Availability of naloxone in retail pharmacies following introduction of over-the-counter status

The over-the-counter approval of naloxone has not translated into equal access across the United States, according to a new cross-sectional study published in JAMA Network Open.

Researchers conducting what they describe as the first national evaluation of same-day naloxone availability and pricing following OTC approval found that both remained inconsistent across pharmacies. The analysis identified notable differences in how the policy has been implemented depending on pharmacy type and the demographic characteristics of the surrounding community.

While making the opioid-overdose reversal drug available without a prescription was a necessary step, the study concluded that its intended benefits have not been realized equally in practice. Independent pharmacies and those affiliated with medical facilities, as well as pharmacies serving rural and underserved areas, appeared to face particular gaps in access.

The authors suggest that expanding pharmacist education and directing targeted support toward independent and medical-affiliated pharmacies could help close these gaps and improve naloxone access where it is most needed.

The study, led by corresponding author Lori Ann Eldridge, PhD, of East Carolina University, is available in JAMA Network Open (doi:10.1001/jamanetworkopen.2026.23617).