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Emergency opioid overdose boxes installed at Cuyahoga Metropolitan Housing Authority residences

The NaloxBoxes, similar to AED boxes, are being installed in a dozen Cuyahoga Metropolitan Housing Authority buildings.
The NaloxBoxes, which are mounted to walls like AED boxes, are being installed in a dozen Cuyahoga Metropolitan Housing Authority buildings. They hold doses of the opioid overdose reversal drug Naloxone.

MetroHealth and the Cuyahoga Metropolitan Housing Authority (CMHA) are teaming up to put Naloxone, a drug used to reverse opioid overdoses, in a dozen residential buildings where overdoses happen the most.

Advocates looked at the Medical Examiners' overdose death reports and realized many were happening at county properties, and there was a need for more Naloxone there, said CHMA’s Special Counsel to the CEO Jeff Wade.

Oftentimes, the communities that we serve don't have access to these forms of treatment,” he said. “So we wanted to take advantage.”

In the month since some of the boxes were installed in CHMA properties, one kit has been used to reverse an overdose, Wade said.

The NaloxBoxes, purchased by the Alcohol, Drug Addiction and Mental Health Services Board of Cuyahoga County (ADAMHS), are displayed on the wall much like automated external defibrillator (AED) boxes, which are used in cardiac emergencies.

Six hundred and fifty people died of drug overdoses in Cuyahoga County last year, according to the county board of health. Experts say many of those deaths were caused by opioids and may have been prevented if someone administered Naloxone.

The ADAMHS Board of Cuyahoga County purchased boxes, which cost between $189 to $309 per unit, not including the Narcan, an agency spokesperson said. The board has purchased more than 500 boxes.

Some advocates are skeptical of the hefty price tag for what they described as a plastic storage box.

The money would be better spent on more Naloxone or to run a distribution program in at-risk communities, said Jonathan J.K. Stoltman, the director of the Opioid Policy Institute.

“It just strikes me as profiteering,” Stoltman said. “There's a lot of work that needs to be done for it to reduce overdose deaths and increase access to care. I just don't think we have the luxury of spending that kind of money right now when so many people are dying.”

A benefit of the boxes is they can put Naloxone on hand in areas where people may be likely to overdose, said Dr. Joan Papp, medical director of the Office of Opioid Safety at MetroHealth.

“We wanted something that was anonymous,” she said. “We wanted something that was 24 hours, and we wanted something that was available throughout the community in the time of need.”

She said her team began installing boxes almost two years ago in Cuyahoga County in places where people are more likely to use drugs like gas station bathrooms or music venues. So far, the kits have reversed at least 28 overdoses.

The hope is to change behavior, said Papp.

When we distribute Naloxone, we encourage them not to use alone. But many people don’t have anyone,” she said. “If they use in a place where they can be found, where they know there is Naloxone access that may be safer for them.”

The harm reduction group Thrive for Change will train CMHA residents to recognize signs of overdose and how to administer Narcan starting this summer.

Thrive for Change’s Executive Director Bethany Roebuck said she thinks there’s room for several approaches.

Ultimately, I think the more strategies we can employ, the better," she said. "Do I think that more funding needs should go to frontline work? Absolutely. But, we've seen many lives already saved by these Naloxone boxes so I don't necessarily believe it's a waste.”

Taylor Wizner is a health reporter with Ideastream Public Media.