Narcan Saves Lives
In the South Bronx, many residents can't get it—or don't know it exists

STORY BY THE INTRO TO DOCUMENTARY STORYTELLING CLASS (HIGH SCHOOL 1)

PHOTOS BY MIA FLORES

Published Dec 2023

Just after 5 p.m. on a cold November evening, near the chaotic Third Avenue–149th Street subway station in the South Bronx, Luis stood in a yellow raincoat, standing hunched over his belongings. He kept his hands clasped together on his stomach and flinched repeatedly while looking around, as if someone was watching him. Earlier that evening, he had used heroin. “I need it, I just need it. Without it I feel like I’m dying,” Luis said. The Centers for Disease Control and Prevention estimates that over two million Americans are addicted to opioids, and that over 80,000 persons nationally died of an opioid overdose in 2021, the most recent year that data is available. Over two thousand of those individuals lived in New York City.

Down the block from Luis, Jose sat in a wheelchair, looking to the ground where orange-capped needles and blood-stained tissues surrounded him. Currently 45 years old, Jose has used opioids since he was 16. Jose, like Luis, said he wanted to stop using heroin. In part, he blamed his surroundings--this area of the South Bronx, at the border of the Mott Haven and Melrose neighborhoods, registers one of the highest rates of opioid overdoses in the city, according to the NYC Department of Health.

But for Jose, the effects of his addiction are just as important as his surroundings in explaining his continuing habit. The drugs haunt his mind, he said, driving him to use again and again.

Opioid addiction causes someone to rely on the drug like a lifeline, even if they know its harmful effects. As little as 2 milligrams, about the weight of a single grain of sand, can be addictive or fatal. If an addicted person attempts to stop taking an opioid, their body quickly enters into withdrawal. Withdrawal symptoms include insomnia, vomiting, high blood pressure and panic, among others. These uncomfortable withdrawal symptoms are the primary factor for why people keep using the drug despite wanting to quit.

“The brain adapts...making it hard to feel pleasure from anything besides the drug,” according to a 2021 report from the National Institute on Drug Abuse, part of the National Institute of Health. Or, as one South Bronx resident said: “[It] isn’t a drug, it’s poison.”

Across the country, the opioid crisis has been worsening for decades. The NYC Department of Health (DOH) registered 2,668 individuals who died of an opioid overdose in the city in 2021- six times as many as in 1999.

The crisis has affected lower-income and minority communities the most intensely. Of all the boroughs, overdose death rates were highest in the Bronx, and three Bronx neighborhoods –Hunts Point-Mott Haven, Crotona-Tremont and Highbridge-Morrisania–experienced the highest death rates citywide. Black New Yorkers died at rates four to six times higher than other racial demographics.

"These deaths are absolutely preventable,” said New York City Health Commissioner Dr. Ashwin Vasan earlier this year, when the 2021 data was released. This September DOH announced a multi-pronged plan to tackle the crisis. Among the actions taken was a recommendation that New Yorkers “carry naloxone and know how to use it.”

Naloxone, also known by the brand name “Narcan,” is a medicine that rapidly reverses opioid overdose. If someone is experiencing an overdose and has stopped breathing, naloxone can resuscitate them. It’s typically found as a nasal spray and simple to use if one knows how: the tip of the nozzle is inserted into an overdosing person’s nose, and the dose is administered by pressing on a plunger. Naloxone has been shown to be incredibly effective, with different studies claiming that it can prevent death 75% to 93.5% of the time when correctly administered.

But, despite the impact of the opioid crisis in “The Hub” (the area around the Third Avenue–149th Street station), a BDC Focus investigation found that many residents had never heard of naloxone. BDC Focus reporters visited 16 local businesses around The Hub. In ten of those establishments, no employees present had heard of naloxone or Narcan. Only one business had it: a pharmacy, where it was available for sale for over $50. Until recently, one needed a prescription to get Narcan from a pharmacy. But on September 1st, the drug became available over-the-counter nationwide. The New York State Department of Health publishes a list of certain pharmacies that sell naloxone to the public. BDC Focus reporters called 15 pharmacies near The Hub that were listed by the DOH as participating, and asked if they had naloxone for sale. Nearly half did not have the drug.

In addition, the NYC Department of Health (NYS DOH) has a program with certain pharmacies that allows them to give free “Overdose Rescue Kits” to any individual who requests one.

There are three such pharmacies in the Bronx, and one is a CVS at 282 East 149th St, just two blocks from The Hub. A BDC Focus reporter asked about naloxone, and was told by a pharmacist that the drug had not been delivered in over five months.

In response to a request for comment, the NYC DOH did not explain why the site had not been stocked with naloxone for nearly half a year. But a spokesperson told us that the pharmacy would be restocked with the life-saving drug by next month. The spokesperson also claimed that the agency had distributed over 37,000 naloxone kits in the Bronx in 2023 - but where exactly these kits were distributed was not made clear.

Back near the subway station, Luis stood against the brick wall of a supermarket. At his side stood a cart stacked with bags filled with coats, shoes, shirts, pants and blankets. He recalled a time when someone used naloxone on him as he was overdosing and saved his life. The experience of overdosing had ”brought fear into my heart,” Luis said. But he admitted that with his heavy addiction, he wouldn’t be able to resist the craving that the drugs caused in him. It was something that deep down he knew had become a part of him. “It makes me feel normal,” he said.

As the night went on, Luis remained at the street corner, talking to himself, struggling to keep his balance, occasionally greeting passersby. Just down the street, a group of men gathered, and prepared their arms to inject themselves.