This story was originally produced by the Valley News. NHPR is republishing it in partnership with the Granite State News Collaborative.
Amy Lappin, deputy director of Lebanon Public Libraries, looked out the window of Kilton Library one day about a year and a half ago as she was shelving books and saw a man suffering from a heroin overdose.
She called 911 and the man was revived by paramedics. The library is across the street from a fire station, so first responders were nearby. But she still recalls the day as a difficult one.
“I’m a librarian,” Lappin said in a recent phone interview. “I don’t often see medical things happen. I love my job. That was one of the worst days for me. I just felt really helpless. I just thought, ‘I never want to see that again.’ ”
That overdose was one of three that occurred outside the Kilton Library in one month in the summer of 2021. In two instances, the people were revived. A third was fatal.
As part of a response to that cluster of overdoses, the library has installed a “NaloxBox” outside containing doses of the opioid reversal drug naloxone, also known by the brand name Narcan. Anyone can take a two-dose box of the nasal form of the medication, which can be lifesaving, at no cost. The Lebanon Library also has a NaloxBox ready to go up when a custodian has time to install it, Lappin said.
The drug is relatively simple to use — a spray into the nostrils — so bystanders without medical training can administer it in the event of a suspected overdose.
The Lebanon-based HIV/HCV Resource Center is working to install more such boxes throughout the Upper Valley to increase access to naloxone. The boxes have been donated by the Center on Rural Addiction at the University of Vermont. And the naloxone comes from the Center on Rural Addiction, the Vermont Department of Health and the New Hampshire Doorway, according to Angel Hudson, the organization’s Vermont medical case manager.
The goal is to “prevent people from dying so they have another chance to make a choice, possibly for recovery,” Hudson said.
The resource center provides support to people living with HIV in Windsor and Orange counties in Vermont and Grafton and Sullivan counties in New Hampshire. It also operates a syringe exchange program and performs testing for hepatitis C.
Last year, the organization gave out 3,747 doses of naloxone, which reversed 362 opioid overdoses “that we know of,” Hudson said. She suspects that the drug was used to reverse other overdoses that weren’t reported back to the resource center.
In hopes of preventing more deaths, Hudson is working to connect with various businesses and groups throughout the Upper Valley to install additional NaloxBoxes. In addition to the Lebanon libraries, plans are in the works to install boxes in downtown White River Junction. Listen’s community dinner site, 42 Maple St. in White River Junction, has had a box up for several months, said Angela Zhang, Listen’s programs director.
“Unfortunately there have been a few times when staff have needed to use Narcan in a couple of instances,” Zhang said. “They’re happy to have it on hand. Unfortunately we do have an opioid epidemic. (It’s) better to have more access and support.”
Listen regularly serves about 120 meals a night, so the site sees plenty of traffic. While the NaloxBox hasn’t had a lot of use, some people have taken naloxone out, Zhang said. Hudson monitors the supply and keeps the box full.
The boxes are an innovation of two Rhode Island professors, one at the Warren Alpert Medical School of Brown University and the other at the Rhode Island School of Design, according to a 2017 news release on Brown’s website. The professors sought to make the medication more readily available to bystanders who might be able to administer the drug more quickly than first responders.
For her part, Lappin doesn’t know what happened to the man she saw overdose in 2021.
“He walked off kind of angry that they had ended his high,” she said. “... Often there isn’t a great story, except that they’re alive.”
She likens having naloxone available in case of an opioid overdose to having an automated external defibrillator, or AED, available in case of a heart attack.
The library also works with the White River Junction-based UVGear to provide tents and sleeping bags to people experiencing homelessness. The library served as a warming station during last weekend’s cold snap and offered hot drinks, snacks, socks from UVGear and scarves from the downtown Lebanon-based Scratch Supply Co.
“Libraries today are about providing resources and helping where we can,” Lappin said. Offering naloxone is “an easy thing for us to be able to do.”
Those interested in installing the boxes elsewhere in the Upper Valley can reach Hudson at 603-306-6386 or Angel@h2rc.org.
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