Ozempic, a drug designed to help manage insulin levels, has become a household name after several people on social media talked about using it for weight loss. Although Ozempic is currently only approved by the Food and Drug Administration for the management of insulin, a known side effect is weight loss and it is often prescribed for just that.

If you’re taking Ozempic, whether to manage your insulin levels or to lose weight, and aren’t seeing the results you want, it’s understandable to ask yourself: Why am I not losing weight with Ozempic? Particularly considering how much chatter has spread about the impact of medications on weight loss.

So, what might be interfering with Ozempic’s potential weight loss? Doctors analyze it.

What is Ozempic and how does it work?

Ozempic, which contains semaglutide, is an injectable drug typically prescribed to patients with type 2 diabetes to help manage blood sugars.

Ozempic is designed to be used in conjunction with a diet and exercise program, according to Medline Plus. The drug specifically works by activating something called GLP-1 receptors in your body, explains Mir Ali, MD, bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, California. This promotes the production of insulin in the body, which helps in blood sugar management. But one of the side effects is that it suppresses people’s appetite, Dr. Ali says.

Ozempic contributes to weight loss in two ways, Dr. Ali explains: It makes patients feel less hungry, and it also slows stomach emptying so they feel fuller, longer. Ozempic notes on its website that the drug can help you lose weight, noting that patients in clinical trials have lost up to 14 pounds with the drug.

The FDA has approved a semaglutide drug called Wegovy for weight loss, which is why Ozempic is often used off-label for this indication as well, says Dr. Ali.

So why am I not losing weight with Ozempic?

A lot has to do with lifestyle changes, says Christina Inteso, Pharm.D., clinical pharmacy specialist at Corewell Health. All of the FDA-approved weight-loss drugs, including semaglutide, are approved as an adjunct to a calorie-restricted diet and increased physical activity, she says. These drugs have been studied with lifestyle changes, more the drug.

If someone taking Ozempic doesn’t make lifestyle changes, such as eating a healthy, nutrient-rich diet and exercising regularly, they may not see the same weight loss shown in clinical trials, Inteso says.

I’ve seen this happen, more commonly than I’d like, where people think they can just take the drug, without making any changes to their eating or physical activity habits, and still lose 10 percent of their body weight, says Inteso. Although these drugs are effective, there is still no magic weight loss pill that allows it.

Dr. Ali echoes this sentiment. The common reason I see in patients not expecting weight loss [on Ozempic] is that they aren’t actually changing their diet.

While experts agree that a lack of lifestyle changes is the main reason someone might not see weight loss results with Ozempic, Dr. Ali says there could be a problem with the dosage.

Depending on how these drugs work, we start on a lower dose and work our way up over a period of months, she says. Some patients see results immediately; others must take a higher dose to see results. Dr. Ali says it can take several months to arrive at the right dose for any given patient.

There may be other factors at play as well, says Inteso. Sometimes people may not see any effects from the weight-loss drug, and that could also be because it’s not the right weight-loss drug for them, she says. For example, if someone struggles with food cravings, but is given a drug that makes them feel full, the cravings for food will still be present, and the individual may have difficulty fighting that craving even though they feel full.

How to lose weight with Ozempic

If you’re taking Ozempic or another semaglutide drug, Dr. Ali says it’s important to have a conversation with your doctor about what type of diet and exercise program is recommended for you, and to follow that guidance.

But if you feel you’re doing everything right, it’s a good idea to have another conversation to check in and see what might be going on. If someone is taking the maximum dose and still not seeing results, we need to reevaluate the situation, says Dr. Ali. We encourage them to keep a food diary and watch the types of calories they are getting. Talking to a dietitian or nutritionist about switching to a healthier diet is also usually recommended.

If you suffer from obesity and aren’t seeing the weight-loss results you want with Ozempic, Inteso says it could simply be that this isn’t the right drug for you. We know obesity is caused by a variety of factors, and things like your individual genetic makeup could be preventing you from losing weight, she says.

Basically, it’s important to talk to and continue seeing your doctor to help you achieve your goals.

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Every year, tens of thousands of Americans lose their lives in what experts have described as the “worst crisis the United States has ever faced.”

