Helping Your Patients Find Naloxone: A Provider's Guide

You've written the prescription — or recommended the OTC option — but your patient still can't find Naloxone. It's a frustrating reality that many providers face in 2026, despite significant improvements in access since Narcan went over the counter in 2023.

This guide provides a practical framework for helping your patients navigate availability challenges, with actionable steps you can integrate into your clinical workflow.

Current Availability Landscape

Understanding the current supply picture helps you guide patients effectively:

• OTC nasal sprays (Narcan, RiVive) — Broadly available at chain pharmacies and online. Most patients can find these without difficulty in urban and suburban areas.
• Kloxxado 8 mg (Rx) — Available at most chain pharmacies; may require 1-2 day ordering at smaller pharmacies.
• Zimhi 5 mg auto-injector (Rx) — Less widely stocked; larger chains and specialty pharmacies are most reliable sources.
• Nalmefene/Opvee (Rx) — Growing distribution but not yet universally available.
• Injectable vials (Rx) — Intermittent shortages; primarily affects institutional purchasers.

For real-time data on what's available, use Medfinder for Providers.

Why Patients Can't Find Naloxone

Even with OTC availability, patients encounter real barriers:

Geographic Disparities

Rural pharmacies may not stock Naloxone consistently. Patients in remote areas may need to drive significant distances to find it, and local pharmacies may need to special-order it.

Confusion About OTC Status

Many patients (and some pharmacy staff) are still unclear about which formulations are OTC versus prescription-only. Patients may assume they need a prescription for Narcan, or may not know to ask for it if it's kept behind the counter.

Cost Concerns

While prices have come down, the $35-$50 cost of OTC Narcan can be a barrier for uninsured or underinsured patients. Some patients don't realize that a prescription can make it free or nearly free through insurance.

Stigma

Some patients report feeling stigmatized when purchasing Naloxone, particularly at pharmacies where staff are unfamiliar with harm reduction approaches. This can deter them from returning to try again.

Product Confusion

With multiple brand names (Narcan, Kloxxado, RiVive, Zimhi, Opvee) and formulations, patients can become confused about what to ask for and what they actually need.

What Providers Can Do: 5 Actionable Steps

Step 1: Prescribe Strategically

Even though Narcan is OTC, consider writing a prescription for several reasons:

• Insurance coverage — A prescription allows insurance billing, often reducing cost to $0
• Specificity — You can prescribe higher-dose formulations (Kloxxado, Zimhi) when clinically appropriate
• Documentation — Creates a record that supports quality metrics and care coordination
• Authority — A prescription from their provider gives patients confidence and legitimacy when interacting with pharmacy staff

Include clear instructions: "Naloxone nasal spray, 4 mg, dispense 2 units, for emergency opioid overdose reversal. May substitute Kloxxado 8 mg if standard not available."

Step 2: Direct Patients to Real-Time Availability Tools

Instead of telling patients to "try a few pharmacies," give them a specific resource. Medfinder provides real-time pharmacy stock information so patients can find Naloxone without calling multiple locations.

Consider adding the Medfinder link to your after-visit summaries, patient education handouts, or EHR discharge instructions.

Step 3: Educate About All Available Options

Ensure patients understand the full range of products available:

• OTC sprays that don't need a prescription (Narcan, RiVive)
• Higher-dose options for Fentanyl risk (Kloxxado, Zimhi)
• Longer-acting alternatives (Opvee/Nalmefene)
• Free programs through health departments and harm reduction organizations

Provide a handout or direct them to alternatives to Naloxone for detailed comparisons.

Step 4: Connect Patients With Free Distribution Programs

For patients facing cost or access barriers, these resources provide Naloxone at no cost:

• NEXT Distro (naloxoneforall.org) — Free Naloxone kits mailed to home
• State health departments — Free distribution programs in all 50 states
• Local harm reduction organizations — Walk-in distribution, often including training
• Community health centers — Many integrate Naloxone distribution into primary care

Keep a list of local resources in your office for easy reference and handoff.

Step 5: Follow Up

Don't assume the patient filled the prescription or obtained Naloxone. At the next visit, ask:

• "Were you able to get the Naloxone?"
• "Do you know how to use it?"
• "Has it expired? Do you need a replacement?"

This brief check-in takes 30 seconds and can be the difference between a patient having Naloxone when they need it and not.

Alternative Agents to Consider

When standard Naloxone nasal spray is unavailable, these alternatives may be accessible:

• Nalmefene (Opvee) — Longer-acting opioid antagonist (up to 8 hours). Especially useful for synthetic opioid exposures. Growing pharmacy availability.
• Kloxxado 8 mg — Higher-dose Naloxone for patients at risk of potent opioid exposure. Often available even when standard Narcan is not.
• Zimhi 5 mg — Intramuscular auto-injector. Good option when nasal administration is impractical or patient prefers injection.

For a full comparison, see our alternatives guide.

Workflow Integration Tips

EHR Integration

• Create a Naloxone co-prescribing alert for patients on ≥50 MME/day or concurrent benzodiazepines
• Add Medfinder link to discharge/after-visit summary templates
• Document Naloxone co-prescribing as a quality measure

Staff Training

• Ensure front desk and nursing staff understand the OTC vs. Rx distinction
• Train staff to provide Naloxone education and handouts at discharge
• Consider having sample Naloxone trainers (non-functional devices) available for patient demonstration

Bulk Availability

If your practice serves a high-risk population, consider stocking Naloxone for direct distribution. Many state programs provide free Naloxone to healthcare facilities. Contact your state opioid response coordinator for details.

Final Thoughts

Helping patients access Naloxone extends beyond writing a prescription. By prescribing strategically, directing patients to real-time tools like Medfinder, educating about all available options, connecting with free programs, and following up — you create a safety net that maximizes the chance your patient has Naloxone when it matters most.

For additional provider resources, see our Naloxone shortage briefing for providers and our guide on helping patients save money on Naloxone.