This is a commonly recurring scene that the Dallas Harm Reduction Aid wants to change. In their version of events, a stranger will push through the crowd, Narcan Nasal Spray in hand, and administer the medication to your neighbor. Within seconds, that person comes to as Narcan saves their lives from an opioid overdose.
Dallas HRA cofounder Nicolas Moreno has lived such an experience and saved one person's life from an opioid overdose. Together with Candice Starnes and Abby Brown, the trio wants to put Narcan in the hands of as many Dallasites as possible, and they’ve got the support of local businesses to do it.
The nasal spray contains naloxone hydrochloride, which counteracts the effects of opioids and is administered in overdose cases. Training on how to recognize an opioid overdose and how to administer Narcan can be found at getnaloxone.org.
“I feel like if we had something like this here in Dallas, at least when I was going through my addiction to heroin, it would have saved a lot more lives,” Brown says. “And we just don't want any family or friends to experience the loss and the grief and the hurts and pain that we've all and many of our friends and family has experienced because of addiction.”
Moreno, Brown and Starnes share the lived experience of past addictions and know firsthand the difference harm reduction could make in the lives of those affected. Together in 2020, they formed the Dallas HRA.
According to AIDS.org, “Harm reduction is a way of dealing with behavior that damages the health of the person involved and of their community." This methodology emphasizes not shaming drug users but instead providing them with ways to reduce potential harm. The Dallas HRA supplies local businesses and individuals with clean use supplies such as needles, fentanyl testing strips, Narcan and training on its administration.
“There was a huge rise in drug use during the quarantine because no one had outlets like getting out and doing things so people were starting to use drugs a lot more frequently and then fentanyl started really becoming a problem,” Moreno says. “That's why so many overdoses were happening. We, in Dallas and the state of Texas, have a pretty old-school way of looking at addiction where if you have an addiction you're on your own, you're not worth saving.”
Fentanyl is a synthetic opioid used pharmaceutically to treat severe pain, typically for cancer patients. The painkiller is often laced intentionally and through cross contamination with other opioids such as heroin and stimulants such as methamphetamine. Self-administered fentanyl can be fatal. A fentanyl overdose was Prince’s official cause of death in 2016. Since then, fentanyl use and overdoses have skyrocketed.
The Texas Department of Public Safety announced Dec. 9 that 160 pounds of fentanyl had been seized in cooperation with Operation Lone Star, efforts between Gov. Greg Abbott and DPS to prevent the smuggling of drugs and people through the Mexico-U.S. border. According to DPS, 2 milligrams is a lethal dose and the seizure equates to approximately 36.2 million lethal doses.
“There's also these fake press tabs, a lot of them are coming from the Southern border, and what it is is that someone's found a way to manufacture what looked like authentic pills, be it Percocet or Xanax or Adderall, which is a big one, and there is actually a large amount of fentanyl in them,” Moreno says. “One of the people that was saved with some of our Narcan had a Percocet that they thought was real. They only took half of it and they're used to taking a full one; they had to have two doses of Narcan administered to them so they didn't die.”
The pill was tested with Dallas HRA fentanyl testing strips and shown to contain the narcotic.
A report released January 2021 by the United States Sentencing Commission found that one third or more of fentanyl offenders sold the narcotic under the guise of another drug. Addiction and overdose remains stigmatized. Most do not understand addiction and the inability to “just stop,” says Starnes.
“You can't judge somebody you don't know," Starnes says. "You don’t know where they've come from, you don't know what situation they're in, and the fact that people have this negative stigma towards drug abuse, it doesn't help anybody. [The stigma] doesn’t, in my opinion as a recovering addict, give you any hope that you can recover or be accepted by anybody.”
“I don't care what people think of me as long as I'm saving someone's potential life ... In the end of the day, if you're going to use and you're going to get high, you're going to do it no matter what anybody else thinks.” –Dallas HRA cofounder Nicolas Moreno
Dallas HRA’s clean supplies include safe-injection kits, safe-sex kits and safe-snorting kits. Along with the fentanyl test strips and Narcan, Dallas HRA delivers all supplies to individuals who request them. Kits, strips and Narcan can be ordered by calling 214-470-2225 and a volunteer will respond within 24 hours to schedule a delivery. The organization ensures complete anonymity beginning with the use of a burner phone to encourage users not to fear utilizing their services. Once the supplies are delivered, the caller's contact information is removed from the phone logs.
While these efforts are made in good faith, Dallas HRA has come across those who disagree with their practices.
“I don't care what people think of me as long as I'm saving someone's potential life,” Moreno says. “We've had people tell us that what we're doing is wrong and that we're aiding in people's substance abuse, but the reality is that unless they've actually been there and have actually seen the things that we've seen in the places we've been they're not going to understand that you can tell an addict no as much as you want, but in the end of the day, if you're going to use and you're going to get high, you're going to do it no matter what anybody else thinks.”
But Dallas HRA has garnered local support. Businesses throughout Dallas are stocking up on testing strips and on Narcan. The testing strips and Narcan are available to be picked up for free at 13 businesses, including Reno's Chop Shop, The Nines, Spinster Records, Ruins, Double Wide Bar and Full City Rooster.
Dallas HRA urges people who know users to pick up a box of Narcan, because being at the right spot and time with Narcan could be a matter of life or death for another person.
Michael Wyatt partnered with Dallas HRA in August 2020. He stocks Narcan at the register at his coffee roasting studio Full City Rooster. At first, he says, customers were hesitant to take the Narcan, citing they didn't need it. Soon, many returned and took a box. Wyatt estimates over 100 boxes of Narcan have been distributed through his business.
“Last year 100,000 people died from an overdose and many of those were accidental, because of fentanyl,” Wyatt says. “Experimentation or drug addiction shouldn't be a death sentence, and giving someone another chance might just be all that they need, so I think it's important for everybody to have [Narcan].”
Wyatt says he hasn't received any pushback for supplying Narcan and wants to inform others that it is legal to do so. Texans can legally distribute Narcan free of cost. Aside from ordering from the Dallas HRA, federally funded and state executed grant Narcan is available free to organizations online at morenarcanplease.com.
“I don't challenge anybody to [stock Narcan], but I respect those that step up and do it because I believe that it's not enough to be a business in the community, you have to be part of the community," Wyatt says. "And because it's with us, drug addiction and abuse, it's part of the community.
"I think that we need to also contribute to changing lives where we can and it's as simple as just having it [Narcan] available. We don't even talk to people about it unless they ask, they just come up and grab it … it's a life saving antidote and it's worth having.”