But it could become a thing of the past thanks to a new vaccine that would be given to high-risk drug users months or perhaps years before an overdose.

The vaccine – which will likely be given via several injections – essentially teaches the immune system how to stop opioids from blocking oxygen to the brain.

The researchers say they expect human trials to begin “in early 2024.” The fentanyl vaccine would be different from the antidote Narcan, which is given during an overdose and has already been approved by the Food and Drug Association (FDA).

In animal studies, including one published last July in the journal Nature npj Vaccines, the researchers were able to show that such fentanyl vaccines could be boosted with the addition of a second small molecule called an adjuvant.

But these tests will need to be safe and repeatable in humans before anyone can get in line for their own injections.

The team, led by researchers at the University of Montana, actually created two new vaccines, with the second targeting heroin overdoses.

Both heroin and fentanyl attack and dull the areas of the brain that control pain and emotion. But during an overdose, these chemicals deprive the brain of oxygen, killing neurons.

The new vaccines, similar to concurrent fentanyl vaccine research elsewhere, are designed to neutralize opioid chemicals with antibodies while these compounds are still in the bloodstream.

“Once safety and early efficacy are established in these early clinical trials,” said molecular biologist Jay Evans of the University of Montana (UM), “we hope to develop a combined multivalent vaccine targeting both heroin and fentanyl.” “.

America is currently in the midst of a fentanyl epidemic, with about 150 Americans dying every day from the synthetic opioid, according to the US Centers for Disease Control and Prevention (CDC).

The CDC estimates that of the 107,081 overdose deaths reported in the United States in 2022, more than two-thirds or more than 72,000 could be attributed to synthetic opioids such as fentanyl.

Evans, who also co-founded the start-up Inimmune designed to bring these drugs to market, has focused his UM team on creating more adjuvants, substances they hope will further boost the effectiveness of vaccines.

“Our adjuvants enhance vaccine response, providing stronger and longer-lasting immunity,” said Evans, whose official title is Director of the UM Center for Translational Medicine.

Evans’ UM team patented the INI-4001 adjuvant, which will be just one aspect of the final vaccine cocktail.

“We have worked closely with researchers from Inimmune, the University of Minnesota, the University of Washington, the Hennepin Healthcare Research Institute and Columbia University over the past several years to design and optimize opioid vaccines for the advancement towards human clinical trials,” he said.

The vaccine itself works by stimulating the T cells of the immune system to make antibodies that bind to fentanyl in the blood.

These immune proteins capture the drug as it enters the body and prevent it from spreading further and causing harm. It is then processed in the kidneys and excreted from the body.

‘Antibodies produced through active immunization with an opioid vaccine sequester the opioid in the blood and prevent it from crossing the blood-brain barrier,’ according to Dr. Marco Pravetoni, Evans’ research partner at the University of Washington where he directs the Center for Drug Development for Substance Use Disorders.

“The first vaccine will target heroin,” Evans said, “followed shortly by a fentanyl vaccine in Phase I clinical trials.”

These Phase 1 human trials, he noted, will be led by team collaborator Dr. Sandra Comer of Columbia University in New York.

Finding the right subjects, patients currently using fentanyl or heroin, could take six months or more.

And the process will have to proceed slowly to protect the health and safety of these human subjects.

Phase 1 trials, Evans said, will involve very gradual increases in vaccine dosage.

“We’ll start with the lowest dose, a dose that may not be effective,” Evans said.

‘Phase I clinical trials focus on safety. Once the first dose cohort is complete, a data safety monitoring committee reviews the data and approves testing at the next dose level if the vaccine is safe. The process takes time until safe and effective dosage levels are reached.’

Evan added that Dr. Comer and others will also follow study patients to assess “how long the antibodies to opioids will last.”

If such trials prove effective and safe, Phase 2 human trials will face the challenge of pinpointing details such as the number of doses needed for effective overdose protection and the appropriate time required between doses.

Next would come Phase 3: a large cohort study with many participants designed to help the FDA decide whether the life-saving benefits of the vaccine outweigh the possible risks from side effects.

But a similar vaccine, targeting prescription opioidoxycodone, is already paving the way for heroin and fentanyl vaccines.

