How Do I Get Free NARCAN® in Tennessee?

Summary

Although the Volunteer State is one of the most difficult states to get naloxone in, there are several ways to get free NARCAN® in Tennessee.

Use our Supply-by-Mail Program

Beginning in January 2023, we began providing access to free NARCAN® kits by mail in Tennessee. As of 2024, our supply-by-mail program now ships nationwide.

We also stock NARCAN keychains, fentanyl test strips, sterile syringes, and safer smoking supplies, offering rates that are competitive with pharmacies, diabetes supply stores, and other specialty harm reduction supply retailers.

Unlike some other programs, we never require prescriptions for our supplies.

Visit a syringe exchange/harm reduction program

Syringe exchanges, also known as syringe services programs (SSPs), offer a full range of harm reduction services — including free naloxone. Even if you don’t inject drugs, you can still get free NARCAN® at any of Tennessee’s SSP locations.

READ MORE: Check out our list of syringe services programs (SSPs) in Tennessee.

Try contacting your region’s Regional Overdose Prevention Specialists

In mid-to-late 2017, the Tennessee Department of Mental Health and Substance Abuse Services used State Opioid Response funding from SAMHSA to hire roughly two dozen Regional Overdose Prevention Specialists.

ROPS (pronounced “ropes”) offer overdose reversal trainings and give out NARCAN®, primarily targeting three groups: first responders, entities that offer addiction services and community resources, and people who use drugs.

One downside to sourcing naloxone from ROPS is that you may be required to go through training, which can last anywhere from 20 to 90 minutes.

Map of the 13 regions of Tennessee to which Regional Overdose Prevention Specialists are assigned.
Tennessee Department of Mental Health and Substance Abuse Services

As of March 2023, TDMHSAS employs 26 ROPS across 13 regions. Most are employed by prevention coalitions, although some work for other local agencies such as housing authorities.

READ MORE: What do Tennessee’s Regional Overdose Prevention Specialists do?

Buy NARCAN® from a pharmacy

You can buy NARCAN® from most pharmacies in Tennessee, whether or not you have a prescription.

Although over 90% of Tennessee’s pharmacies stock NARCAN®, most consumers can’t afford to shell out $132.49 for two nasal sprays — the cash price of this life-saving drug.

That said, it is possible to buy naloxone for as little as $3 to $5 using CoverRX, a prescription drug program that subsidizes the cost of over 200 medications for uninsured Tennesseans.

Consider other mail-based naloxone supply options

Although Tennessee Harm Reduction is the only organization in Tennessee that offers free naloxone kits by mail, there are several other groups across the country that offer mail-based naloxone access.

Naloxone Exchange (NXG) is an online pharmacy that mails naloxone to most states, including Tennessee. On the downside, you’ll have to pay — prices just one naloxone kit start at $39.

What is NARCAN®?

Woman holds an unopened box of NARCAN Nasal Spray in her hands.
Matt Rourke/AP Photo

NARCAN® is a patented, name-brand formulation of naloxone, an opioid antagonist used primarily to reverse opioid overdose. It comes in one strength: 4 mg per nasal spray.

A 2-mg version was developed, but never brought to market — 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 it.

Product photo of a NARCAN Nasal Spray device.
NARCAN® nasal spray device

What’s 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. Rather, we prefer people use “naloxone” to refer to this life-saving drug, no matter which form you’re talking about.

Naloxone is mainly available in two forms: a nasal spray and an intramuscular injection. We strongly prefer the injectable kind, almost exclusively giving IM naloxone kits to our participants.

Intramuscular naloxone works twice as fast as NARCAN® nasal spray. One 2019 study published in JAMA found that IM naloxone reversed overdose in 8 minutes, on average, whereas intranasal naloxone took as long as 17 minutes to work.

IM naloxone is also less likely to cause serious side effects like precipitated opioid withdrawal, as most intramuscular naloxone formulations contain less naloxone than high-dose nasal sprays like NARCAN® and Kloxxado®.

READ MORE: Why do we prefer injectable naloxone?

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 training to carry NARCAN® (naloxone) in TN?

NO, you do not need training to receive, provide, or administer NARCAN® nasal spray in Tennessee.

Tennessee’s training and self-assessment to use NARCAN®

The State of Tennessee’s website has a training and self-assessment online. After watching a few minutes worth of poorly formatted videos, you take a quiz — and get a certificate. You do not need this certificate to use, possess, or distribute naloxone in Tennessee.

If you don’t have anyone else to show you how to use NARCAN® nasal spray, the training and self-assessment can’t hurt — but better resources exist.

Where can I find an online training on how to use NARCAN®?

Looking for a shorter, more visually friendly guide on how to use NARCAN®? Check out this two-page overdose reversal booklet from UC Davis.

Or how about a more in-depth resource on how to use narcan injection and nasal spray? The National Harm Reduction Coalition’s got you covered.

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.

A 2015 amendment called the Addiction Treatment Act protects people who get help from emergency services for an opioid overdose from:

  • Misdemeanor drug possession charges
  • Misdemeanor drug paraphernalia charges
  • Violating a protective or restraining order
  • Violating a condition of pretrial release, probation, or parole based on a drug violation

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 nasal sprays).

Is there a NARCAN® generic?

Yes — three, actually, made by Sandoz, Teva, and Perrigo. With discount cards, this generic NARCAN® can cost as little as $30 to $50.

Visual comparison of the three brands of NARCAN generic: Sandoz, Teva, and Perrigo.

Analysts expect these generic NARCAN® nasal spray alternatives to be 20% to 30% cheaper than the name-brand, though wholesale prices remain largely the same.

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.

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