Back to Newsroom

Nasal naloxone spray: Nowhere to be found 

Why isn’t this easy-to-use, life-saving drug available to more people?

October 2, 2025

Pharmacies in Vancouver’s Downtown Eastside, both big and small, are out of nasal naloxone — the life-saving spray that reverses opioid overdose. London Drugs confirmed the shortage over the phone, while Owl Drugs and Jeff’s Pharmacy confirmed in person. 

When Megaphone asked why, it was told there hadn’t been enough people wanting to purchase the life-saving spray. Instead, those who are wanting to access naloxone are typically given one option — the injectable version.   

But for many people, injectable naloxone can be intimidating to use. The free kits require several steps: giving rescue breaths, drawing the medication into a syringe, locating an appropriate injection site — usually a thigh or upper arm — and inserting the needle. In the high-stress moments of witnessing an overdose, these instructions can feel nerve-wracking and slow. It’s a major barrier.  

In one case, a friend of mine was given nasal naloxone spray from a major Canadian pharmacy chain, only to discover it was three years past its expiry date.  

The shortage of nasal Narcan in Vancouver’s Downtown Eastside is raising alarm among harm reduction advocates, who say the life-saving spray is easier for bystanders to use than injectable naloxone, especially in high-stress emergencies.  

The spray is currently provided free to Indigenous Peoples through the provincial First Nations Health Benefits program and a pilot project with the BCCDC Take Home Naloxone program — leaving non-Indigenous drug users who want the nasal version to pay steep out-of-pocket costs, if they can find it at all.  

With pharmacies out of stock, expired doses appearing on shelves and many too intimidated to administer injectable naloxone, some are questioning whether this aspect of the health care system is failing the very people it’s meant to protect. 

Who gets free nasal naloxone — and who doesn’t 

According to the Government of Canada, the easy-to-use nasal naloxone spray can bring someone back from an opioid overdose within two minutes. Just administer one spray into one nostril, and repeat if necessary. It’s the preferred choice for frontline workers and drug users because it’s quick, needle-free and easier to use in chaotic situations.  

But for most people in B.C., it’s out of reach. The province provides the spray free only to First Nations individuals through the First Nations Health Benefits program. Eligible people can pick it up at community pharmacies by giving their Status number and Personal Health Number — no prescription needed.  

Everyone else must pay out-of-pocket costs. A two-dose box of nasal naloxone for non-Indigenous people is around $125. Whereas, an injectable take-home naloxone kit costs about $35 for two doses.  

I’ve heard some drug users say this two-tiered system is unfair, especially during an ongoing toxic drug crisis. Others question whether the policy rests on a discriminatory assumption — that non-Indigenous people are more able to use injectable naloxone.  

Frontline workers say the spray is worth the price: it’s faster to use, carries no risk of needle-stick injuries and can be administered by anyone with minimal instruction — making it especially valuable for bystanders in emergencies. 

“The only downside,” explained a local EMS worker, “is that withdrawal symptoms from nasal naloxone can be much more intense.” 

They noted that the spray delivers a dose up to four times stronger than injectable naloxone, which can make the experience of withdrawal far more severe and overwhelming for the person being revived. 

Spray has longer shelf life 

A 2022 study found that properly stored nasal naloxone spray remained effective for at least 10 months past its labelled expiry date. Reflecting this evidence, Health Canada in 2024 directed major manufacturers to extend the official shelf life of nasal sprays from three years to four.  

Even so, it’s alarming that a major pharmacy handed my friend a spray already three years past its expiry date.  

Under B.C. law, “a person must not sell a drug after a date on which the drug is indicated or labelled to expire.” The College of Pharmacists of British Columbia also requires pharmacies to remove expired medications from their shelves and dispose of them properly. 

In this case, the sale wasn’t just negligent — it was against the law. 

When Megaphone asked the pharmacy whether it’s possible they sold out-of-date nasal naloxone to a patient, they responded:  “Are you sure that wasn’t from somewhere else? We check all our medications for accuracy and expiry dates before we release them to our customers. It must have been from somewhere else.” 

In an emailed response to queries, the B.C. Centre for Disease Control told Megaphone it is not aware of any shortages or supply chain issues affecting nasal naloxone. Narcan, a widely used nasal naloxone brand, also confirmed there was no shortage of their product in Canada. 

Megaphone also reached out to Health Canada, which declined to comment. 

A case for furry friends 

In Vancouver’s Downtown Eastside, pets are often a person’s closest companions. Unfortunately, it’s not uncommon for animals to accidentally overdose after sniffing or coming into contact with drug paraphernalia. 

Administering injectable naloxone to small pets is intimidating and generally not recommended unless you are a veterinarian, have been trained by one or have no other options to try to save an animal’s life. 

Some people may not have the calm mindset needed to be able to give an injection to their fur baby, or someone else’s. 

When my cat slipped out into the hallway of my Downtown Eastside SRO, he was gone for less than a minute. I quickly brought him back inside, but within seconds I could tell something was seriously wrong. He hadn’t wandered far from my door, but there’s a garbage can kept just outside that isn’t cleaned often enough. Thankfully, he was OK. 

Greater availability of nasal naloxone would not only save more human lives but also make it easier for pet owners to help their animals during accidental overdose emergencies.   

Jules Chapman was born and raised in Vancouver and has been living, working and surviving in the Downtown Eastside for more than 20 years. She is one of The Crew, a.k.a. Research 101 co-authors, and works part-time for Vancouver Coastal Health. She has been a Megaphone vendor since 2003. She is a published poet and writer, and is a member of The Shift peer newsroom.  

Published in Megaphone magazine on October 3, 2025