Evans’ research partner, University of Washington’s Dr. Pravetoni brought the oxycodone vaccine into Phase I trials with Columbia’s Dr. Comer in 2021.

“Our vaccines are designed to neutralize the target opioid, sparing critical drugs such as methadone, buprenorphine, naltrexone and naloxone,” Evans noted, “which are used in the treatment of opioid addiction and overdose reversal.”

That needle is threaded by so-called “hapten” and “drug conjugate” vaccines developed by Dr. Pravetoni, which can stimulate the body’s immune system to produce antibodies only against target opioids.

While these findings have shown great success in animal tests and other lab-scale experiments, Evans cautioned that there are many regulatory steps that need to be taken before these vaccines can begin helping users currently at risk.

“It takes many years to get to an approved final product,” he said.

“Based on the efficacy data we see in our preclinical data and the established safety profile in animal models, we are very confident that these vaccines will be successful. But there’s still a lot of work to do.”

Reducing the cost of insulin in the US has been a great achievement, but we must, in Bidens parlance, finish the job. Ozempic and other brands of semaglutide cost five times as much in the United States as in other countries, or even more. Novo Nordisk researchers are serious about finding ways to help diabetics, but their sales department is just as greedy as the rest of Big Pharma. The other manufacturers of semaglutide products are just as greedy, but less successful in selling worldwide.

How do the prices of weight loss drugs in the United States compare to those in other countries?

Note: List prices in $USD based on web searches as of August 15, 2023. Prices are for one month’s supply of Ozempic 1 mg, Rybelus 7 mg, Wegovy 2.4 mg, and Mounjaro 15 mg. Some medicines are not available in all countries and it was not possible to find prices in other countries. Some drugs are approved for diabetes and prescribed off-label for weight loss.

These are the prices for a three month supply.

Future Diaries

There will be a lot of news about diabetes care and Medicare, continuous glucose monitors, a stupid lawsuit by Big Pharma against Medicare price negotiation, and more. I’ve been messaging Lynnekz to do a series on all of this on a Wednesday or Friday.

As a friend of the Good News group regularly says, I love living in the future. Today we celebrate Medicare’s ability to begin negotiating drug prices in the Good News Roundup and various other venues around DKos.

The opioid crisis has profoundly impacted communities across the United States, prompting a $50 billion opioid resolution framework approved by a consortium of Attorneys General and the US Department of Justice.¹ This landmark deal holds drug and health insurance companies accountable for their involvement in the opioid epidemic.

However, the picture could also have wider implications, potentially shaping the distribution of cannabis in large pharmacies and its integration into mainstream health plans. This article explores the potential impact of the opioid regulatory framework on the future of cannabis distribution and its role in healthcare.

Correlation between cannabis and opioid seizures

New and existing research has suggested a potential correlation between the availability of medical cannabis and a reduction in opioid-related deaths and overdoses.² As the opioid crisis continues, some states have legalized medical cannabis as an alternative option for pain relief and as a possible means of addressing opioid abuse. The Opioid Resolution Framework acknowledges this connection, providing an opportunity to consider cannabis as a potential pain management tool in mainstream health care.

Regulatory changes and legalization

The opioid resolution framework is still under evaluation and is broken down into 3 categories: (1) substantial multi-billion dollar settlements, (2) rehabilitation coverage, and (3) developing alternative diversion plans. This paves the way for further regulatory changes regarding cannabis.

As public opinion and popularity shifts towards legalizing cannabis, 68% of US adults are in favor of legalizing marijuana.³ This agreement could encourage more states to legalize medical and/or recreational cannabis. Establishing a legal precedent may facilitate legislative support for cannabis as a safer alternative to opioids for pain management.

For example, the Compassionate Care Act and similar laws in various states allow for the legal use of cannabis for medical purposes. These laws aim to offer legal protections and accessibility to cannabis for people suffering from specific medical conditions that its therapeutic qualities can alleviate. Importantly, these legal measures generally ensure that employees who are part of state-sanctioned cannabis programs are protected from being fired for their participation, and this aspect of the legislation is unlikely to change.

