Seconds count for someone facing an opioid overdose, and the availability of naloxone, also known as Narcan, can be crucial.

In the past, however, factors such as limited funding and few training opportunities have hampered efforts to get the lifesaving drug to Hoosiers who needed it most. Now, acrylic boxes, emblazoned with the red letters “Opioid Rescue Kit” and containing free multiple doses of naloxone overdose-reversal medication, are available across Indianapolis and elsewhere in the state. They are part of a statewide program coordinated by Overdose Lifeline and the Division of Mental Health and Addiction of the Indiana Family and Social Services Administration.

Where to find rescue kits in Indianapolis

The Overdose Lifeline website shows more than 70 NaloxBoxes in use within a 10-mile radius of downtown. 

The boxes are attached to outside walls near the entrances to public buildings, including Salvation Army locations, Indianapolis Fire Department and Indianapolis Metropolitan Police Department branches, Eskenazi Health Centers, and some local government offices, community organizations, small businesses and houses of worship. 

Vending machines that carry up to 300 naloxone kits are also available at the Marion County Jail, 675 Justice Way, and other locations in the city. 

The Marion County Public Health Department also offers free Narcan kits containing two nasal sprays each. The free Narcan kits — and training on how to administer the drug — are available through the department’s Substance Use Outreach Services program, 1650 N. College Ave., which can be contacted at 317-221-4618. 

Overdose Lifeline also supplies quantities of naloxone to partnering community organizations, which then distribute the drug directly to populations they serve. 

How to get training for NaloxBoxes

The NaloxBoxes include instructions for use of the drug as well as referral information for treatment of substance use disorder.

The clear boxes provide six to eight free doses of the Narcan nasal spray and are available 24/7 to the public. The boxes will be restocked regularly, according to Indiana Health Centers.

In addition to the Marion County Public Health Department’s training, the Overdose Lifeline website lists numerous training opportunities to share information about naloxone and help provide certifications for everyone from medical professionals to first responders to everyday citizens.

Justin Phillips, founder and CEO of Overdose Lifeline, said many people in Indiana received training on administering naloxone through her organization. That includes self-paced online courses, on-site and virtual training sessions for groups of five or more, naloxone training for school personnel and a layperson trainer program to increase community and staff training efforts. The trainer program shows participants how to recognize the signs of an opioid overdose, demonstrates how to administer naloxone and offers overdose prevention tips for people who use drugs.

Acting quickly is vital

It’s important to act quickly in an opioid overdose, since it can overwhelm a person’s nervous and respiratory systems, causing them to fall unconscious and stop breathing. A dose of naloxone typically works within five minutes, according to Indiana Health Centers, and, because there is no maximum dosage, it can be given over and over until a person wakes up. Such repeated doses of naloxone may be necessary for long-lasting or extremely potent forms of opioids, such as fentanyl, says the American Addiction Centers, so it’s also crucial to call 911 as soon as possible.  

The need for naloxone is real in Indiana, where more Hoosiers die from prescription drug overdoses each year than in motor vehicle accidents, according to the Indiana State Department of Health. A state health department report in 2019 noted drug overdose deaths in Indiana have risen for almost two decades with a loss of more than 15,000 Hoosier lives from drug overdoses since 1999. Another state health department report in October 2021 said there was a 41% increase in drug overdose deaths in 2020 and a 66% increase in EMS naloxone administrations across Indiana that year.

Access hasn’t always been easy

However, it wasn’t always easy to get or to administer naloxone, even though a version of the drug that could be injected into muscles was approved to treat overdoses more than 50 years ago. An easier-to-use, nasal-spray version of naloxone was approved by the Food and Drug Administration in 2015.

“When we started our organization in 2014, you couldn’t get naloxone over the counter without a prescription,” said Phillips of Overdose Lifeline. 

That changed in 2015, when Aaron’s Law — named after Phillips’ son, Aaron Sims, who died of a heroin overdose in 2013 — allowed people with substance use disorders, family members and friends access to get access to naloxone at pharmacies without a prescription. The law now also allows organizations to register with the state health department to distribute naloxone without a prescription.

Another hurdle to making naloxone more available had been the cost. In 2016, an injectable dose of the drug could cost $40 or more and the nasal spray could cost twice that much, putting it out of reach of many Hoosiers.

“We have distributed naloxone since 2015, but we didn’t have dedicated funding to do so until 2020,” Phillips said.

State funding has increased access

In May 2020, Overdose Lifeline first received funding from the state to increase access to naloxone. 

In February 2021, Gov. Eric Holcomb announced a plan to place NaloxBoxes in all 92 counties, an effort which Overdose Lifeline is overseeing. This May, Indiana Health Centers announced that it would expand access at all of its health centers and WIC locations across the state. 

According to Phillips, the majority of naloxone available in Indiana is now distributed by her organization, adding that Overdose Lifeline now provides 6,000 doses a week to organizations statewide.

Anonymity is key

The increase in NaloxBoxes may have made a lack of availability a thing of the past. But the challenge now is getting the word out to the people who need it most.

Anyone who wants to access a NaloxBox can do so without an appointment or identifying themselves.

That anonymity is key to its success, Phillips said, because the embarrassment that people with addictions can experience often dissuades them from seeking help or treatment.

“Not everyone wants to engage with a human being because of the shame and stigma attached to substance use disorder,” she said. 

Dwight Adams is a contributor for Mirror Indy. Contact him at hdadams0621@gmail.com.