CHARLESTON, W.Va. — For decades, Jeff Card’s family company was known for manufacturing the once-ubiquitous tin boxes in which people could buy newspapers on the street.
If you reach into one of his containers today, you might find something completely different and free. That is naloxone, an opioid overdose reversal drug.
More than a year after the U.S. Food and Drug Administration approved the drug for sale without a prescription, distribution containers of naloxone have proliferated across the United States. Naloxone, a nasal spray best known as Narcan, is used as an emergency treatment to reverse drug overdoses.
Boxes like these are placed in front of neighborhoods, hospitals, health departments, and convenience stores to help people who support people with substance use disorders get Narcan, which costs about $50 over the counter, to those who need it most. This is one of the ways we are trying to make it possible. . Unlike small free libraries that hand out books to those who request them, the metal boxes once used as newspaper holders are not locked and there is no need to pay. People can take as much as they think they need.
Supporters say the packaging helps normalize medicine and is evidence that the stigma surrounding its use is steadily decreasing.
Sixty Narcan containers were distributed to 35 states in honor of Thursday’s Save-A-Life Day, a naloxone distribution and education event launched in 2020 by a West Virginia nonprofit. The container was purchased from Card’s Texas-based Mechanism Replacement & Repair Company, which is still in service. Initially a newspaper customer, the company expanded into manufacturing other products as the newspaper industry declined.
“It’s both fortunate and unfortunate,” said Card, who started making Narcan containers more than two years ago. “We’re lucky to have something to build on, but it’s unfortunate that this is what we have to build on, given how serious America’s drug problem is.”
Opioid deaths were already at record levels before the coronavirus pandemic, but skyrocketed when the pandemic hit in early 2020. The Centers for Disease Control and Prevention estimates that there were approximately 85,000 opioid-related deaths in the 12 months ending in April 2023. Since then they have fallen. The CDC estimates 75,000 infections in the 12 months ending in April 2024, still higher than at any point before the pandemic.
The reasons for the decline are not fully understood. But that’s because Narcan, a drug that has been difficult to obtain in some areas, is now available over-the-counter, and more money is being spent from legal settlements between governments and drug companies, wholesalers and pharmacies. It’s consistent with what I did.
The U.S. Food and Drug Administration approved the use of Narcan to treat overdoses in 1971, but its use was limited to emergency personnel and hospitals for decades. Narcan nasal spray was first approved as a prescription drug by the FDA in 2015, approved for over-the-counter sale in March, and sales began at major pharmacies last September.
“That removed a barrier. That’s when we realized, ‘Okay, now we need to increase access.’ How can we get naloxone to our communities? ” said Caroline Wilson, a social worker and survivor in West Virginia who coordinated this year’s Day to Save Lives.
Last year, all 13 Appalachian states participated in the day, led by West Virginia nonprofit Solutions Oriented Addiction Response. Community groups in hundreds of counties are setting up tables in parking lots and outside churches and clinics to hand out Narcan and fentanyl test strips and train people on how to use them. They are also working to educate the public about the myths surrounding the drug, including that it is dangerous to keep it in easily accessible areas. Narcan is not effective for people who use Narcan without having opioids in their system.
This year, the effort has expanded to 35 states and, with the theme “Naloxone Everywhere,” the group sent 2,000 emergency kits containing one dose of Narcan and placed them in locations such as convenience store restrooms and parks. Sixty tin newspaper boxes (sold for about $350 each) were purchased with grant money.
Aonya Kendrick-Barnett’s Harm Reduction Coalition Safe Streets Wichita installed one of Kansas’ first Narcan containers, which she calls a “Narox box,” in February. Boxes currently sold by several different companies may also look different. Some look like newspaper boxes, others like vending machines.
Since installing the Narcan containers in the vending machines, access to medicines is as simple as entering a postal code on a keypad, and approximately 2,600 packages have been distributed per month.
“It’s very bold in this Bible Belt state to say, ‘Hey, we have vending machines that are open 24 hours a day, so you can come over here and get what you need. Don’t criticize.’ And it helps break down the stigma,” she said. she said.
Kendrick-Barnett said she has no judgment about life-saving medical care, saying, “People are going to use drugs. It’s not our job to condemn or condone that. Our job is to make sure they get the medical care they need to survive.”
The “Save a Life Day” boxes her organization received will be placed in front of the new clinic, which is scheduled to open in October.
In Eerie, Pennsylvania, stained glass artist Larry Tuitt, 74, said he became concerned after seeing an increase in overdoses in the city. He began placing Narcan packages in the windows of the town’s 24-hour market, which sells products such as pipes and rolling papers. He was shocked that they disappeared so quickly.
“Even if we give out a lot, we’ll use it up quickly,” said Tuite, who has cases of drugs stacked up along the walls of her studio apartment.
The “Save a Life Day” containers he has permission to place outside such stores are helping disperse even more Narcan. At least a dozen people were saved by the medicine he distributed, he said.
Tasha Withrow, a recovering woman who runs a harm reduction coalition based in Putnam County, West Virginia, said she didn’t have access to Narcan when she was using opioids.
“People can reach out and get what they need. That didn’t happen back then,” she said while stocking up on shipping containers in a residential area earlier this week. “We’re happy to see that we’re actually getting access to it and that we’ve at least made a little bit of progress in that direction.”
— Leah Willingham Associated Press
AP journalist Jeff Mulvihill contributed to this report.
