In the first statewide program of its kind, New Hampshire will be placing more than 700 public units around the state that give public access to medication that can reverse opioid overdoses.
The program will use NaloxBoxes, a program developed in Rhode Island that is organized like publicly accessible defibrillators. The transparent acrylic boxes hold naloxone distribution units, in this case 4-milligram nasal sprays, that can be used by anybody to reverse an opioid overdose. Naxolone is the drug used in Narcan; its over-the-counter use in nasal sprays was approved last month by the Food and Drug Administration.
Mounted in public places and ready to be used by anybody, NaloxBoxes are designed to not only save lives of people suffering from an overdose but to “normalize access to naloxone, which can reduce the stigma often associated with opioid overdose,” the Department of Health and Human Services wrote in a press release.
“The data is clear: Administering naloxone at the first sign of an overdose can save lives,” said DHHS Chief Medical Officer Jonathan Ballard. “During a medical emergency, every minute counts, and providing public access to life-saving medication that can reverse the impact of an overdose while it is occurring is a critical step in reducing the number of lives lost to substance use disorder.”
While hundreds of NaloxBoxes have been sold and installed around the country, New Hampshire’s effort is the first coordinated statewide program, said Brooke Lawrence, executive director of the non-profit Naloxbox.org.
“It’s a lot of grass-root efforts, a lot of county health departments, non-profit organizations who are working locally. New Hampshire took it to the next level,” Lawrence said.
The models, called vertical NaloxBoxes, are closed with a breakaway security seal that can be opened by hand. It includes a red tag that gets broken whenever the box is opened.
“You can walk by and see the tag is there, know that the system is intact,” Lawrence said.
Many of the NaloxBoxes are placed alongside public defibrillators, which can save heart-attack patients.
“It’s the same strategy: wherever there’s an AED (automated external defibrillator), there should be a NaloxBox,” said Lawrence. He noted that it is also possible to add a hemorrhage control box, which contains bleeding-control kits, to creat an emergency control center.
About 400 people die from opioid overdoses in New Hampshire each year, according to state statistics. Deaths have spiked this year because a more potent form of fentanyl is circulating: in February, for example, Manchester and Nashua saw 18 opioid deaths between them, the most in any one-month period since tracking began in 2015.
Opioids are far deadlier than any other illicit drug in the state, causing 10 time the number of fatalities compared to cocaine and 6 times as many as meth.
Health and Human Services will partner with the state’s 13 regional public health networks, the New Hampshire Harm Reduction Coalition, and Recovery Friendly Workplace locations to distribute the units.
Businesses or organizations wishing to install a NaloxBox can contact State Opioid Response Director Jennifer Sabin at Jennifer.A.Sabin@dhhs.nh.gov. First responders, families, caregivers, and other individuals who would like access to naloxone for individual purposes can reach out to their local Doorway. Each NaloxBox costs $275, according to the website; the expense will be covered by the State Opioid Response funding.
Naloxone is an opioid receptor antagonist, meaning that it blocks opioid receptors, the cells that attach to opioid molecules and produce effects in the body.
NaloxBoxes include bilingual instructions and a mask so the caregiver can assist with breathing or provide full CPR.
