The box at 400 E. Chelten Ave. (Photo: Danielle Smith)

Recently, you may have noticed a white box with red and yellow markings outside of your local fire station. It doesn’t contain any materials related to fire safety, but it holds lifesaving equipment nonetheless.

The newspaper-style boxes are filled with Naloxone, more commonly known as Narcan, an overdose-reversing nasal spray for opioid users.

They’ve been placed at all 61 fire stations in the city by Naloxone in Black, a new initiative addressing disparities in overdose rates among Black substance users in Philadelphia. The Germantown fire station is located at 400 E. Chelten Avenue.

Anyone can take a box, which has two doses of the medicine, at any time, completely anonymously. Each box has a QR code that can be scanned for a brief tutorial on how to administer Naloxone, a process not unlike other over-the-counter nasal sprays that treat allergies or congestion.

The fire stations keep an eye on inventory, and the boxes are replenished periodically by the city as the supply dwindles.

What recent data tells us about Black overdoses in Philadelphia and Germantown

From 2019 to 2023, overdose deaths rose 61% among Black individuals, and the median age of overdose decedents in the city rose from 43 to 47.

Among Black males, the group with the highest percentage of overdose fatalities, the median age of death was 52. These numbers come against the backdrop of overall decreasing rates of fatal overdoses in Philadelphia and throughout the country.

“It’s incredibly sobering data,” notes Keli McLoyd, Director of the Overdose Response Unit for the City of Philadelphia.

McLoyd, a Germantown resident herself, says she’s committed to making sure that neighbors have access to help whenever they need it, however they feel most comfortable getting it. She also reminds us that the representation of drug use in Philadelphia that we’ve become accustomed to, which focuses heavily on Kensington, isn’t entirely accurate.

“We know that overdose rates are rising specifically in Northwest Philadelphia, in Southwest Philadelphia, and in North Philadelphia, and we know that the highest risk of overdose right now in the city of Philadelphia is Black men age 45 to 65.”

A 2024 study found that 35% of white adults were aware of Naloxone, compared with 18.6% of Black adults. While 18.6% of white adults reported knowing how to access Naloxone, only 9.5% of Black adults said the same.

In 2023, both the 19138 and 19144 zip codes experienced more than 10 overdose fatalities, with 19138 losing between 11-24 individuals, and 19144 losing 25-49 lives. However, fatal overdoses only represent one aspect of the crisis. 

Non-fatal overdoses are counted as those who call 911, are transported by an EMT to a facility, or present at an emergency room. But long-term drug users may not accurately register in this data, as they’re more likely to possess Naloxone and know how to use it, thereby avoiding medical attention.

McLoyd also notes that Philadelphia’s substance use epidemic is much quieter than some portrayals would have us believe. Qualitative data sources, including conversations with loved ones of those who’ve passed, have shown that many weren’t even aware that the person they cared about was using drugs.

“…what we see on TV is a very visual, very visceral representation of the overdose crisis, what’s really happening is that the overdose crisis is something that’s happening behind closed doors, alone, and it’s not as sensational,” McLoyd says.

Overcoming barriers to accessing Naloxone

Naloxone in Black is a partnership between Vital Strategies, the PA Department of Health, the Philadelphia Fire Department, and the city’s Overdose Response Unit. 

While Naloxone can be found for free at various resource hubs and is stocked at many pharmacies due to a Pennsylvania Standing Order, availability doesn’t always translate to accessibility. 

One of the key aims of the initiative is to acknowledge the importance of anonymity for folks seeking treatment. 

McLoyd says the fear of outing oneself as a drug user remains prevalent in the Black community, due to abuses of power and unequal treatment of Black populations going back to the War on Drugs in the early 90s.

High levels of historic distrust mean that a lot of Black people aren’t comfortable interacting with someone else when looking for help.

“…that requires a level of self-identification that I think we are asking too much of our communities, who have been so overly penalized, to then sort of out themselves, or self-identify themselves as a person who uses drugs in order to access these really lifesaving and important products that they need,” McLoyd says.

Privacy isn’t the only barrier that exists for Black residents in need of Naloxone. Marisa Kosman is a Germantown resident and the founder of Not Another Outreach, a harm reduction organization that works primarily in Kensington. Kosman also supports unhoused residents in the neighborhood with hygiene products and harm reduction supplies, and she stocks the Germantown Community Fridge with Narcan and drug test strips.

Kosman finds that, in contrast to Kensington, the layout of Germantown makes it more difficult to pinpoint high substance use areas and get necessary treatment to neighbors.

“…you can pretty much set up on any block [in Kensington], and you’ll find people that you need, whereas in Germantown, I know little pockets here and there where people might need it, but I don’t have a set area that I know I can go to, that’s not gonna piss the neighbors off,” Kosman says.

Additionally, there are misconceptions within the Black community about who uses opioids, according to Kosman, with many residents believing that opioid use isn’t as common among Black substance users as other kinds of drugs.

She says she frequently hears these sentiments from Black community members while doing harm reduction work in the field.

“I get in arguments with people about it all the time, ‘Oh Black people don’t do this, we don’t do that’…well, no, the last five overdoses that I responded to, although they were in Kensington, not Germantown, were Black men,” says Kosman.

Understanding the options if you witness an overdose 

Besides knowing where to find free Naloxone and how to administer a dosage, McLoyd says there are a couple more points neighbors should know. 

Firstly, there are no adverse side effects of Narcan, so it won’t harm someone who doesn’t need it. Secondly, through the “Good Samaritan” provision of Act 139, bystanders cannot face any penalty for intervening to help someone experiencing an overdose or for reporting an overdose to 911.

Even if a bystander is in possession of controlled substances themselves, there is immunity for any would-be charges in the case of trying to save a life, as long as the attempt was made in good faith.

“You’re not gonna get in trouble, you can’t be prosecuted for helping somebody, and so we want people to be aware of that. Don’t let that be what holds you back from helping somebody,” McLoyd says.

Witnessing a substance user in distress is often scary — it can be difficult to tell if the symptoms are actually an overdose, and it can be paralyzing to have to make a split-second decision about whether to intervene. 

If you find yourself confronted with that choice, McLoyd offers this advice: “Saving somebody’s life is an incredibly powerful experience, and if you have the opportunity to do so, I would recommend that you do it.”

This story was done in collaboration with Equally Informed Philly, another Resolve Philly program that distributes vetted, actionable news, stories, and resources centered on the perspectives and information needs of underrepresented communities. Equally Informed Philly comprises three core programs: the Equal Info Text Line, the Info Hub Captains program, and a Community Newsletter, all designed to engage residents with tools that help them better navigate the systems in Philadelphia.