Partnership May Bring Lockboxes Stocked With Narcan to Massachusetts Street Corners

At least 54 people in Cambridge, Massachusetts, stumbled upon the scene of an overdose in progress on a Central Square sidewalk on a Friday in late April.

Fortunately, this particular scenario was merely a simulation and the overdose “victim” in question was actually a test dummy placed on the sidewalk by a team of doctors and the Cambridge Police Department.

The exercise was set up as a way for officials to test out a pioneering delivery system for naloxone, the life-saving opioid overdose-reversing drug that often comes in nasal spray form.

If the project is undertaken, Cambridge would be the first city in the country to install high-tech lockboxes stocked with Narcan—the brand name for naloxone—on street corners and in other public places to make it easier for bystanders to act quickly if they were to come upon a real-life overdose emergency. And, the whole thing is the result of an innovative public-private partnership.

How Would It Work?

First, a passerby witnesses someone experiencing an overdose. The bystander first calls 9-1-1—volunteers indicated on a survey that this would be their initial move—and once on the phone, the dispatcher asks standard questions, including: Is the person breathing? What do you see? The dispatcher would then inform the good samaritan that a lockbox is in the vicinity and ask if they are willing to help while emergency personnel are on their way.

If the person agrees to help, the dispatcher would proceed to provide them with a code to open the lockbox, and information on how to administer the Narcan.

It should be noted, that Narcan is a life-saver in the event of an overdose, but it’s also perfectly safe to administer to someone who isn’t experiencing an emergency due to opioid narcotics.

Who Is Behind the Idea?

GEMS, the startup that created the lockbox prototype, was founded by two friends, Andrew Schwartz and Jeff Lipton.

One day in July 2016, Lipton and Schwartz were having an ordinary conversation about the tragedy of the opioid crisis in their midst. The two were discussing the medical miracle of Narcan, and lamenting the fact that it isn’t readily available to people who call 9-1-1 to report an overdose.  

According to Schwartz, who spoke with Route Fifty over the phone, it was at that point in the conversation that Lipton, a post-doctoral student in engineering at the Massachusetts Institute of Technology turned to him and said: “I can building something like that.”

It didn’t take the two of them long to discover they weren’t the only ones in the greater Boston area working on a Narcan project. Vincent Ted Liao, an emergency doctor in residency at Massachusetts General Hospital had also been dreaming of ways to make Narcan available to the general public in urgent situations alongside Drs. Scott Weiner and Scott Goldberg, the respective directors of Opioid Response and Emergency Medical Services at Brigham and Women’s Hospital. Liao is now the GEMS chief medical officer, while Goldberg and Weiner continue to advise the company.

The group’s ideas further coalesced in September of 2016 during the Opioid Epidemic Challenge Summit and Hack-a-thon, an event convened by the GE Foundation, CAMTech and MGH Global Medicine. While the group didn’t win any awards at the initial hackathon, they did win the event’s $10,000 post-hack prize for the work the group undertook in the 100 days following the event.

Why Collaborate?

In that intervening time, the GEMS team brought their idea to the Cambridge Police Department, where it was met with instant enthusiasm. Since the department was first approached in December, law enforcement in Cambridge have worked closely with GEMS to provide input to make the lockbox system more efficient and more effective from a public safety perspective.

That input, after all, will be crucial to the success of the lockbox system. While the tech comes from GEMS, the process hinges on a strong collaboration with emergency services and law enforcement. Every potential 9-1-1 call will require the passerby, the lockbox, and the 9-1-1 dispatcher to work in tandem as a team.

The April 28 simulation was the first time the police, doctors and the team from GEMS have seen the product in action. The whole exercise was co-run by the Cambridge Police Department and Goldberg, and according to Jeremy Warnick, the director of communications and media relations for the Cambridge Police Department, the experiment was a success. Volunteers in the study reported “that it was easy to execute, that they didn’t have any issues in terms of unlocking the box, or following instructions from dispatch.”

While this early study is promising, the product is still a long way from being ready to be introduced for public use. The team may need to get a waiver from state regulators to even stock the lockbox with Narcan, given the existing rules regarding distribution of the nasal spray.

Nevertheless, it’s an innovation the department sees as worthwhile to pursue.

“Ultimately the reason why we are interested in and have been supportive of this project is, like many other cities around the country, we have seen year over year increases of overdoses,” Warnick told Route Fifty in a phone interview.

According to Warnick, the power of the Narcan lockboxes lies in what they could potentially do to overdose response times.

“This could enable us to decrease the response time, by having someone who’s on the scene at the time of the overdose,” said Warnick. “If they could administer a couple of doses in that time while public safety is en route, that could ultimately make the difference between life and death.”

Overall, these types of public-private collaboration between law enforcement, the medical community and the world of tech startups have the potential to be a source of innovation in the fight against the opioid epidemic. State and local government budgets are notoriously tight, and small companies like GEMS may be able to move faster, and change courses with more agility than a local health department.

While GEMS is still seeking a sustainable funding source for their opioid-related solution, the goal remains clear for Schwartz and his team.

“The goal is the get these into the communities that need them, whether that’s Cambridge or Alaska,” he said.

“We’re just trying to save some lives.”