Challenges in Narcan distribution hamper efforts to slow pace of drug overdose deaths | Milwaukee Neighborhood News Service
Edgar Mendez
November 30, 2023
As soon as Rafael Mercado gets word in his South Side neighborhood that people are overdosing on a bad batch of fentanyl-laced drugs, he races to distribute Narcan before more lives are lost.
Narcan, a drug used to reverse the effects of opioid overdoses, is in short supply in Milwaukee. This worries advocates like Mercado who distribute the life-saving drug.
“We’ll take Narcan if we have it and fentanyl test strips and post up at the hot spots on National and Greenfield Avenue,” Mercado said. “We can’t hit the streets without Narcan or with minimal supplies of it.”
Mercado is the leader of Team HAVOC, a grassroots group that conducts street outreach, needle cleanups, and other addiction awareness activities in Milwaukee.
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He said obtaining doses of Narcan, the brand name for naloxone medication and a key tool in slowing the pace of drug overdose deaths, is a challenge in the city for groups like his that support individuals who use opioids.
Mercado is not alone, according to Desilynn Smith, clinical director at Gateway to Change, a treatment center located at 2319 W. Capitol Drive.
She also is the executive director at Uniting Garden Homes Inc., 4201 N. 27th St., a nonprofit that provides support to families and hosts Narcan training events.
“There are many agencies that need [Narcan] that don’t have it or don’t have enough,” Smith said. “We need enough of it to saturate the community if we want to save more lives.”
From Jan. 1 to Oct. 28, there were 362 confirmed drug overdose deaths, with 183 suspected cases pending toxicology in Milwaukee County, according to data provided by Karen Domagalski, operations manager for the Medical Examiner’s Office.
If all the pending cases are confirmed as drug overdose deaths, the total this year would jump to 545, nearly identical to last year’s total of 547 through the same period. In 2022, Milwaukee County recorded a record high 665 drug overdose deaths.
Mercado said his group obtains Narcan through several different avenues, none of which is always accessible.
One option, he said, is to pick up doses from the city’s 11 Narcan vending machines, but, he said, many are not open after hours or accessible at all.
A recent visit by NNS to a vending site at 1615 S. 22nd St. revealed that while the vending machine was filled with supplies, it wasn’t turned on.
“The machines are supposed to be accessible 24 hours a day, but that’s not always the case,” Mercado said. “Regardless, not everyone can get to these sites.”
Many local organizations, including Team HAVOC, access some of their Narcan supplies through the Milwaukee Health Department, which is a participant in the Wisconsin Department of Health Services Narcan Direct Program. The program provides free Narcan for community distribution.
The program is available to county human service departments; local health departments; tribal health clinics or their designees; syringe-exchange programs; programs with recovery coaches and certified peer specialists; and state-certified opioid treatment programs.
While many organizations, including local participants such as the United Community Center, Vivent Health, and the Milwaukee Health Department, are eligible for and participate in the Narcan Direct Program, those stipulations leave out other organizations such asTeam HAVOC.
Capt. Gregory Miller, mobile integrated health care manager for the Milwaukee Fire Department, said his agency is no longer eligible for the Narcan Direct Program.
“We were prior to this year, but we’re not allowed to renew,” he said.
Miller, who helps oversee the Milwaukee Overdose Response Initiative, a partnership between the Fire Department, Milwaukee Health Department and other community partners, said the change resulted in low supplies of Narcan for a time.
But that gap closed when his department joined the Wisconsin Department of Health Services Leave Behind Program.
The Leave Behind Program provides emergency medical service providers funds to purchase Narcan and fentanyl test strips.
Smith’s organizations, Gateway to Change and Uniting Garden Homes, are also both ineligible for the Narcan Direct Program and rely on the Milwaukee Health Department and Wisconsin Voices for Recovery, a Madison-based organization, for the Narcan they distribute.
“We’ve run into situations where we don’t have it and can’t meet that immediate need,” Smith said.
Another issue is that there’s simply not enough Narcan available locally, said Courtney Geiger, who was the public health strategist, specializing in overdose and substance use disorder prevention for the City of Milwaukee Health Department at the time she was interviewed by NNS. She resigned from that position on Oct. 26.
“In Milwaukee, there’s not enough [Narcan] to get out the doors and not enough for all agencies,” said Geiger, adding that the city received 1,200 doses of Narcan through the Narcan Direct Program this year and submitted a request to obtain 6,000 in the next cycle.
A request for comment from the Milwaukee Health Department on any changes since Geiger’s departure did not receive an immediate response.
Despite the challenges, there are still places to find Narcan in Milwaukee, such as purchasing it at a pharmacy or going to any local fire station to receive a Hope Kit, which contains the drug and fentanyl test strips.
While those options can be helpful, Mercado said not having an ample supply on hand isn’t ideal when you’re racing to save lives.
“I get it when I can, but when I run out, I’m stuck because people need it and I can’t provide it,” he said.
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