A recent paper using data from the state’s Overdose Education and Naloxone Distribution (OEND) programs analyzed how people move between communities to access naloxone and respond to overdoses. By examining where people live, where they reverse an overdose, and where they get their naloxone refilled, researchers uncovered important patterns in access and use.
Most People Stay Local
Across much of the state, naloxone is both obtained and used close to home. It’s encouraging that people know where to find local harm reduction programs, pharmacies, or community centers that distribute naloxone.
Where to Find Narcan in Essex County
Here is Mass.gov’s Harm Reduction Program Locator, which shows where you can find naloxone in your area. Reach out to your local health department or check out drop-ins like ONESTOP and Healthy Innovations for supply. There are also publicly accessible naloxone kits placed in various community locations. For example, Salem has installed five Narcan distribution boxes in downtown locations. The boxes are in Lappin Park near the Bewitched statue, on the pedestrian mall across from the large fountain, outside the public restrooms on Artist Row, near the flag poles in Riley Plaza, and near the swings in Charlotte Fortin Park on Derby Street. The boxes are designed to provide low-barrier access to this life-saving medication, with a QR code and phone number available to report issues or request restocking.
Boston Stands Out
Many individuals travel into Boston from surrounding regions—such as Metro-West, Northeast, and Southeast Massachusetts—often along commuter rail routes, to respond to overdoses and refill their naloxone supplies. This pattern suggests that drug use and overdose events frequently occur in these areas, drawing people into Boston, which makes it a vital regional hub for harm reduction services and overdose response.
Self-Contained Access in Central and Western Massachusetts
In these regions, people typically respond to overdoses and obtain naloxone refills within their own communities. This pattern may result from factors like fewer transportation options, more localized drug markets, and strong community-based harm reduction programs that effectively serve their immediate areas. Residents may also have tighter social networks within their region, making it more practical to access naloxone and respond to overdoses close to home.
Refills Happen Near the Overdose Location
People often refill their naloxone supplies close to where they have responded to an overdose, rather than near their place of residence. This behavior reflects the complex realities of drug use and harm reduction access. Many individuals purchase and use drugs outside their home neighborhoods, which means they are more likely to encounter and respond to overdoses in those areas.
Additionally, harm reduction programs and naloxone distribution sites may be more accessible or better known in certain locations, influencing where people go to restock. Transportation availability also plays a significant role. Some may find it easier to access services along common travel routes or near places where they spend significant time, even if that’s outside their home community. Understanding these patterns helps tailor naloxone distribution efforts to meet people where they actually are, rather than where they live on paper.
The Rescue-Centric Hypothesis
One theory, the “commuting” hypothesis, suggests people obtain naloxone in one town, use it at home, then return to refill it where they got it. However, this data report supports a “rescue-centric” hypothesis: people tend to refill naloxone near where they actually use it to reverse overdoses, often in major population centers like Boston. This aligns with travel patterns along commuter rails and metro areas. Similar findings from other regions show overdoses frequently occur far from where individuals live, highlighting the need to focus naloxone distribution and outreach where overdoses happen—not just where people reside.