- What is NARCAN®?
- What is the difference between naloxone and NARCAN®?
- What is NARCAN® used for?
- Do you need a prescription to buy NARCAN® in TN?
- Is naloxone a controlled substance?
- Do you need NARCAN® training to carry NARCAN® in TN?
- Tennessee’s training and self-assessment to use NARCAN®
- What is the Good Samaritan law?
- How much does NARCAN® cost?
- Is there a NARCAN® generic?
- How can I get NARCAN®?
Every Possible Way to Source NARCAN® (Naloxone) in Tennessee
- Visit a harm reduction program or syringe exchange in Tennessee and ask for free naloxone. There are currently 15 official Syringe Services Programs (SSPs) and at least one unofficial syringe exchange — us, actually. Here at Tennessee Harm Reduction, rural West Tennessee‘s only syringe exchange and harm reduction program, we offer two types of naloxone: name-brand NARCAN® nasal spray and intramuscular (IM) naloxone injection kits. We never require participants to attend training events before receiving naloxone. You can request naloxone — or free, sterile syringes — by navigating over to “How to Request Supplies from Us” and following the simple instructions there. Follow this link for a complete list of all SSPs in Tennessee.
- You can get free naloxone from Tennessee’s anti-drug coalitions and prevention coalitions. They may require you to attend a town-hall-style NARCAN® training first.
- You can also get naloxone from the state’s Regional Overdose Prevention Specialists, but only if you attend a naloxone training first. These town-hall-style meetings are lengthy (90+ minutes) though, as early as 2020, some ROPS have offered shorter training sessions (20+ minutes) via phone. While ROPS are great at reaching addiction services facilities and first responders, they largely struggle to reach people who use drugs. If you use drugs or are seeking naloxone for someone who uses drugs, you’re better off getting naloxone from a harm reduction program or Syringe Services Program (for a full list of these programs, check out the list above (in #1). Read more about Regional Overdose Prevention Specialists here.
- Buy NARCAN® at a pharmacy with a prescription* — your insurance may require a prescription to cover NARCAN®, not to mention a co-pay. Fortunately, however, two companies (Teva and Sandoz) began selling generic versions of NARCAN® nasal spray; it’s unclear how much it costs at retail, but with a GoodRX discount card, the cost of generic NARCAN® nasal spray runs between $48 and $52 at most pharmacies. Considering the average cost of brand-name NARCAN® in Tennessee is $132.49, the generic nasal spray should offer considerable savings.
- Buy NARCAN® at a pharmacy without a prescription.* Fortunately, Tennessee hasn’t required a prescription for NARCAN® since 2018.. Unfortunately, this option isn’t free — the mean price of brand-name NARCAN® nasal spray in Tennessee is $132.49. On the bright side, Teva and Sandoz, two pharmaceutical giants, independently released their own versions of generic NARCAN® nasal spray earlier this year. With discount cards, which can freely be found online, the cost of generic NARCAN® nasal spray runs between $48 and $52.
- Get NARCAN® at a pharmacy with CoverRX. CoverRX is a prescription drug program that helps pay for prescription medications. It offers access to over 200 drugs, including name-brand NARCAN® nasal spray and generic NARCAN® nasal spray. While most drugs have a co-pay of $3 to $5, one naloxone kit/month is available for free through CoverRX. To qualify for CoverRX, you must have an income equal to or below 138% of the federal poverty level.†
- Buy naloxone at an online pharmacy.* nXg (Naloxone Exchange) is an online pharmacy that sells naloxone — specifically intramuscular injection naloxone kits — for as low as $59. They contain two 0.4-mg doses, enough to reverse the vast majority of opioid overdoses.
- If you don’t live near any harm reduction programs, syringe exchanges, or anti-drug coalitions and have trouble attending a Regional Overdose Prevention Specialist’s naloxone training, you can ask the New York City-based nonprofit NEXT Distro to mail you naloxone.
† Scroll to bottom of page for the current (2022) federal poverty level table
Here’s our list of all harm reduction programs and syringe exchanges in Tennessee. It’s frequently updated, easy to use, and includes every Syringe Services Program’s website, phone number, address, and social media.
What Is NARCAN®?
NARCAN® is a patented, name-brand formulation of naloxone, an opioid antagonist that is primarily used to reverse opioid overdose. It comes in 2 mg and 4 mg doses, although the 2-mg version was never brought to market — NARCAN®’s creator, Adapt Pharma, obtained FDA approval for 2-mg NARCAN® roughly a year-and-a-half after first releasing the 4-mg version, but never began manufacturing the 2-mg version.
What Is the Difference Between Naloxone and NARCAN®?
NARCAN® is a patented, name-brand nasal spray version of naloxone. Naloxone is a medication used to reverse opioid overdose — it’s the active ingredient in NARCAN®.
We recommend not using the term “NARCAN®” unless you’re specifically referring to the name-brand nasal spray. Even then, we prefer people use “naloxone” to refer to this life-saving drug, no matter which form you’re talking about.
