When it first became available over the counter last year, a bottle of Narcan nasal overdose spray cost $45. Now activists and health officials across Tampa Bay are working to make the life-saving drug available free to anyone who needs it.
The most common form of naloxone is a nasal spray such as Narcan. It pumps naloxone through the nasal membranes into the bloodstream and blocks the effects of opioids on the body’s nervous system, allowing the patient to breathe again after an overdose.
However, resuscitation is short-lived – 30 to 90 minutes later, the antidote’s effects wear off. Without additional doses or medical attention, the patient is still at risk of death. However, in the time it takes for an ambulance to arrive, those extra minutes can save a life.
Recovery advocates distribute kits at festivals and on the beach, drop them off at shelters and recovery centers, and refill them at public mailboxes in Pinellas, Hillsborough and Pasco counties. Thousands of naloxone doses were pumped into the Tampa Bay area last year as part of these efforts.
The affected region is slowly recovering. For the first time in more than a decade – and despite the nationwide trend of declining overdose numbers – Tampa Bay saw a decline in overdose deaths in 2023. There were 219 fewer deaths in the three counties than in 2022.
“He would have been dead”
Jim Spencer found out in March how valuable these extra minutes can be.
Spencer had started working as a peer support specialist at Catcher’s Mitt in Clearwater the month before. The short-term shelter opened in 2023 as a recovery home and provides food, showers and beds to people ready to quit drug use.
After Spencer began his own recovery from alcohol and drugs 30 years ago, he wanted to help others take the same step. His son referred him to Will Atkinson, director of the Recovery Epicenter Foundation in Clearwater and founder of the Catcher’s Mitt.
That’s where Spencer encountered Narcan for the first time.
Dan Zsido, a former Pinellas County sheriff’s lieutenant, has trained shelter staff on how to use the drug, telling them that the person doesn’t have to breathe for it to work and that they should use it even if it’s unclear whether the person’s overdose was due to opioids.
Five days later, Spencer’s training was tested.
Spencer, who was on duty at the shelter that day, went from room to room checking on the residents. When he opened the door to one man’s room, he found him “all crumpled up” on the floor between the bed and the dresser. He was unresponsive.
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Another staff member grabbed the Narcan. They gave the man three doses until the ambulance arrived. No amount of naloxone is dangerous, Zsido said. The best course of action is to give a dose every few minutes until the man comes to.
“It’s kind of surreal,” Spencer said. “If I hadn’t come into that room and he had been there for another half hour, 45 minutes, without anyone knowing – he would have been dead.”
Spencer now carries a backpack with three Narcan kits so he can intervene if needed, but he hopes he won’t have to, as he describes the experience as “nerve-wracking.”
think in other directions
In Pinellas County, health officials are setting up naloxone drop containers to ensure everyone is ready to intervene.
Inspired by a similar program in Buffalo, New York, Pinellas County purchased dozens of red boxes, each the size of a mailbox, in 2019. The plan was to ask businesses, restaurants and care providers to set up boxes on site.
There were two stumbling blocks. First, the stigma: Business owners feared that local Narcan would damage their reputation. Second, the date: early 2020. Most mailboxes waited in storage until the pandemic was over.
As the pandemic subsided, some of the stigma also faded. Businesses that were skeptical readily accepted boxes, and by April 2024, the health department had distributed nearly 200 boxes. Local nonprofits like Atkinson’s Recovery Epicenter Foundation took over some of the refilling and helped keep the boxes filled.
Marianne Dean, program manager at the Pinellas County Health Department, said the goal is to make naloxone as ubiquitous as a fire extinguisher. “Hopefully you’ll never need it, but if you need it, you’ll have it.”
Other initiatives in Tampa Bay have followed suit. Atkinson’s group set up 20 boxes in Pasco County last fall. To counter stigma, they painted them purple – the color of recovery. In July of this year, Pasco asked for 40 more. Atkinson estimates that his group has distributed about 450 Narcan kits through those boxes.
Across the bay, the Hillsborough Recovery Coalition has built five gray “birdhouses” modeled after public bookstores. The first was delivered in June to Tampa’s Rainbow Recovery Club, a local support group. It sits next to the coffee machine in the back of the boardroom.
Other groups are looking to something else – the mailbox. The Florida Harm Reduction Collective runs a program that allows anyone in the state to get free Narcan delivered straight to their door. Their efforts have resulted in at least 267 overdose relapses, according to the group’s website.
In Pinellas, the health department is revamping the initiative after setbacks. Too many businesses that had partnered with the county had to go through a change in leadership or closed, Dean said, and many boxes were forgotten.
The health department is currently retrieving the unused supplies and preparing a new plan to make them available throughout the county. Dean hopes to have that plan in place in January. In the meantime, Pinellas residents can walk into any health department clinic and receive free Narcan kits.
The road to recovery
With naloxone, recovery from an overdose is much more likely. But the region’s recovery will require ongoing support, advocates say.
Much of that support comes from local nonprofits and support groups. Spencer, a Catcher’s Mitt employee, said the support landscape in Tampa Bay — support groups, residential addiction centers, treatment facilities — is thriving today compared to the lack of resources he remembers from his first time in the support group in 1985. “It’s definitely needed because beds are scarce.”
Dean pointed to another local program designed to reduce barriers to recovery – a “concierge” service run by Unite Us and USF. They schedule counseling appointments for those in need and monitor patients’ attendance.
Beyond the boxes, local groups are finding innovative ways to distribute Narcan. Atkinson’s foundation distributes naloxone during spring break and to local hotels and businesses—including the drop boxes, about 4,000 kits were distributed last year.
IDEA Exchange Pinellas, a syringe exchange, is also working with the county on spring break education and advocates are distributing naloxone directly in the county. Program director Amanda Bonham-Lovett said the group has distributed more than 6,000 kits since September 2022, resulting in more than 300 reversals.
The Hillsborough Health Department says it has distributed 3,231 naloxone kits this year. Pinellas has distributed 1,425 through July.
An important piece of the puzzle is the continued fight against stigma, Bonham-Lovett said.
“Anyone who distributes naloxone knows that the usual default reaction from someone who isn’t really familiar with it is, ‘Oh, I don’t need that,'” she said. “That always kind of makes us smile, because no, you can’t administer Narcan to yourself. That’s for someone else.”
Dean said the drop in overdoses is a testament to the collective efforts of all activists in Tampa Bay. “We had a huge problem and we just did everything we could to address it,” she said. The next step is to optimize the programs and improve their effectiveness.
“There is definitely a better way,” Dean said. “The health department’s ability to distribute naloxone, in my opinion, has been a game changer for the county.”
