MOUNT VERNON —Knox County has seen 10 overdose deaths thus far this year. Several autopsy reports are pending, so that number might climb.
In 2022, the county had 110 overdose calls and 10 deaths. The numbers for 2021 were 119 calls and 14 deaths.
Julie Fisher and Dave Priest, Mount Vernon Municipal Court probation officers, are leading a countywide initiative to prevent overdose deaths so that individuals have a chance at recovery.
“Treatment is available, but they have to survive the overdose first.”
Dave Priest, mount vernon municipal court probation officer
Through a community partnership, the pair is working to install NaloxBoxes throughout the county.
The boxes derive their name from naloxone, the generic name of a medication that rapidly reverses the effects of opioid overdose. It is the standard treatment for opioid overdose.
Narcan is a brand name of naloxone.
The boxes contain Narcan nasal spray, a rescue breathing mask, and a resource navigator guide listing resources for emergencies, housing, and other assistance.
A QR code on the front enables quick access to instructions on using Narcan and administering CPR. It also asks the user to note what they took from the box.
“Save a life, get people past the overdose and into recovery. If you are fighting for tomorrow, this is an answer,” Priest said.
Users do not have to scan the QR code to use or access the Narcan or rescue mask. Both officers emphasized that any information submitted via the QR code is confidential, not used in court proceedings, and does not require a user’s name.
“Every time you scan the QR code, a notice comes back to Dave and I. We want to know if someone’s using it or even just getting information,” Fisher said. “They don’t have to use it.”
Narcan has no effect on people who have not overdosed. It is effective only when it binds with an opioid.
24/7 access
Individuals can get Narcan kits at Knox Public Health and The Freedom Center through Project DAWN (Deaths Avoided With Naloxone). However, access is limited to their daily operating hours.
In contrast, the NaloxBoxes are located in vestibules or areas that are open 24/7.
“This was a way to expand the Project DAWN program,” Priest explained.
Four boxes were installed on Nov. 14:
•Mount Vernon Police Department, 5 N. Gay St., Mount Vernon
•Riverside Recovery Services, 402 Coshocton Ave., Mount Vernon
•Danville Police Department, 512 S. Market St.
•Fredericktown Police Department, 182 S. Main St.
The 911 dispatchers know the box locations in the county.
“If 911 gets a call, they can direct that person to the nearest box,” Priest said. “The boxes are not meant to replace EMS. Rather, they are a way to administer aid until EMS arrives.”
Priest said they want to get a box in Centerburg and then to other locations around Mount Vernon.
The goal is to put out 10 boxes eventually.
Background
The project stemmed from Fisher and Priest attending the city’s leadership program.
“Each team had to come up with a leadership project and present it at the end of training,” Fisher explained.
The teams also had to include goals, strategy, and funding for their project.
Fisher had read an article about Cuyahoga County’s successful NaloxBox program.
“So I thought, why not have the NaloxBoxes in Knox County?” she said.
“We’re right in the midst of dealing with a drug overdose situation. Doing nothing is not the answer,” Priest said. “With these boxes, we can kill two birds with one stone and make it a community buy-in.”
The duo approached Mental Health and Recovery for Licking and Knox Counties. They asked for funding for three boxes to get started and were surprised to find funding already available.
Licking County had planned to implement a NaloxBox program three years ago. Then COVID hit, and the product became unavailable.
But, the funding remained, and MHRLKC enthusiastically provided it to Knox County.
Priest said that if the community really wants to tackle opioid overdose, the boxes need to be available to everyone. That includes friends of someone who uses and a mom or dad who wants to protect their child.
“So our goal is to get it to people who will be affected by the length of time for squad runs,” Priest said, referencing the desire to get the boxes into the county.
“The key is we want to get 24-hour access.”
Reducing stigma
Fisher acknowledged some do not feel Narcan should be readily available to reverse the effects of an overdose.
“When we began, one of my main concerns was negative stigma,” Fisher said. “People say, ‘Why are we trying to save these people? Let them die.’ But it’s parents and grandparents who will utilize this to save their family members.
“If we save one life with these boxes, then they’ve done their job,” she said.
“Treatment is available, but they have to survive the overdose first,” Priest said.
“There’s not one person out there who is not affected by this,” Fisher added. “If that one is your child …
“Our hope is this will reduce the stigma about addiction. Everyone is all for recovery, but no one is accepting of addiction.”
Community partnership
“We have had so much help from the rest of our community,” Fisher said of the process to acquire and install the boxes.
Critical partners include Knox Public Health, law enforcement, Riverside Recovery Services, Conway Pharmacy, and the Mount Vernon Fire Department.
“Those who have accepted the responsibility of monitoring the box will check each day. As we move on, we don’t know whether we’ll leave supplies there for refills,” Fisher said, adding that she does not anticipate problems getting product to refill the boxes.
“Theft is not a problem in this case,” she continued. “If they want it, take it. If it gets into the hands of someone who can use it, take it.”
Fisher said Cuyahoga County has not experienced problems with theft or vandalism.
Down the road, the duo is looking to install boxes in public areas such as parks. Priest said the worry is not theft but related to damage to the box.
Even though the boxes are waterproof, Narcan is not. It’s subject to freezing and sunlight.
The boxes cost $275 each. A temperature-controlled box is much more expensive, costing around $2,500. Priest said manufacturers are working to get an electric version of the box to cut the cost.
“Hopefully, we’ll be first on the list to pilot one,” he said.
Priest said the ultimate goal is to get NaloxBoxes in businesses. Kenyon College is interested; having one on campus gets a box into the Gambier area.
“In our field, sometimes I wonder if I am doing any good,” Fisher said. “And then people comment ‘You saved me,’ and I feel like I am.”
“This can be one solution to save a life,” Priest agreed.
“Every meeting we go to, the discussion is that we’re still in an epidemic. When someone asks what can we do, there’s silence. Now we have something.”
Other communities’ results
Rhode Island has found success with the NaloxBox program, as has Massachusetts. Indiana started its program in 2021.
Closer to home, Cuyahoga County’s program began in 2021 with 607 initial boxes. According to Tiffany Ponds-Kimbro, director of External Affairs for the ADAMHS Board of Cuyahoga County, 247 have been installed.
Ponds-Kimbro said that according to the medical examiner’s office, the county had an estimated 654 overdose fatalities in 2022.
“If we save one life with these boxes, then they’ve done their job.”
Julie Fisher, Mount Veron municipal court probation officer
Based on overdoses since January, the county has already seen over 700 fatalities this year.
Ponds-Kimbro said the board started the program “to save lives.”
“While we do not condone the use of drugs, we know that there is hope and help, and that people do recover,” she said.
NaloxBox locations throughout Cuyahoga County include the MetroHealth campus, Cuyahoga Metropolitan Housing Authority, gas stations, and music venues.
“Two individual’s lives have been saved at gas stations by using the Narcan available in those NaloxBoxes,” Ponds-Kimbro said.
“We’ve overcome obstacles by saving lives. Those at the outset who were initially resistant usually come around as more lives are saved.”