It’s a Friday evening just as happy hour kicks off, and Garret Cocteleria in Little Italy is already booming with a sea of bar patrons. Luis Arango, the establishment’s head bartender, is prepared to weather anything that could happen at the Broome Street bar — even an opioid overdose.
The Garret is part of the growing number of New York City’s nightlife establishments that are stocking their cabinets with an opioid overdose rescue kit.
“I’ve had friends who have overdosed. I always keep [a kit] handy,” said Arango, in between shaking his next order of cocktails.
In New York City, where one resident dies from a drug overdose every three hours, opioid-related deaths continue to reach record highs, driven by swells during the COVID-19 pandemic. Last fall, Mayor Eric Adams signed into law a bill introduced by City Councilmembers Chi Ossé and Keith Powers to curtail overdoses by making medical kits — equipped with the overdose prevention drug Narcan — more accessible across the nightlife scene.
“This is an overdue measure that will, simply, save lives,” said Councilmember Ossé in a press statement. “Each overdose death is a preventable tragedy; we do not accept them here in New York City.”
Rolling out Narcan
The sprawling effort to distribute free Narcan, the brand name for the drug naloxone, is led by the Mayor’s Office of Nightlife. It has spent the last few years piecing together how to partner with nightlife owners, promoters and workers to reduce overdoses.
“While the fentanyl overdose crisis is not exclusive to nightlife venues, accounting for less than 1% of cases, we see these spaces as places where people can look out for and protect each other,” said Ariel Palitz, executive director at the Office of Nightlife.
The staggering increase in overdoses has largely been driven by drugs cut with fentanyl, a cheap synthetic opioid that is up to 100 times more potent than morphine. Fentanyl and other synthetic opioids were involved in nearly 80% of statewide overdose deaths in 2021, according to the New York State Comptroller’s Office. Data released by the New York City health department last week found a similar proportion of fentanyl-related deaths in 2021.
An NYC health department pamphlet provides instructions in Spanish on how to administer Narcan, a critical need as overdoses jumped among Latino New Yorkers over the last decade.
Back at the Garrett Cocteleria, Arango urged that having Narcan embedded across the city’s nightlife is a no-brainer.
“Alcohol itself is a drug, which stimulates people to use other drugs. [Narcan] may not be required, but it can save lives,” Arango said.
Demystifying Narcan
Narcan is a potentially life-saving medication that can reverse the effects of an opioid overdose within minutes.
Often administered by first responders, a person places the tip of the nasal spray inside the nostril of the drug user and pushes a circular red plunger to release a 4-milligram dose of naloxone. Then they wait.
To help decrease overdose deaths, local advocates have pushed for a harm reduction approach, which advocates for safer drug use rather than outright condemning the consumption of substances.
“It’s just scientifically proven to be most effective,” expressed Elena Rotov, who is the naloxone coordinator and patient navigator at the After Hours Project, a community-based harm reduction nonprofit serving low-income and minority communities in Brooklyn.
Rotov spends her week as the organization’s resident Narcan expert, training groups on the proper administration of the overdose prevention drug.
You’re not going to get in trouble for using it, but you should only use it on somebody who’s unresponsive.
“The absolute need to know is that it’s safe to use on anybody,” Rotov said. “You’re not going to get in trouble for using it, but you should only use it on somebody who’s unresponsive.”
Giving Narcan to someone who is responsive can accidentally put a person in withdrawal, which can be uncomfortable but not life-threatening for an active opioid user if treated.
Nestled underneath the J train’s subway tracks in Bushwick, the After Hours clinic is reminiscent of a doctor’s office waiting room. When clients arrive downstairs, a team member greets them behind a glass-protected desk.
The health department’s overdose rescue kit is packed with two Narcan nasal sprays, a foldable information card, two pairs of gloves and a breathing face shield in case CPR needs to be performed.
On the clinic’s busiest days, a line forms. People looking for Narcan receive a brief yet informative training from Ruben Bonilla, a community outreach coordinator. Others ask for other harm reduction supplies, like safe injection syringes and condoms.
“A lot of [prohibition] has to do with addiction and how we just criminalize it rather than trying to treat it as a disease,” shared Rotov, adding that people will continue to use drugs whether or not others approve and criminalizing it will only lead to deadly consequences.
Keep in mind: Narcan wears off
As more bars and community programs carrying Narcan kits steadily increase, knowing where to find them remains challenging.
“The City does not keep a list of businesses that have taken advantage of the program but encourages all venues to have their staff trained in these potentially life-saving techniques,” said Johanna McCabe, press secretary of the NYC Office of Nightlife, in an email.
Rotov also emphasized that while putting these kits in as many hands as possible is key, Narcan is only a temporary solution.
People celebrate New Year’s Eve in a bar near Times Square on Jan. 1, 2023.
“Narcan wears off in 30 to 90 minutes … You definitely see people who end up dying because they get Narcan’d, they get left alone, and once it wears off, then they overdose again,” Rotov said.
While having Narcan across bars is an important step forward, Bonilla, who has been with After Hours Project since 2011, urged that the solution can’t stop at clinics and bars.
“These kits need to be in the bathrooms of McDonald’s, in KFCs, really anywhere where people are overdosing.”