Cannabis in Big Box Pharmacies

The financial repercussions of the opioid deal framework are prompting pharmaceutical companies to explore diversifying their product lines, focusing on entering the medical cannabis market and potentially emerging as prominent suppliers. This transition is underway, especially evident in major pharmacy chains, which have reported nearly $1 billion in retail sales of CBD products.

When federal legalization eventually comes, these companies may consider adding medical cannabis items to their inventories to generate new revenue streams.⁴ This change could have a substantial impact on the distribution of cannabis, potentially improving its accessibility to the general public. However, consumers may face a significant challenge in the form of high tax rates, reaching as high as 37% in some states, placing a financial burden on cannabis users.

Traditional health plans to the rescue

The opioid regulatory framework has sparked debate about including cannabis in conventional health plans. With growing evidence supporting the therapeutic benefits of medical cannabis, health insurance companies are starting to incorporate coverage for cannabis-based treatments targeting specific conditions for which efficacy is well established. This supplementation has the potential to reduce patient expenses, making medical cannabis a recognized and viable option for medical care.

Research and development

Allocating funds in the opioid accord to fight addiction and support treatment centers can indirectly benefit cannabis research.5 With more financial resources available, scientists and researchers can conduct more comprehensive studies of medical applications, safety and on the efficacy of cannabis. This research could form a stronger basis for integrating cannabis into mainstream health plans to reduce the consumer’s out-of-pocket expenses.

Public perception and education

A major challenge in integrating cannabis into mainstream healthcare is overcoming public skepticism and misinformation. In light of the opioid regulatory framework, pharmaceutical companies could launch public education campaigns to educate the population about the medical benefits and risks of cannabis. Such proactive efforts could foster a more informed and welcoming environment for the inclusion of cannabis in mainstream health plans and large pharmaceutical companies.

Conclusion

The $50 billion opioid resolution framework marks a substantial step in addressing the opioid crisis in the United States. Beyond its immediate implications, this deal has the potential to affect how cannabis is distributed within pharmaceutical chains and how it finds its place in conventional health care plans.⁶

As awareness of the therapeutic value of medical cannabis grows among the public and policy makers, it becomes imperative to base decisions on robust evidence to ensure its safe and efficient integration into mainstream health care.

About the author

Frank Labrozzi, CEO of Novus Cannabis MedPlan, supplemental health insurance company.

References

1. US Department of Justice: Comprehensive resolution of criminal and civil investigations with opioid manufacturers. United States Department of Justice. Press release. October 21, 2020. https://www.justice.gov/opa/pr/justice-department-announces-global-resolution-criminal-and-civil-investigations-opioid

2. Balu A, Mishra D, Marcu J, Balu G. Medical cannabis certification is associated with decreased opioid use in chronic pain patients: a retrospective cohort study in Delaware. I care. 7 December 2021;13(12):e20240. doi: 10.7759/cureus.20240. PMID: 35004055; PMC ID: PMC8730800.

3. Jones J.’s views on marijuana related to ideology, religiosity, age. Gallup. November 15, 2022. https://news.gallup.com/poll/405086/marijuana-views-linked-ideology-religiosity-age.aspx#:~:text=Using%20this%20aggregate%2C%20Gallup%20finds, Gli Americans%20are%20i%20most%20 favorable.

4. Wiley JL, Gourdet CK, Thomas BF. Cannabidiol: science, marketing and legal perspectives [Internet]. Research Triangle Park (NC): RTI Press; 2020 April. Available from: https://www.ncbi.nlm.nih.gov/books/NBK565434/doi:10.3768/rtipress.2020.op.0065.2004.

5. Dentons: Cannabis Customer Alert Week July 7, 2023: Federal government considers further cannabis reforms for veterans. Press release. big teeth. July 7, 2023. https://www.dentons.com/en/insights/newsletters/2023/july/7/us-cannabis-newsletter/cannabis-client-alert-week-of-july-7th-2023

6. Shulman H, Sewpersaud V, Thirlwell C. Evolving global perspectives of pharmacists: medical cannabis distribution. Cannabis Cannabinoids Res. 2022 Apr;7(2):126-134. doi: 10.1089/can.2020.0144. Epub 2021 April 16th. PMID: 33998897; PMC ID: PMC9070745.

