AMHERST — At the University of Massachusetts, a passionate team is expanding campus access to Narcan and fentanyl testing strips, and their efforts are being welcomed by students, staff and faculty.

At a recent outreach event — one of many initiatives held on campus in recent months — students picked up more than 100 free kits stocked with two doses of Narcan and a rescue breathing mask.

“Every single person that came up to me had their own personal story,” said Aidan Leonard, a graduate student assistant for UMass Recovery, a peer recovery community on campus that often helps with Narcan distribution.

While doing campus outreach on overdose and substance use, Leonard has found that, “so many people care so deeply about it, because they’ve seen it firsthand.”

The Narcan kits are distributed by the UMass Public Health Promotion Center, which has distributed 2,684 kits since launching the initiative in March 2023. That’s 5,368 doses of naloxone, a drug capable of reversing opioid overdoses. The kits are stocked at the University Health Services pharmacy and a free vending machine in the Campus Center basement. They are also available for pickup at the UMass Recovery space in Worcester Dining Commons.

An average of six kits have been taken daily since the program began a year ago.

This initiative illustrates a shift in how UMass approaches drug use, in line with a growing nationwide belief that incorporating harm reduction practices is crucial to combating the opioid overdose epidemic.

Widely available

The Harm Reduction Ambassadors, a working group that includes UMass Recovery and the Public Health Promotion Center, follows the harm reduction approach of meeting people where they are at and are spearheading the efforts on campus to make Narcan, rescue breathing masks and fentanyl test strips widely available.

“Everyone is connected to the [overdose crisis] in ways that basically strike us right in the heart,” said Betsy Cracco, assistant vice chancellor of Campus Life and Wellbeing, who works closely with the Harm Reduction Ambassadors. “And so, to be silent about it feels like we’re not listening.”

In November, the group installed the vending machine in the Campus Center basement that dispenses all kinds of harm reduction supplies — condoms, Narcan, masks, fentanyl testing strips — at no cost. In April, 64 Narcan kits and 20 fentanyl test strips were dispensed.

Additionally, eight “NaloxBoxes” have been installed in dorm service areas. Each unit is stocked with five kits, each one containing two doses of Narcan, fentanyl test strips and a rescue breathing mask. These units are intended as distribution centers and are not limited to emergency use, said Diane Fedorchak, director of substance misuse prevention at UMass and a central coordinator with the Harm Reduction Ambassadors. Fedorchak said hosting tables at events throughout campus is also expanding access and awareness of harm reduction supplies.

Leonard, the grad student who frequently staffs tables as a UMass Recovery representative, commonly finds that people know what Narcan is but not how to use it. While handing out kits, Leonard will often share tips for responding to a potential overdose, including reminders to call 911, check for breathing, responsiveness and pupils, and emphasizing that someone can’t be hurt by administering naloxone, even if they aren’t dealing with an opiate overdose.

Expanding Narcan access, fentanyl crisis

“Harm reduction is not a strange concept to me,” said Ann Becker, co-director of the Public Health Promotion Center. “I’ve always embraced it. I feel like it has evolved and matured far more, and I feel like a lot more people ... are much more fluent in the concepts and ideas than before.”

The harm reduction strategy has received support from the student body and UMass staff. Fedorchak has been in conversation with staff members at Campus Recreation, the W.E.B. Du Bois Library and dining halls who want to see Narcan distribution boxes placed in those spaces, too.

The working group is in the beginning stages of exploring where outdoor NaloxBoxes could be best positioned near where people are using drugs and are at risk of having an overdose. Northampton and Greenfield last fall installed outdoor Narcan distribution boxes, and initial findings suggest that the outdoor boxes get much more use than indoor boxes.

Every day in 2022, six people died of an overdose in Massachusetts, according to the state Department of Public Health. This is the third wave of the opioid overdose epidemic and it is one defined by the synthetic opioid fentanyl, a substance at least 50 times stronger than heroin, meaning that even a small concentration can trigger a deadly overdose. Fentanyl is common in many fake prescription drugs sold illegally, as well as in illicit cocaine and methamphetamine.

People without a tolerance to fentanyl are at high risk of overdose, making harm reduction an essential practice for not just people with substance use disorder but also “experimental” users — not uncommon on college campuses where many individuals may be exposed to illicit drugs for the first time.

Naloxone has remained largely inaccessible to the average person because of prescription requirements, financial costs and stigma. In March 2023, naloxone was approved for the over-the-counter sale.

“What’s changed in public health is the wider availability of Narcan in lay people’s hands and lay people can carry it,” Fedorchak said, “and we want more and more people to carry it because we’ve got too many people dying.”

Now, as a certified naloxone distribution program, the Public Health Promotion Center is able to acquire fully subsidized Narcan from the State Office for Pharmacy Services, and is authorized to distribute it to community members.

“It not only sends a message that this is something that’s available for you in case of an emergency, but it also sends a message that we care about our students,” Leonard said. “Even if they’re using drugs or engaging in types of risky behavior, [UMass] wants you to do it safely.”

The Public Health Promotion Center also orders fully subsidized fentanyl testing strips — capable of detecting whether the synthetic opioid is present in a variety of substances — from the state. This is especially significant, Leonard noted, as it’s not just a “medical lifesaving device” but a safety practice that in no way carries the connotation that people should be prevented from using drugs.

The presence of fentanyl testing strips in the vending machine and kits throughout campus signifies to Leonard that UMass “is not going to try to punish you for using. We want to make sure you do it as safely as possible.”