Boxes of naloxone—the generic form of Narcan, the treatment for opioid overdoses—are stacked among water bottles, condoms, and other free resources on a table inside Majestic Hair Salon in Irondequoit.
There’s no pressure to take one of the boxes, but given that Monroe County’s drug overdose-related deaths are at an all-time high, salon owner Debbie Wise makes sure her clients know they’re available.
“If I suspect someone should have one,” Wise says, “I’ll ask, ‘Do you have anybody in your family who does drugs?’ Most of the time I get a ‘No.’ But then the next time they’re here they say, ‘Know what? Let me just put one in my purse.’”
Wise works as a community health educator—someone trained to educate others on health matters, including how to use a naloxone kit—for Common Ground Health.
“The response has been remarkable,” says Jackie Dozier, director of community health and well-being at Common Ground Health. “This is an epidemic in our community, and people are realizing that it's hitting close to home.”
The most up-to-date overdose death statistics confirmed by Medical Examiner Dr. Nadia Granger’s 2021 Heroin and Fentanyl Overdose report shows that Monroe County saw 293 deaths in Monroe County related to the drugs. That was an increase of more than 23 percent over record-breaking numbers in 2020. Nearly 30 percent of the 2021 deaths were members of the Black community and 14 percent were members of the Hispanic community.
As of Aug. 1 of this year, Monroe County’s Emergency Medical Services had reported 1,746 non-fatal opioid-related overdoses.
Earlier this year, Monroe County Executive Adam Bello unveiled a new community-wide opioid/fentanyl data dashboard to better track overdoses and other relevant information in real time.
While the dashboard was welcome news, more needed to be done to get educate people about how deadly the region’s drug supply is and how to get treatment, says Tisha M. Smith, director of addiction services for the Monroe County Department of Public Health.
“The situation is pretty dire at this point; our community is struggling and we’re losing people left and right,” Smith explains. “When we have trusted members of the community who can deliver a crucial message about healthcare, why not take advantage of the opportunity to do that? It’s a brilliant strategy.”
Common Ground Health and the health department are funding this particular naloxone initiative with part of a grant from the National Institutes of Health's National Institute on Drug Abuse as well as the Substance Abuse and Mental Health Services Administration. NIDA and SAMHSA launched the HEALing Communities Study—of which Monroe County is a part— to reduce opioid and overdose deaths at the local level. Also partnering with the Columbia University School of Social Work, the research study’s goal is to slash those figures by 40 percent over the course of three years.
“Both its grasp of local needs and its superb ability to deliver services has made Common Ground Health the kind of partner we hope to see across the 16 communities where the study has been implemented in New York State,” says Nabila El-Bassel, PhD, principal investigator of the study.
Despite expanded local efforts to reduce opioid overdoses over the past year, Smith says she has been frustrated “with the pace of progress” within the City of Rochester. The county is developing ways to collaborate with the city on naloxone distribution, and “in the meantime this has been a brilliant strategy for targeting communities that either had proved resistant or were an afterthought for a lot of programs.”
Those communities need this “boots-on-the-ground kind of work,” she says, to promote awareness in communities not only disproportionately affected by overdoses, but distrustful of medical providers.
Wise, for example, has been in business for more than three decades, so her clientele spans generations.
“A lot of rapport gets built in that time,” she says. “And the word is getting out.”
Taking a break from coloring a client’s hair, Wise walks over to a notepad in which she documents the number of naloxone kits—packaged with easy-to-understand, illustrated directions—that have left her table. She flips through the pages and turns to the first two weeks in July.
“Thirty-three,” she says. “I’m supposed to give out no less than 40 a month, so this is good. You’d be surprised how the word gets out.”
Common Ground Health knows the value of barbers’ and stylists’ close connections with their clientele. Years ago it began training people who work in salons and barber shops to take blood pressures, encourage clients to see their doctors if the readings are higher than normal, and pass out health-related material.
In fact, “a stronger relationship with community partners is the most helpful thing to come from the NIH grant,” which is scheduled to run through December 2023, notes Jessica O’Connor, addiction services program manager at the health department. “And in doing so, we are fostering a greater sense of trust in communities where it may be lacking.”
According to Smith, the goal is to distribute 4,000 naloxone kits by the end of the year.
Naloxone has benefits beyond opioid overdoses, says Christopher Abert, executive director of the New York Recovery Alliance, who provided two-hour training sessions to barbers and hair stylists interested in offering the kits.
“You’re more likely to stumble across someone having an overdose than having a heart attack,” he says, adding that any place with fire extinguishers and automated external defibrillators should also provide access to naloxone.
The focus for many is on destigmatizing the treatment.
Similar to Wise, barber Ronnie Davis doesn't push his customers to take home naloxone, especially those blatantly trying to hide their drug use.
“I say, ‘It’s just for somebody you might know,’” says the co-owner of Visions Barbershop in Rochester, whose kits once saved a woman overdosing outside his doors. “A couple people have come back and said ‘Thank you. We really needed it one day.’ So I know it’s helping out.”