The FDA approved Narcan for over-the-counter use in March 2023. The antidote was poised to be a game changer for those at risk of suffering a drug overdose. However, recent indications suggest that there are serious obstacles when it comes to making it available to those who might need it.

NBC News conducted an investigation across 64 stores in 15 states and found that the availability of Narcan was inconsistent at best. From locked display cases in Pittsburgh to obscured displays in Chattanooga, the rollout has been flawed, which has likely resulted in missed opportunities to save lives.

Since the launch of the over-the-counter version last fall, the drug can be purchased at more than 32,000 mass, drug, grocery and online retailers and e-commerce sites, Paul Williams, a senior vice president at Emergent BioSolutions, the maker of Narcan, said in a statement. In 2023, the company distributed more than 20 million doses of the antidote, both over-the-counter and prescription, in the U.S. and Canada, he said.

In the fourth quarter of last year, Emergent reported $111 million in Narcan sales, a 22% increase from the year prior. The increase was mainly driven by sales of the over-the-counter version, the drugmaker said.

Dennis Cauchon, president of Harm Reduction Ohio, a nonprofit group that distributes Narcan for free, said it’s still too early to gauge the impact the over-the-counter version is having on the opioid crisis.

Hadland knows of at least one case where a patient used Narcan bought over the counter to save a friend.

“People are recognizing it as something that everyone should consider carrying with them,” he said. “I think it will save lives.”

The report detailed the findings of the investigation, noting that in many instances, it might not be easy to procure Narcan, noting that “Most major drugstores and big-box store pharmacies NBC News visited carried Narcan, but none of the convenience stores or gas stations did.”

Another problem is the issue of stigma, which presents a formidable barrier to those who might need the nasal spray. If the product is locked up in a case or otherwise out of reach, some might be hesitant to ask for it out of fear of being judged. Moreover, the $45 price point is prohibitive for many who would benefit from it.

The lack of availability is particularly pronounced in Texas. The inconsistent availability, along with reluctance on the part of pharmacies to carry the product, has amplified the problem.

From August 2022 to 2023, there were an estimated 5,566 drug-related deaths in Texas, 45% of which involved the synthetic opioid fentanyl, according to the Centers for Disease Control and Prevention. Texas Health and Human Services reported last year that, on average, five Texans die every day from fentanyl poisoning.

The rise in both the illegal use of the drug and now the manufacturing of counterfeit prescription drugs that contain fentanyl has made this a particularly deadly problem. But access to the quick-acting Narcan is inconsistent in Texas and nationwide.

Students at Rice University’s Baker Institute for Public Policy called major retail pharmacies in 48 zip codes – including 22 in high poverty zip codes – to ask about availability, brand, price, and location within the store. The group contacted a variety of retailers including Walgreens, CVS, H-E-B, Kroger, Walmart, Costco, and Sam’s Club pharmacies over several months in 2023.

The report found most pharmacies contacted in the Houston area had some version of naloxone, but 71% of them still kept it behind the counter. Of those reported carrying naloxone, 45% said pharmacist assistance is required, 26% said cashier assistance is needed, and three pharmacies even mentioned ID was required for purchase.

In some areas, local and state governments have implemented programs to make Narcan more available to those susceptible to drug overdoses. In Mountlake Terrace, Washington, the police department has been working to make it available to the community.

"When someone's in need of it, you pull the dose out, and they administer it,” said Scott King, commander with the Mountlake Terrace Police Department. “One nice thing about Narcan is you cannot overdose it with it. So, if someone doesn't respond right away, we can use another dose and another dose.”

King said Mountlake Terrace officers have been equipped with Narcan since 2019. He said their officers save a handful of people with Narcan every year. Last year, the department saved three lives. The department saved five people in 2022.

"There's a great need to have Narcan in our community,” King said. “There's an opioid epidemic, we counter it every day."

Narcan is still relatively new on the scene when it comes to over-the-counter treatments, so it is probable that these problems will be worked out as it becomes available at locations beyond pharmacies. As time goes on, my hope is that America will overcome the financial and societal obstacles hindering the effort to make it available to people in need.