy or in retail settings. There are also many naloxone distribution programs across the Commonwealth where you can get trained on overdose response and receive a naloxone rescue kit. You can also order naloxone to be delivered to your home address through the You Can Save a Life website.
Q: Do I need a prescription to get naloxone?
A: No, you do not need a prescription to get naloxone. The statewide standing order for naloxone at the pharmacy serves as a prescription for Massachusetts residents. That means you can get any naloxone product at the pharmacy counter and bill your insurance even if you don’t have a prescription. On March 29, 2023, the Food and Drug Administration (FDA) approved naloxone nasal spray for over the counter (OTC), nonprescription use. OTC naloxone products are available through both online and brick and mortar retail settings.
Q: If I get naloxone through a pharmacy, and my insurance is billed, how much will my co-pay be?
A: MassHealth members do not have a co-pay for naloxone. Most private Massachusetts-based insurance providers are required to fully cover the cost of naloxone and not charge a co-pay. Private insurers based outside of Massachusetts are not required to cover the cost of naloxone so coverage from those insurer types may vary. If you have private insurance, contact your insurance provider for more information about insurance benefits and co-pays.
Q: Where can my organization get naloxone?
A: Organizations in Massachusetts have several options for acquiring naloxone depending on organization type. Naloxone products are available for purchase from medical supply wholesaler companies as well as through online and brick and mortar retail settings. Manufacturers of naloxone products also offer direct purchasing programs.
State and municipal public agencies (such as police and fire departments and public schools) may purchase naloxone from the State Office of Pharmacy at the public interest price through the statewide medical supply contract. Depending on federal and state appropriations, additional discounts may be offered to some customer types.
Some organizations may be eligible to get naloxone through the DPH Community Naloxone Program (CNP). Find out more about the CNP here.
Where to get overdose education and naloxone training
Q: Where can I get training on overdose prevention and response?
A: Please visit the You Can Save a Life website to watch simple training videos on how to prevent, recognize, and respond to an overdose. Individuals who get naloxone from a naloxone distribution program receive education and training on how to prevent and respond to an overdose from program staff. Individuals who get naloxone from a pharmacy receive education and training from the pharmacist on how to use naloxone.
Q: How can I get a training on overdose prevention and response for my program staff ?
A: Many naloxone distribution programs can train your program staff upon request. Please see the training and events page at Careers of Substance for more information about training for staff.
Product information
Q: How should naloxone be stored?
A: Naloxone products should be stored at room temperature (between 68°F and 77°F) and should be protected from direct sunlight. Short exposures to temperatures as low as 41°F and as high as 104°F should not affect the efficacy or shelf life of naloxone. Please review package instructions for your naloxone products for further details.
Q: What should I do if my naloxone is exposed to extreme temperatures?
A: Naloxone will freeze if its temperature drops below 5°F. Frozen naloxone will thaw if left at room temperature for 15 minutes. It can be used normally once it is thawed. In the event of an overdose, if you find that your naloxone is frozen, do not wait for it to thaw. Call 911 immediately and perform rescue breathing until your naloxone is thawed, or until help arrives. If your naloxone has been exposed to temperatures above 104°F, you may want to consider replacing your naloxone as soon as possible. In the event of an overdose, if you only have naloxone that has been exposed to extreme temperatures, you should use it, as it may still be effective.
Q: How long is the shelf life of naloxone? What should I do if it expires or reaches the end of its shelf life?
A: Please review your specific naloxone product for shelf life and expiration details. If your naloxone expires or reaches the end of its shelf life, you may want to consider replacing your product. In the event of an overdose, if you only have expired naloxone, you should use it, as it will likely still be effective.
Q. My naloxone has expired. Can I get it replaced?
A. DPH does not offer product exchange for expired doses.
Q: How should I dispose of expired or used naloxone?
A: Individuals with a few doses of expired or used naloxone can dispose of them at any prescription drop box location. However, if that is not available, naloxone is not toxic and can be disposed of with regular solid waste.
Q. If my agency/organization has many doses of expired naloxone, what should we do with them?
A. Entities with many doses of expired naloxone should utilize their organization/agency’s pharmaceutical waste disposal systems, if this resource is available. Alternatively, large quantities of expired naloxone may be utilized as demonstration devices for training purposes. First responder agencies and/or other organizations may find bulk quantities of expired naloxone useful, if they provide large community or employee training.
MA laws and restrictions
Q: How does DPH determine what formulations of opioid antagonists to include on the Community Program and Pharmacy Standing Orders?
A: The medical director of DPH, through the Bureau of Substance Addiction Services (BSAS), is the signer of the Statewide Community Program and Pharmacy Standing Orders. The medical director determines which formulations of opioid antagonists are included in the standing order by weighing benefits and risks for community overdose response. DPH, through the Bureau of Substance Addiction Services (BSAS), provides no cost and subsidized opioid antagonists for overdose reversal to qualified programs that are on the State Office of Pharmacy Services (SOPS) formulary. Given funding limitations and the significant need for opioid reversal agents in the Commonwealth, current funding prioritization aligns with the framework for a tiered system described in our Statewide Pharmacy Standing Order, requiring that the formulary selections remain evidence-based and of highest clinical effectiveness.
This has been made necessary because over the past decade, several new products have become available for opioid-related overdose reversal, including long-acting overdose reversal agents and high dose overdose reversal agents. While these products are approved by FDA for use in reversing opioid-related overdoses, they are more likely to precipitate and lengthen opioid withdrawal symptoms, due to their greater potency and longer duration of action. Precipitated and protracted withdrawal may increase mistrust and foster avoidance of future use of overdose reversal agents among people who use drugs.
While the state formulary may not contain all overdose reversal agents currently FDA approved and available for sale, the standing order does not impact what individuals may receive via prescription from their provider, or what products can be purchased directly through pharmacies and/or medical supply companies. The statewide standing order does not preclude a municipality or local authority from issuing their own standing order, as DPH only oversees issuance of relevant statewide standing orders and does not oversee municipal or other standing orders. Standing orders are orders by a practitioner stating the conditions for administration of a medication/product and are issues of clinical judgment and practice.
Q: Does naloxone need to be securely locked when in storage?
A: No, naloxone must be stored in a secure location that is under observation of the dispensing entity, but it does not need to be locked.
Q: Are there any restrictions on who can purchase/receive naloxone?
A: There are no restrictions on who can purchase/receive naloxone. This includes age.
| Date published: | May 11, 2022 |
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