Phillips-Medisize, insidecollaboration with your client, Ascendis Pharma,has recently been recognized with a third industry award for the Skytrofa autoinjector.

The Red Dot Award recognizes the outstanding design and positive impact of the drug delivery device. The device is designed to allow for convenient and efficient preparation and administration of Skytrofa, a growth hormone treatment for children. The Red Dot jury praised the device for its ease of use and optics, as well as convenient and safe process control with a reduction in pharmaceutical waste.

Traditionally, children requiring growth hormone treatments were given daily injections which often led to non-adherence to treatment, due to pain and/or bruising with the injection, as well as a fear of needles. The introduction of the Skytrofa auto-injector has reduced the frequency of injections to once a week, using a discreet needle.

The device has previously received thePharmaceutical package Healthcare Product Award for Patient Centered Design in May 2022 and theParenteral Drug Association (PDA) Innovation Award.in October 2022.

How the Skytrofa autoinjector works

Skytrofa is aLyophilized powder available in a double chambered single-dose prefilled cartridge containing lonapegsomatropin-tcgd in one chamber and water in the other.

The cartridge is designed for once-weekly subcutaneous injection with the Skytrofa autoinjector. The delivery device provides fully automated reconstitution of lyophilized drug, followed by a device-controlled manual mixing step. The device automatically dispenses the drug after inserting the injection needle into the skin.

Integrated electronics and software assist the user through the entire preparation and injection sequence and confirm that the full dosage is delivered.

By making the device reusable and refillable, Phillips-Medisize and Ascendis Pharma did away with itthe waste of disposable injector pens and batteries with a full charge lasting four weeks, with one weekly injection. The life of the autoinjector is approximately four years or 210 injections.

John Christensen, Senior Contract Development Project Manager at PhilipsMedisize, recently spoke MD+DI a demonstration of how the Skytrofa auto-injector works (see video below).

Design considerations for the Skytrofa autoinjector

Paul Erik Fabricius, director of front-end innovation at Phillips-Medisize, said there were several key considerations when designing this device due to the intended user population (parents of young children needing growth hormone therapy ).

The team wanted the design to be visually appealing to children and found that the device’s bright white and green colors made it more appealing to this user population.

“We wanted to facilitate this very complex preparation procedure in a simple and safe way,” said Fabricius MD+DI. “This means both physically handling the device—for example, it needs to remain upright during reconstitution to ensure the drug isn’t lost through the needle—but it also needs to have a good grip when injecting.”

Phillips-Medisize conducted numerous usability studies with more than 300 participants who helped shape the design of the device. Participants included a mix of experienced and novice users, trained and untrained users, healthcare professionals and healthcare professionals.

It was especially important to test the device with inexperienced and untrained users, Fabricius said, to ensure it was as intuitive and simple to use as possible.

“It’s a challenge because, if you imagine, when you see the device, you don’t have any reference because you’ve never seen a device like it,” he said. “So, you start out with no prior knowledge of how to use it, so pretty much anything can go wrong. But we tested it with naïve and novice users, and they all successfully got their dose.”

Some of the users in these test groups thought the device actually had no needle because the 31-gauge needle is so thin they couldn’t even feel it.

In addition to in-depth usability studies, Fabricius said it is crucial to maintain an open dialogue with the customer throughout the device design and development phase.

“This has been a key thing to success here because things have come up in the process where we needed to change things,” he said. “For example, that manual mixing step that John showed you, we didn’t think it was necessary at first. But it was simply because we could see that the drug was not homogeneous after the stable mixing step.”

Could a new weight-loss drug open the door to anti-aging therapies?

Preparing for various conference presentations and not wanting to repeat last year’s talk, I wanted to see what was happening outside of our longevity industry to draw parallels to our industry’s progress.

Some of the questions I wanted to answer:

Are we at the peak of the longevity hype? Answer: No, not yet, but Bryan Johnson’s work is raising awareness of humans’ ability to roll back biological age. Kim Kardashian’s whole-body MRI is a harbinger of longevity awareness and, in fact, prompted us to launch our own survey of longevity clinics: You need to know what’s going on.

