For the last few months, the Jordan neighborhood association has hosted a naloxone dispensary outside of its headquarters in north Minneapolis. Wrapped in white and red, the "Save a Life Station" is a recycled Star Tribune newspaper box with the coin mechanism removed. Anyone can reach inside and take a naloxone kit — for reversing opioid overdoses — or fentanyl testing strips for free, no questions asked.
Audua Pugh, executive director of the Jordan Area Community Council, can hear the box's metal door slam when someone uses it. She said it's become a frequent sound — and one she welcomes to help counter the "beast" of fentanyl.
"It's prevention of death," said Pugh, who has been in addiction recovery for 20 years. "Where our offices are located, that's a high-traffic area of people and product, of drug users, and so I saw the need. I know the importance of it."
Jim Barrett, a certified peer recovery specialist, and friend Andrew Kamin-Lyndgaard are the people behind the idea. They convert newspaper boxes into harm reduction dispensaries and try to get local service organizations to host them. Another box is inside East Side Neighborhood Services on NE. 2nd Street in northeast Minneapolis. Barrett and Kamin-Lyndgaard aren't a business or nonprofit, just "two guys who want to change a bad situation."
Barrett said he was moved by a CDC statistic: About 40% of overdose deaths occur with a bystander present, and most deaths happen in private residences.
"We have to try a lot of different things and figure out what does and doesn't work," he said. "But there's a lot of stigma around this. People don't understand the nature of it. They think drug addicts are people who live in encampments and under bridges and stuff, so ... basically what I want to do is normalize distribution of naloxone kits, so it's as common as fire extinguishers and AED machines."
There have been challenges. Some businesses fear having a Save a Life Station will invite addicts to congregate, or that it will be expensive to provide the supplies.
Pugh says the first concern is unfounded — "People get what they need to get and then they go about their business" — but keeping her box stocked has been tough. The Jordan neighborhood headquarters is an official Naloxone Access Point where people can pick up free safe use supplies provided by the Steve Rummler Hope Network. But the opioid awareness advocacy organization won't supply outdoor dispensaries like the Save a Life Stations. Pugh has to tap other community connections to get naloxone.
Alicia House, executive director of the network, said outdoor naloxone boxes may be helpful in places with a 24/7 need for naloxone, and for people who may feel uncomfortable getting it elsewhere.
But they also come with complications. Naloxone is best kept in a temperature-controlled place because it can freeze when it's cold and lose effectiveness in the extreme heat. Like all Little Free Libraries, outdoor Save a Life boxes risk being vandalized or wiped out of supplies. And if a box goes a long period without having its supplies replenished, the community it's meant to serve could come to think of it as an eyesore and a broken promise.
"Is it really getting distributed to make the biggest impact and also getting into the right hands? It's just hard to know," House said.
Nevertheless, the idea of outdoor naloxone boxes is gaining steam.
Last year the Overdose Prevention Project — a partnership between advertising agency SixSpeed and Southside Harm Reduction Services — set up Narcan nasal spray dispensaries outside SixSpeed's offices in St. Louis Park, and at the Episcopal Church in Minnesota in north Minneapolis. A third box was recently installed at Prince of Peace Lutheran Church in Brooklyn Park, and a fourth is tentatively coming to Southside Harm Reduction in south Minneapolis later this month.
SixSpeed creative director Grant Parsons said operating the boxes for the past year has been a "good idea in theory" that has often been "difficult in practice." They found that supplies would get completely cleaned out each week for at least the first month of the box being set up — a pace at which SixSpeed couldn't afford to keep replenishing. But as time went on, the community learned to trust that that the boxes would be restocked again and people seemed to start taking only what they needed, leaving kits for others.
"The hardest part actually was finding locations that would say yes," said Parsons. "We are in contact with a lot of the public libraries. They're trying to figure out how to do it with the red tape of government regulation."
Mary Anstett, president of East Side Neighborhood Services, said accepting a Save a Life Station was a no-brainer.
"For 109 years we've been a place for community to access different resources, and I just thought, of course, we're going to have that available to anyone that needs it," she said.
The Star Tribune has been decommissioning its coin-operated newspaper boxes as the company transitions from print to digital. Once numbering more than 1,000 on street corners across the metro, there are now about 50 boxes located in certain stores and restaurants.
Community members who sign a contract agreeing to repaint them any color other than green can purchase the decommissioned boxes for $20 each and reuse them as Little Free Libraries, food pantries and more. They're often donated for good causes, said Mick Timmons of the Star Tribune's single copy operations.