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Health workers put 'naloxboxes' with overdose reversal drug in St. Louis neighborhoods

A clear naloxbox shows doses of Narcan, a breathing barrier and an instruction sheet inside.
Sarah Fentem
St. Louis Public Radio
A naloxbox contains doses of the opioid overdose reversal drug naloxone, instructions and a barrier for rescue breathing. Health advocates say they would like the boxes to become as ubiquitous as a fire extinguisher or automated external defibrillator.

Health workers in St. Louis will soon be placing dozens of life-saving “naloxboxes” in St. Louis and St. Louis County neighborhoods where there are many opioid drug overdoses and few clinics and hospitals.

The clear boxes are about the size of a large shoebox and are designed to be hung on a wall like an automated external defibrillator. They contain instructions, a breathing barrier for mouth-to-mouth resuscitation and two doses of the overdose reversal drug naloxone — also known as Narcan.

“We have to bring public health solutions into the community, instead of continuing to use models where residents come to us or other health care providers,” said Dr. Mati Hlatshwayo Davis, St. Louis' health director.

Missouri recordedmore than 900 overdose deaths in 2021. Black men and womenare dying more than white people of drug-related deaths, Hlatshwayo Davis said.

Naloxone has saved countless lives, health officials said. It’s one of the most powerful tools to use against the ubiquity of fentanyl, the potent opioid that has infiltrated the country’s drug supply.

The nonprofit PreventEd and the community health clinic People’s Health Centers are enlisting local groups to decide where to hang the 100 boxes. They’re designed to work like a fire extinguisher: readily available, easy to find and free to use in an emergency.

St. Louis-area resident Pooja Reddy asked PreventEd to consider installing the boxes when she was a student at Lafayette High School. Reddy served on the PreventEd board as a teen representative and had seen the boxes introduced in other cities.

PreventEd Deputy Executive Director Jenny Armbruster envisions the boxes being placed in recreation centers, laundromats, gas stations and other public places.

When it comes to responding to an overdose, speed is crucial, she said. Naloxone is available at pharmacies and clinics. Emergency medical teams and law enforcement carry the medicine with them.

But that doesn’t matter if people aren’t using it, Armbruster said.

“It’s not good enough to be sitting on a shelf somewhere in a storage room, or available at a pharmacy,” she said. “ We need to make sure it’s available in the community, because we know overdoses happen in communities.”

PreventEd will place most of the boxes in Dutchtown, Spanish Lake, Baden and other St. Louis neighborhoods with high rates of opioid overdoses. A small number will also be sent to parts of north St. Louis County, PreventEd officials said.

Hanging a box on a wall for everyone to see shows there are people who care about those who use drugs, said Rashonda Thornton, a counselor at Living with Purpose, one of the organizations that will help place the boxes around the city.

“Individuals that use any type of substance have always been looked at as under classed, underprivileged, underserved,” she said. The boxes “put a picture out there that overdose matters, overdose awareness matters.”

Follow Sarah on Twitter: @Petit_Smudge

Sarah Fentem is the health reporter at St. Louis Public Radio.