It is becoming easier for friends and family of heroin users or patients taking strong painkillers to buy an antidote that can reverse the effect of an overdose, as policymakers look for ways to fight a growing epidemic.
Naloxone, which is known by the brand-name Narcan, can quickly revive someone who has stopped breathing after overdosing on so-called opioids, highly addictive drugs that include prescription painkillers like Vicodin as well as illegal narcotics like heroin. In the past, naloxone has been available mostly through clinics, hospitals or first responders like paramedics.
Now, nearly every state has passed laws that allow people to buy naloxone without requiring a prescription from their doctor, and drugstores and other retailers around the country are making it easier to buy the drug.
"This saves lives, doesn't seem to have any negative impact that we can identify, therefore it should be available," said Dr. Corey Waller of the American Society of Addiction Medicine.
Walgreens, CVS, Rite Aid, Target and Wal-Mart have joined independent drugstores in either relaxing access to naloxone through their pharmacies in dozens of states, or are making plans to do so. The grocer Kroger is also selling it without requiring a prescription in a few states.
Deaths linked to opioids soared to more than 28,000 in 2014, the highest number on record. The Centers for Disease Control and Prevention estimates that 78 American die every day from an opioid overdose.
Autopsy results released Thursday show that the musician Prince died in April from an accidental overdose of fentanyl, an opioid painkiller that is up to 50 times more potent than heroin. Prince, 57, died less than a week after his plane made an emergency stop for medical treatment as he was returning from an Atlanta concert, where first responders gave him a shot of naxalone.
Naloxone can restore a person's breathing after it is injected or sprayed in the nostrils, bringing overdose victims back from near-death inside a few minutes.
Increased access to it through drugstores and other retailers comes with some limitations. The drug can cost around $80 per dose or more, which might make it unaffordable for someone with little disposable income and no insurance coverage. Customers also have to ask a pharmacist for it.
"You can't treat it like an over-the-counter decongestant," said John Beckner, a pharmacist with the National Community Pharmacists Association, a trade group for independent pharmacies. "It's a powerful drug product that's going to require some instruction on how to use it."
Beckner said pharmacists can teach the average customer how to recognize signs of an overdose and administer the drug and about what side effects to expect.
Only five states — Hawaii, Kansas, Missouri, Montana and Wyoming — have yet to pass a law improving naloxone access, according to The Network for Public Health Law, a nonprofit that helps government agencies.
Legislatures in two of those states, Hawaii and Missouri, have passed bills that await governor signatures, and Montana regulators have worked out an agreement with CVS to allow for wider access at its stores.
Opponents of this push, like Maine Gov. Paul LePage, have noted that naloxone doesn't treat addiction and have said it discourages people from seeking treatment by essentially offering a safety net if they do overdose.
Waller doesn't buy that argument. He said research shows that greater access to naloxone doesn't draw people to illegal drug use or foster an addiction. He said naloxone is a drug that simply keeps someone from dying from their disease. He compared it to an EpiPen, which is used for the emergency treatment of allergic reactions.
"If you have an EpiPen, it's not going to make you go out and seek out your allergy more often," he said.