In 2014, the RI Disaster Medical Assistance Team’s Medical Reserve Corps (RIDMAT/MRC) started the Naloxone and Overdose Prevention Education program (NOPE-RI) in response to the overwhelming overdose epidemic we were seeing in Rhode Island. RIDMAT/MRC’s NOPE program provided resources to the state to increase education and access to naloxone, the opioid overdose reversal drug. At that time, we focused primarily on agencies and organizations that were implementing a naloxone response program like public schools, law enforcement and other first responder agencies. Since that time, we have branched out to provide medical direction and policy development to more public facing institutions like libraries, university and campus police, mall security services, public transit and construction companies.
In 2016 and 2017, two separate RI Department of Health mini-grants to Lifespan Hospital, allowed the originators of the NaloxBox, Geoff Capraro, MD (Lifespan/Brown University) and Dr. Claudia Rébola from Rhode Island School of Design to construct the original NaloxBox. These boxes were placed throughout RI with much success and interest. There are 56 original NaloxBox units across RI and you can see some of the locations on an interactive map at PreventOverdoseRI.org’s “Find A NaloxBox”. The original boxes were designed to be placed in semi-public and public spaces, including state and municipal agencies, public libraries, homeless shelters and treatment centers for community access to rescue opioid overdose victims.
Demand quickly began to outweigh the original funded supply, so RIDMAT, Inc., a non-profit organization, assumed operations on scaling-up production while maintaining the original mission to increase access, reduce stigma and save lives one box at a time. Through the development and distribution of NaloxBox as a nonprofit effort among partner agencies including Amos House, the MET, RiverzEdge Arts and VR Industries, RI is in a unique position to provide an innovative, community-based solution to address a nationwide epidemic.
The NaloxBox mission is to improve the capacity of bystander rescuers to save the lives of victims of opioid overdose by increasing access to publicly available overdose response tools in indoor settings most in need of quickly accessible, public use naloxone. The NaloxBox units are durable, easy to recognize, wall-mounted enclosures that can be centrally located inside an organization to provide the tools and resources needed for individuals willing and able to help during an opioid overdose situation.
Opioid overdose is a medical emergency characterized by inadequate breathing which can lead to respiratory depression and hypoxia, which is a lack of oxygen. This will lead to death if no intervention is made. Like other medical emergencies where bystanders can improve the outcome of the victim prior to the arrival of emergency services (i.e. cardiac arrests), opioid overdose victims can benefit from the early administration of naloxone. If we begin to treat opioid overdose like any other bystander enabled medical response, we will begin to reduce the stigma often associated with opioid overdose.
The early intervention by bystander rescuers with naloxone administration can reduce morbidity and mortality and help improve the outcome for the individual experiencing the medical emergency. Naloxone is an opioid antagonist that when administered to someone experiencing an opioid overdose, removes the opioid form the receptors of the brain, blocks their effects and allows the individual to start breathing on their own again. The NaloxBox ships with bilingual opioid overdose recognition and response instruction cards and a barrier device for rescue breathing. These tools, in addition to the naloxone, can go a long way saving more lives from overdose by enabling lay responders to intervene.