Will the FDA classify aging as a disease? Answer: still soo off if ever if needed.

But frame the question in a different way Will a longevity drug need FDA approval to be commercially successful? Answer: No, because all longevity drugs will have a positive effect on at least one disease of aging, they will eventually receive approval. If a drug is based on an aging pathway that demonstrates efficacy in more than one aging-related disease, then who’s going to complain? After all, it’s about more revenue for the pharmaceutical sector, more prescribing options for doctors, more patients under management, and less consequences of the diseases of aging for governments.

Longevity.Technology: Yes, system rejuvenation is the panacea for longevity therapies that turn back the clock in all cells and, therefore, organs. But what about a drug that addresses multiple diseases of aging, basing its aging mechanism on a recognized aging pathway, mechanism, or hallmark? Yes, that would work.

Semaglutide, sold under the brand names Ozempic, Wegovy and Rybelsus, and referred to in some markets as ‘skinny jab’, is the weight loss drug recently approved for use in the UK’s NHS for millions of people.

Not thousands, millions!

Used for the treatment of type 2 diabetes, Semaglutide is an anti-obesity drug prescribed to lose weight, but being overweight is not a disease (in most cases). Being old is also not a disease – an interesting parallel.

Based on the GLP-1 hormone, Semaglutide can be used for conditions other than weight loss; it has also demonstrated efficacy in improving symptoms related to heart failure in human studies [1]as well as neuroprotective properties in mouse studies, promoting DNA repair in neurodegenerative diseases [2].

So the “scarce” drug eliminates diabetes, cardiovascular diseases and potentially neurodegenerative ones: a drug for longevity?

In the United States alone, these age-related diseases cost $363 billion, $470 billion, and $361 billion, respectively, each year.

The U.S. Food and Drug Administration has already approved Wegovy (Semaglutide) Injection (2.4 mg once weekly) for chronic weight control in obese or overweight adults with at least one weight-related condition (such as high blood pressure of type 2). diabetes or high cholesterol) [3].

Injected weekly, the drug must be prescribed by a specialist; a similar drug, liraglutide, marketed as Saxenda and made by the same company, is already available, but must be injected daily [4].

So what does this have to do with the longevity industry? Well first, the longevity revolution will be a slow revolution, success may creep up on us with Semaglutide, perhaps this creep may have already begun.

Since development cycles are so long in the therapeutic industry and the struggle to bring a compound to market through safety and efficacy is so daunting, don’t expect a big bang any time soon.

Consider the switch instead. Switch the weight loss theme to an aging theme in these August 2023 Financial Times headlines and you’ll get an idea of ​​how successful longevity therapy will pan out once it gains market attention and peak of the hype:

Weight Loss Drugs: Will Health Systems and Insurers Pay for the ‘Lean Jabs’?
Anti-aging drugs: Will health systems and insurers pay for the ‘longevity shots’?

Chinese pharmaceutical makers are developing copycat versions of the “wonder” weight-loss drug
Chinese pharmaceutical manufacturers are developing copycat versions of the longevity ‘miracle’ drug

Do Big Pharma Get Longevity?

Give me a ‘hell yes’. Our team works with the investment arms of Tier 1 pharmaceutical companies through our separate investment brokerage operation, they are interested in longevity biotechnologies working on aging pathways and diseases. Just check Novo Nordisk’s share price to see the benefits (or even) the potential for future approvals and orders.

It’s not often you have a 100-year-old company and still grow at 30%, Novos chief executive Lars Fruergaard Jrgensen told reporters. The company now expects sales to grow 27-33% this year and operating profit to rise 31-37%. [5].

As this drug and others make their way to market and researchers test their effectiveness in targeting other diseases related to aging, we will see the biotech longevity thesis play out in national health care systems and clinics around the world.

To revisit the questions I wanted to answer:

Are we at the peak of the longevity hype? Not yet, but Semaglutide is an interesting example of how things could be.

Will the FDA classify aging as a disease? As Semaglutide proves, you don’t have to.

