Why Gas Stations Should Stock Naloxone
More than a million people have died due to drug overdose since the 1990s, with opioids accounting for 72% of these deaths. A major advancement to address the overdose crisis was made in 2023 when the U.S. Food and Drug Administration (FDA) made naloxone available over the counter in pharmacies in the form of a nasal spray, the most popular one being Narcan. The goal behind this change was to improve public access to Narcan, such that anyone could purchase and use it without the need for a prescription.
However, the emphasis on making Narcan available over the counter has primarily focused on pharmacies, overlooking other potential retail locations. For example, why are we skipping out on gas stations?
They are widely dispersed throughout the country, particularly along highways, and are designed to be easily spotted and accessible when you are on the road. In fact, there are 150,000 more gas stations than pharmacies in the United States.
Gas stations represent an ideal place to stock naloxone for someone to purchase. Additionally, gas stations are an overdose hotspot in many states, especially in their bathrooms, emphasizing the need for naloxone to be readily available in these areas.
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Yet, that’s not the current situation. In February 2024, an NBC News investigation that visited 64 stores in 15 states and Washington, D.C., found that none of the gas stations checked carried Narcan. With more than 46% of U.S. counties being pharmacy deserts, gas stations offer a critical opportunity to increase access to naloxone.
When the FDA made naloxone available over the counter, the intention was to allow it to be sold in a variety of settings, including gas stations, as stated in the original news release. This intention was echoed by other organizations, such as the National Association of County & City Health Officials, which highlighted the potential for gas stations and supermarkets to now stock Narcan given its over-the-counter status.
Gas stations have been slow to react, however, likely due to some very real barriers. First, the stigma surrounding opioid use and naloxone often shuts down possible conversations about accessibility before they even begin. This stigma may be reinforced by gas station owners who, like other community members, fear that increasing access to naloxone could encourage drug use despite research demonstrating otherwise.
Second, stocking naloxone requires coordination with suppliers and could result in potential upfront costs, which may be particularly burdensome for smaller or independently owned gas stations.
Third, the conversation around over-the-counter naloxone has largely centered around pharmacies, so it is likely that the idea of stocking gas stations may have been overlooked in policy.
Although these challenges are significant, some communities are making strides toward overcoming them. For example, in Chicago, an initiative led by the Lawndale Christian Legal Center provided over-the-counter naloxone for free at gas stations in the South and West sides that had high reported numbers of overdoses.
Other cities should follow Chicago's precedent and ensure that naloxone is available over the counter in gas stations.
So, how can we make this happen? First, gas station owners have to have the opportunity to establish direct partnerships with naloxone manufacturers or wholesalers to negotiate fair prices, and collaborate with local public health departments to receive guidance, grant opportunities and training on naloxone distribution. Additionally, they could support and advocate for local legislation that would allow for incentives, like tax breaks or funding, to promote naloxone stocking in gas stations.
Town health departments also should make this effort a priority and, if met with resistance in their advocacy, they should organize community meetings and engage in one-on-one conversations with gas station owners to address stigma and clear misconceptions.
Local harm reduction organizations should launch public awareness campaigns in their communities, utilizing local newspapers, radio stations and media to highlight the importance of naloxone availability in gas stations.
Naloxone being available over the counter means that it should be truly accessible at any counter, including those of gas stations. Doing this has the potential to save countless lives and significantly reduce overdose deaths.
Suhanee Mitragotri is an undergraduate student at Harvard University and the cofounder of the Naloxone Education Initiative. Kevan Shah, MSc, MSM, is an MD Candidate at Cooper Medical School of Rowan University and is the founder and executive director of End Overdose Together.
Editor's note: The opinions expressed in this column are the authors' and do not necessarily reflect the views of Convenience Store News.