Frequently asked questions (FAQs) about naloxone

FAQs about naloxone in Massachusetts

Table of Contents

Where to get naloxone

Q: I’m at risk of an opioid overdose, where can I get naloxone?

A: Individuals at risk of an opioid overdose can get naloxone free-of-charge at most naloxone distribution programs, which includes any Overdose Education and Naloxone Distribution (OEND) program.

Alternatively, anyone in Massachusetts can use insurance or cash to purchase naloxone through a pharmacy.

Q: I have a client, friend, or loved one who’s at risk of an opioid overdose, where can I get naloxone?

A: Any individual who regularly interacts with someone at risk of an opioid overdose can get naloxone free-of-charge at most naloxone distribution programs, which includes any Overdose Education and Naloxone Distribution (OEND) program.

Alternatively, anyone in Massachusetts can use insurance or cash to purchase naloxone through a pharmacy.

Q: Where can my organization get naloxone to administer in the event of an overdose?

A: Please see below for information on your organization type.

Municipal Police and Fire, Emergency Medical Services, hospitals, hospital-affiliated clinics/departments, and public/non-public schools: may obtain naloxone to administer in the event of an overdose from the State Office of Pharmacy.

Community Naloxone Purchasing Program (CNPP): CNPP allows many eligible programs to obtain naloxone through the State Office of Pharmacy (SOPS). The goal of the CNPP is to prevent death from opioid overdose by increasing distribution of free naloxone to community bystanders across Massachusetts. Organizations that qualify for CNPP can order naloxone at a partial or full subsidy directly from the State Office of Pharmacy Services (SOPS) depending on preference. Find out more about the CNPP here.

Q: Where can my organization get naloxone to provide to our patients or clients?

A: Please see below for information on your organization type. More information can be found on our Community Dispensing of Naloxone page.

Community Naloxone Purchasing Program (CNPP): The CNPP allows many eligible programs to purchase obtain naloxone through the State Office of Pharmacy (SOPS). The goal of the CNPP is to prevent death from opioid overdose by increasing distribution of free naloxone to community bystanders across Massachusetts Organizations that qualify for CNPP can order naloxone at a partial or full subsidy directly from the State Office of Pharmacy Services (SOPS) depending on preference. CNPP affiliate programs may distribute naloxone purchased through this mechanism to the individuals their organization serves. Find out more about the CNPP here.

Q: I don’t interact regularly with anyone at risk of an opioid overdose, but I want to carry naloxone on me, just in case. Where can I get naloxone?

A: Anyone in Massachusetts can use insurance or cash to purchase naloxone through a pharmacy.

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: Is over-the-counter (OTC) naloxone available in MA?

A: On March 29th 2023, the Food and Drug Administration (FDA) approved Narcan®, a 4 milligram (mg) naloxone hydrochloride nasal spray, for over-the-counter (OTC), nonprescription use. OTC Narcan® will become available in September 2023. It will still be available at pharmacies but may no longer be behind the pharmacy counter. It will instead be available on shelves, like any other non-prescription pharmaceutical product. However, this is up to pharmacy discretion due to theft policies. It may also become available at retailers other than traditional pharmacies. This OTC approval does not apply to other formulations and dosages of naloxone; they will remain available by prescription only. This includes injectable naloxone & Kloxxado®.

  • Getting Naloxone from Pharmacy: Go directly to a pharmacy and request a naloxone kit. A prescription from your doctor is not needed. The Department of Public Health (DPH) has issued a statewide standing order (PDF) l (DOCX) that allows retail pharmacies to dispense naloxone without a prescription.

Where to get overdose education and naloxone training

Q: I’m at risk of an opioid overdose, where can I get training?

A: Individuals who get naloxone from an naloxone distribution program receive education and training on how to prevent and respond to an overdose from OEND program staff.

Individuals who get naloxone from a pharmacy should receive education and training from the pharmacist on how to use naloxone.

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.

Q: I have a client or loved one who’s at risk of an opioid overdose, where can I get training?

A:  Individuals who get naloxone from an naloxone distribution program can receive education on how to prevent and respond to an overdose from OEND program staff

Individuals who get naloxone from a pharmacy can receive training from the pharmacist on how to use naloxone.

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.

Q: I work for an organization that serves individuals at risk of opioid overdose, how can our staff get training?

A: There are many options for staff training on overdose and naloxone. Please see our training resources page for more information.

Q: I work for a municipal agency, how can our staff get training?

A: There are many options for staff training on overdose and naloxone. Please see our training resources page for more information.

Q: I don’t interact regularly with anyone at risk of an opioid overdose, but I want to know how to identify an overdose and use naloxone, just in case. Where can I get training?

A: Individuals who get naloxone from a pharmacy can receive training from the pharmacist on how to use naloxone.

Additionally, some OEND programs offer virtual or in-person community overdose prevention and response trainings. If community trainings are available, they will likely be advertised on a program’s website or social media pages.

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.

Product information

Q: How should NARCAN®  (a common brand of naloxone) be stored?

A: NARCAN® 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 NARCAN®.

Q: Can NARCAN® freeze? What should I do if my NARCAN® freezes?

A: NARCAN® will freeze if its temperature drops below 5°F. Frozen NARCAN® 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 NARCAN® after 12 months from the date it was first frozen.

In the event of an overdose, if you find that your NARCAN® is frozen, do not wait for it to thaw. Call 911 immediately, and perform rescue breathing/chest compressions until your NARCAN® 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 NARCAN® is exposed to extreme heat?

A: NARCAN® 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 NARCAN® as soon as possible.

In the event of an overdose, if you only have NARCAN® that has been exposed to temperatures above 104°F, you should use it, as it may still be effective. Always call 911 in the event of an overdose. Please see our how to reverse an overdose page for more information.

Q: How long is the shelf life of NARCAN®? What should I do if it expires or reaches the end of its shelf life?

A: If stored properly, NARCAN® 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 NARCAN® even more.

If your NARCAN® 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 NARCAN®, you should use it, as it may still be effective. Always call 911 in the event of an overdose. Please see our how to reverse an overdose page for more information.

MA laws and restrictions

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 programsCNPP affiliate programspharmacies, EMS, Police, Fire, and certain community personnel/programs may distribute naloxone. All entities must maintain an active Massachusetts Controlled Substance Registration (MCSR) for naloxone.

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 dropbox 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, OEND programs, 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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