[1] https://www.bhf.org.uk/what-we-do/news-from-the-bhf/news-archive/2023/august/wegovy-weight-loss-drug-has-benefits-for-people- with heart failure and obesity
[2] https://pubmed.ncbi.nlm.nih.gov/30741689/
[3] https://www.fda.gov/news-events/press-announcements/fda-approves-new-drug-treatment-chronic-weight-management-first-2014
[4] https://www.telegraph.co.uk/lifestyle/wellbeing/diet/11367203/Daily-injection-that-is-better-than-dieting-or-exercise-on-NHS-soon.html
[5] https://www.ft.com/content/710c1048-7717-4553-a831-9e13ff27fb6c

The opioid overdose antidote Narcan will be available over the counter in the coming days, a move that is hoped to increase access to the life-saving drug in the context of the country’s worsening opioid epidemic.

Emergent BioSolutions, which makes the drug, said Wednesday that shipments were on the way to major retailers, including Walgreens, Walmart, Rite Aid and CVS. It may also be available to purchase online from select companies this week.

Dr. Scott Hadland, an addiction specialist at Mass General for Children in Boston, said the shift to over-the-counter drugs will help spread Narcan, make it more normal for people and their families to carry around and have a home for safety, which is critical to reducing the growing number of overdose deaths occurring nationwide.

The drug’s cost, however, $44.99 for a two-dose box, may make it out of reach for some.

Unfortunately, for many people who are living with addiction or want to protect a loved one living with addiction, this cost will be too high, Hadland said. I know, because I see it in my own practice, where drugs that cost this much are just out of reach.

Overdoses are the leading cause of accidental death in the United States and the fourth leading cause of death overall in the country. In 2021, according to the Centers for Disease Control and Prevention, there were more than 107,000 overdose deaths, an all-time high. Fentanyl, a potent synthetic opioid, was involved in more than 71,000 of these deaths.

Narcan can quickly reverse overdoses of fentanyl and other opioids, including heroin and prescription pain relievers.

It was previously prescription-only, although many states created workarounds that allowed people to get it directly from pharmacists. In many places, it is also available free of charge at community centers, local health departments, and needle exchange programs.

The Food and Drug Administration’s approval of Narcan for over-the-counter use this year means it can be sold in even more places, including convenience stores, airports, and even vending machines.

Emergent will ship several hundred thousand boxes of Narcan to major retail chains in the first week, followed by more boxes to smaller chains in September, said Paul Williams, senior vice president. Any company wishing to supply the drug can purchase it directly through a wholesaler.

In addition to being available on store shelves, the product will be available for online ordering, which is important for those who don’t want to interact with other people to get the drug.

The time is right, Williams said of the shift to over-the-counter use, particularly in the past two years with the number of opioid-related deaths rising significantly.

Tricia Moriarty, a spokeswoman, said Walmart will have over-the-counter Narcan in some of its stores and online as early as this weekend.

Walgreens will begin selling the over-the-counter version in some of its retail stores on Sept. 5, followed by the entire fleet on Sept. 7, said Dr. Kevin Ban, its chief medical officer.

However, Narcan will not be sold directly on Walgreens shelves. Instead, people who want to buy it will need to get a card from the pain management section and give it to an employee, who will then supply the drug, Ban said. Walgreens has taken a similar approach with other products, including Sudafed.

Heather Saunders, postdoctoral researcher in the Medicaid and the Uninsured program at KFF, a nonpartisan group that studies health policy issues, said offering Narcan over-the-counter has the potential to reduce stigma around opioid use. , but that its price raises concerns.

Insurance, he said, typically doesn’t cover the cost of over-the-counter products.

At around $45, its cost may be too high for many, including friends and family who wish to carry Narcan with them as a precaution.

Williams, of Emergent, said many people will still be able to get rid of Narcan from community organizations and local health departments.

The opportunity to have Narcan available in the form of what retailers can supply, online and expanding, is critically important, he said.

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How does psilocybin, a psychedelic substance that remains illegal in the vast majority of the United States, compare to the frequently prescribed SSRI Escitalopram to treat depression?

According to the results of a study published by the Cambridge University Press last June, pretty good. But not so much that the hallucinogen turned out to be that superior.