Naloxone comes in several forms, though the most common form is injectable vials like this:
Note: We strongly believe NARCAN® is inferior to generic intramuscular (injectable) naloxone. If you want to read about this, click here to check out our article, “Why Generic Naloxone Is Superior to NARCAN®… and Kloxxado®… and Zimhi™”.
What Is NARCAN® Used for?
Naloxone is used to reverse opioid overdose. It stops opioid overdose symptoms like loss of consciousness, extreme drowsiness, and respiratory depression.
Do You Need a Prescription to Buy NARCAN® in Tennessee?
NO, you don’t need a prescription to buy naloxone.
In 2018, Public Chapter 596 gave the Tennessee Department of Health’s CMO to implement a collaborative pharmacy practice agreement to dispense an opioid antagonist to people at risk of opioid overdose or to friends, family members, and associates of people at risk of opioid overdose without a prescription. Also known as a “standing order for naloxone,” the CPPA has been in place since 2018.
Is Naloxone a Controlled Substance?
Naloxone is not a controlled substance on the federal or state level.
Do You Need NARCAN® Training to Carry NARCAN® (Naloxone) in TN?
In practice, you do not need training to use or carry NARCAN® (naloxone) in Tennessee. Technically, however, to be protected from civil prosecution, you must receive basic instruction (the “training and self-assessment” linked below). You do not need to attend a formal, town hall-type naloxone training offered by the state. These trainings actually prevent people from getting free naloxone from the state’s Regional Overdose Prevention Specialists because they’re inconvenient to attend, cumbersome, and inherently unwelcoming of people who use drugs.
Tennessee’s Training and Self-Assessment to Use NARCAN®
The state of Tennessee’s website has a pitiful training and self-assessment online. After watching a few minutes worth of poorly formatted videos, you take a quiz — easily the worst “self-assessment” I’ve ever seen — hosted on SurveyMonkey, of all places.
In our first six months of operation, our organization recorded dozens of overdose reversals from our participants. In other words, this means the naloxone we gave out was used to save dozens of lives. None of the participants were formally trained to reverse opioid overdose.
Personally, I’ve used naloxone to reverse opioid overdose and had contact with police afterward. I was not asked for the self-assessment certificate.
What Is the Good Samaritan Law?
In 2014, Public Chapter 623 (Senate Bill No. 1631 in the 2014 legislative session) enacted the “Good Samaritan” law. It’s got four components, but here’s the skinny: it gives you civil immunity for using NARCAN® on someone you think is experiencing an opioid overdose.
Also, the Addiction Treatment Act protects people who get help from emergency services for an opioid overdose from being charged with simple possession/casual exchange or possession of drug paraphernalia.
Per law, you must take the state’s training and self-assessment training online to be protected under the Good Samaritan law. In practice, however, you will never be asked for proof of having completed the training.
How Much Does NARCAN® Cost?
A 2020 study by the University of Tennessee Health Science Center surveyed 178 pharmacies, finding the average price of name-brand NARCAN® nasal spray to be $132.49 per box (a box contains two 4-mg doses of naloxone).
Is There a NARCAN® Generic?
Yes — two, actually, though these aren’t the only generic formulations of naloxone on the market. But we’re here to talk about NARCAN®, specifically! Both of these NARCAN® generics hit the U.S. market in March 2022.
Although the FDA approved a generic in 2019, no generic actually existed until December 2021, when Sandoz launched its generic for NARCAN® — on the same day, Teva launched its own generic for NARCAN® nasal spray. With discount cards, this generic form of NARCAN® nasal spray can cost as little as $30, though it costs around $50 with a discount card at most pharmacies.
While analysts expected these generics to be 20% to 30% cheaper than name-brand NARCAN®, though, on a wholesale level, Teva’s generic is priced just 5% lower than NARCAN® and Sandoz’s generic is priced just 6.2% lower than NARCAN®.
While the Sandoz version is approved and the Teva version is not approved by NARCAN®’s current owner, Emergent BioSolutions, we believe both versions of generic NARCAN® nasal spray are perfectly fine. The Sandoz version is not shown to have any practical, real-world, clinical advantage over the Teva version.
How Can I Get NARCAN®?
We recommend not bothering with buying NARCAN® from a pharmacy and, instead, getting a free NARCAN® injection kit — as opposed to a nasal spray — by finding a harm reduction program near you.
If you live in West Tennessee, you can get free naloxone from us. We give out NARCAN® and generic injectable naloxone kits for free. Simply reach out to us by Facebook, phone, or by using our Contact Us page.
If you don’t live in West Tennessee, scroll back up to the top of this page and use any of the eight options we’ve listed to get your hands on naloxone.
† The following U.S. Federal Poverty Guidelines are current through January 2023.
|Persons in family/household||Poverty guideline|
|For every additional family/household member…||add $4,720/person|