Where to get naloxone
Q: Where can I get naloxone in MA?
A: People who may experience or witness an overdose most naloxone distribution programs..
Alternatively, anyone in Massachusetts can use insurance or cash to purchase naloxone through a pharmacy.
If the above options are challenging for you, you can also order naloxone to be delivered to your home address through the You Can Save a Life website.
Q: If I get naloxone through a pharmacy, and my insurance is billed, how much will my co-pay be?
A: MassHealth co-pays are between $0-$3.65, and private insurance co-pays typically range between $0-$25, but could be more, depending on your insurance plan. Not all private insurers cover the cost of naloxone. If you have private insurance, contact your insurance provider for more information.
Q: Where can my organization get naloxone?
A: Please see below for information on your organization type.
State and municipal public agencies (such as police and fire departments and public schools) may purchase naloxone to administer in the event of an overdose from the State Office of Pharmacy at the public interest price. Depending on federal and state appropriations, additional discounts may be offered to customers.
Naloxone products are available from medical supply wholesalers and retail settings for bulk purchase.
Some organizations may be eligible to get naloxone through the DPH Community Naloxone Program. Organizations that qualify for CNP can order naloxone at a partial or full subsidy directly from the DPH depending on preference. Find out more about the CNP here.
Q: Do I need a prescription to get naloxone?
A: On March 29th, 2023, the Food and Drug Administration (FDA) approved naloxone nasal spray for over-the-counter (OTC), nonprescription use. OTC naloxone products are available through online and brick and mortar retail settings.
Where to get overdose education and naloxone training
Q: Where can I get training on overdose prevention and response?
A: Please see our opioid overdose risk factors page and how to reverse an overdose page for information on how to prevent and respond to opioid overdoses.
You can also 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 an 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 should 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: There are many options for staff training on overdose and naloxone. Please see our training resources page for more information.
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 of your naloxone products for further details.
Q: Can naloxone freeze? What should I do if my naloxone freezes?
A: Naloxone will freeze if its temperature drops below 5°F. Frozen naloxone will not spray but will thaw if left at room temperature for 15 minutes. It can be used normally once it is thawed. Discard and replace any previously frozen naloxone after 12 months from the date it was first frozen.
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/chest compressions until your naloxone is thawed, or until help arrives. Please see our how to reverse an overdose page for more information.
Q: What should I do if my naloxone is exposed to extreme heat?
A: Naloxone should remain effective for up to 12 months when stored in extreme heat (up to 104°F). If it has been exposed to temperatures above 104°F, discard and replace your naloxone as soon as possible.
In the event of an overdose, if you only have naloxone that has been exposed to temperatures above 104°F, you should use it, as it may still be effective. Please see our how to reverse an overdose page for more information.
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: If stored properly, naloxone should remain fully effective for 24 months (2 years). Exposures to freezing temperatures and heat up to 104°F may decrease its shelf life to 12 months (1 year). Exposures to temperatures of above 104°F have not been tested and may decrease the shelf life of naloxone even more.
If your naloxone expires or reaches the end of its shelf life, it should be discarded and replaced as soon as possible. In the event of an overdose, if you only have expired naloxone, you should use it, as it may still be effective. Please see our how to reverse an overdose page for more information.
Q. My naloxone has expired. Can I get it replaced?
A. DPH does not offer product exchange for expired doses.
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 on 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.
Q: Are there any restrictions on who can distribute naloxone?
A: Yes, currently only OEND programs, CNP affiliate programs, pharmacies, EMS, Police, Fire, and certain community personnel/programs may distribute naloxone. If the entities listed above are distributing OTC approved naloxone products, they do not need to maintain a MA Controlled Substance Registration (MCSR). Any prescription only naloxone products do require an MCSR for distribution activities.
Expiration, transfer, and disposal
Q: My agency/organization has many doses of naloxone that are going to expire soon, what can we do with them?
A: Any duly registered entity with an active MCSR for naloxone may convey or exchange naloxone to another duly registered entity. For example, a hospital may transfer doses to local EMS, or other first responders with an MCSR for naloxone. Transfers must be recorded in a memo. For more information, please see Massachusetts General Law Part I, Title XV, Chapter 94C, Section 19B ½.
Q: How should I dispose of expired naloxone? If my agency/organization has many doses of expired naloxone, what should we do with them?
A: Individuals with a few doses of expired naloxone can dispose of them at any prescription drop box location. 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 trainings.
Using one of the above methods of disposal is preferable. However, if none of these are feasible, naloxone is not toxic and can be disposed of with regular solid waste.
| Date published: | May 11, 2022 |
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