All 50 states allow individuals to buy naloxone at the pharmacy without a prescription. States don’t have the authority to designate it as an over-the-counter medication, but they’ve created workarounds — such as a state health official writing one prescription that can be used for every resident. But these workarounds don’t apply to organizations that purchase naloxone in bulk from drugmakers.

When a hospital, harm-reduction group or any other organization orders naloxone from pharmaceutical companies, the companies are required to treat naloxone the way the federal government sees it: as a prescription medication, Dasgupta said. As a result, the companies impose a series of requirements on buyers.

For example, an organization that orders naloxone must have a doctor sign for the order, and that doctor must be someone who has not signed for another group. The organization must also have an address that is not a private home to receive shipments, a medical or pharmacy license and the ability to comply with regulations for storing and dispensing the drugs.