San Francisco board member wants to mandate pharmacies carry naloxone as overdose cases grow

Amid an ongoing overdose crisis, San Francisco Supervisor Matt Dorsey said he wants to mandate that all retail pharmacies in the city carry naloxone which, if administered on time, can reverse the effects of an opioid overdose.

Dorsey proposed on Tuesday the mandate that would require every retail pharmacy in the city to carry at least two boxes of naloxone. Pharmacies not in compliance could face a $1,000 fine.

“Although a majority of pharmacies in San Francisco stock naloxone, mandating that it be carried by all retail pharmacies all the time is an important step we can take to maximize its availability and help save lives,” Dorsey said in a release.

Dorsey introduced the legislation at Tuesday’s Board of Supervisors meeting. The measure must be approved by the board at a later date.

The proposal comes a few months after the FDA approved the Narcan brand of naloxone for over-the-counter, nonprescription purposes. The approval would allow anyone to buy Narcan, which comes as a nasal spray, directly from a pharmacy.

In California, naloxone can already be dispensed by a pharmacist upon request.

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The FDA ruling is expected to go into effect later this year as San Francisco continues to experience a wave of opioid overdoses, with 2023 on pace to see the most fatal overdoses in the city’s history.

Between January and May of this year, 275 people have died of fentanyl overdoes, according to the San Francisco medical examiner’s office. During the same period in 2022, the city reported 168 fatal fentanyl overdoses.

“Even with Narcan set for over-the-counter sales later this year, we know that some retailers’ hesitation to engage consumers around illicit drug use is preventing the market from facilitating what should be universal access,” Dorsey said.

”...[Recently], a ‘secret shopper’ survey conducted by the San Francisco Department of Public Health found that approximately 20% of local retail pharmacies surveyed did not have naloxone in stock, despite having legal authorization to provide it on request,” Dorsey’s office said in a release.

Walgreens, which in May agreed to a $230-million settlement with San Francisco over opioid prescriptions, and grocery store chain Safeway said they support the mandate.

“Walgreens believes that saving lives from deadly opioid overdoses is a shared responsibility amongst all public health stakeholders,” Perry Han, Walgreens regional vice president, said in a release.