From 2019 to 2022, access to naloxone grew in every state except New Mexico, where it shrank, and New Hampshire, where it stayed the same. In California, an additional 0.1 prescriptions were doled out per 100 residents, below the national average.

California provided 0.6 naloxone prescriptions per 100 residents in 2022, compared to 0.5 prescriptions nationwide.

Overall, naloxone prescriptions per resident remain much lower than buprenorphine due in part to the different purposes each drug serves. Naloxone is used in emergencies and is not prescribed as a medication to take on a routine basis. In addition to over-the-counter purchases, the drug is distributed through public health programs and emergency care outside traditional prescription avenues. Buprenorphine, on the other hand, is dispensed only by health care providers for long-term opioid use disorder treatment to ease withdrawal symptoms and cravings, often necessitating refills on a regular basis for complete treatment.

Cost is also an issue. A two-dose packet of Narcan runs just under $50 at many drugstores, and like most over-the-counter drugs, insurance doesn't cover it. While a lifesaving measure might seem worth the price tag, $50 is prohibitive for some. To help reach communities in need, there are several resources available for free naloxone supplies and emergency kits.

Despite efforts to reduce the stigma around substance-related disorders, walking into a Walgreens or CVS and purchasing overdose medication might be challenging for those with OUD.

However, the use of lifesaving treatments is imperative as the opioid epidemic continues to take its toll. Obsolete and incorrect beliefs about the nature of addiction, which liken the disease to moral failure, can prevent people from seeking help and hinder the development of health and public policies. In contrast, a punitive approach to OUD can increase drug use by dehumanizing those who need help while failing to address the underlying cause of the disease.

Medication-based treatment has not been a first line of defense in treating opioid misuse disorder long-term. According to a study by the National Institutes of Health and CDC, just over 1 in 5 adults with opioid use disorder received medication-based treatment, namely buprenorphine, methadone, or naltrexone, in 2021. The study also found that Schedule III, II, and unscheduled drugs, respectively, were dispensed for substance use treatment 38 times more often when it was a telehealth appointment.

California distributed 1.6 buprenorphine prescriptions per 100 residents in 2022, up 0.3 prescriptions since 2019. The national prescription rate is 4.8 per 100 residents, up 0.1 from 2019.

West Virginia leads in prescriptions per capita, which have increased by 4.4 prescriptions per 100 residents to reach 27.2—over a quarter of the state's total population. Indiana, whose capital city is a national hot spot for opioid overdoses, saw the second-highest increase in buprenorphine prescriptions, reaching 10.7 per 100 residents in 2022.

Despite having the second most overdoses due to opioids, Washington D.C. issued an average of 1.5 fewer prescriptions per 100 people. Prescriptions fell the most in Vermont by 3.1 overall, dropping from 28.6 per 100 people to 25.5 per 100 people. In 2021, the state became the first to decriminalize buprenorphine possession in limited quantities. In a promising outlook for this harm reduction strategy, Vermont is experiencing a three-year low in opioid overdose rates based on 2024 data so far.

This story features data reporting by Paxtyn Merten, writing by Colleen Kilday, and is part of a series utilizing data automation across 50 states and Washington D.C.