Harvard students bring overdose-reversing drug to Red Line stations

Arun Rath: Nationwide, opioid overdoses have seen a drastic spike, including here in Massachusetts. In 2022, almost 2,400 people died due to an opioid-related overdose, per the Department of Health. What's especially devastating is that most of those deaths were preventable. The drug naloxone, also known as Narcan, was found to be almost 94% effective in reversing opioid overdoses.

Narcan has been made more accessible to the public in recent years; Governor Maura Healey's administration has supported increasing access to the lifesaving drug. But questions about where to actually get it remain unanswered. A group of Harvard students decided it was time to change that by launching a new project to provide boxes of Narcan at every MBTA Red Line station.

This week's edition of The Joy Beat is celebrating those students and the work they're doing to save lives. Two of the students are joining me today, Sanjeev Kohli and Swathi Srinivasan, both Harvard graduates and leaders of the university's overdose prevention and education students. Sanjeev, Swathi, welcome to All Things Considered.

Sanjeev Kohli: Thank you so much. So, so glad to be here.

Swathi Srinivasan: Thank you for having us.

Rath: So, Sanjeev, let's start with you. Tell us about how this project began. It started as a pilot study, right?

Kohli: Yeah, absolutely. So in my first year of college, I was very surprised at the disproportionate number of individuals, even just across campus, who were living in the streets, who unfortunately did not have access to stable housing or food security. So I joined a local homeless shelter, hoping to try to help with these — these unfortunate situations.

While there, I witnessed an overdose incident for a guest who was 19 years old. Now, luckily, the shelter was equipped with this intranasal naloxone spray. It was administered, and 911 was called in, and this individual, in particular, was fine afterwards. But I think this experience, to me in particular, really emphasized the power of the small, inexpensive, easy-to-use spray that can really, you know, mean the difference between life and death in these kinds of situations.

I think from there, I just grew really interested in trying to ensure that those people who need access to this, you know, life-saving nasal spray have that access and looking towards regions where we could increase accessibility.

I joined the HCOPES organization, and, you know, upon doing research, we saw that the T — in particular, Red Line stations in Cambridge — are opioid overdose hotspots that, unfortunately, are not equipped with public access to naloxone. So we decided we'd try to do what we could to start that process.

Rath: And Swathi, what drew you to get involved in helping fight the opioid crisis?

Srinivasan: Yeah. I mean, I'm from the state of Ohio, and sadly, the state is no stranger to overdose, and nor was I, kind of, in my community growing up. We've had our fair share of overdoses in my town, which is Cleveland.

And, you know, I got to Harvard thinking that, OK, well, I'd come to this new location, this new place on the East Coast. And then, I was shocked that within the first week, I saw the crisis just outside my dorm. The local bathroom, just a few years prior, it was shut for overdoses. I realized that there was no place I could go that I would escape this crisis. It is everywhere. It is among every community that I have been a part of and will be a part of.

I just got really, you know, both frustrated with that — that I could see this issue that not a lot of people were talking about. I mean, Harvard is a premier institution, and it works in so many fields, including, you know, public health, and this is a major public health crisis that is just at the steps of our institution and also within it.

So in kind of seeing that, I reached out to a professor who connected me to two other students of his who were starting to try and push for naloxone in Harvard itself so that students, faculty, staff could have access to it as needed. But that process was, you know, really, really strenuous. The university said no to us several times. And with, you know, those two students, Eana Meng and Kailash Sundaram, in the room, we set out instead to kind of think bigger.

And they graduated, but I was like, you know what? What we need are more students thinking about these issues. More students kind of devoted to fighting for this, whether through policy or through advocacy, activism, mentorship. And through that, the group HCOPES was born, which is Harvard College Overdose Prevention and Education Students.

And that group has various arms in policy, community advocacy. And through that organization, a lot of the work that, you know, students — I think, from different sides who are at all interested in this — were able to kind of convene and pursue, and I think that's in part where a product like this came from.

Rath: You mentioned that earlier effort on providing Narcan around campus. There was institutional resistance to it. University officials weren't very enthusiastic. This time around, with this project, are you encountering any institutional resistance? Or how is it going?

Srinivasan: So this project is dealing with different institutions, right? So that project was dealing with the Harvard Institution, it was dealing with the Harvard Health Services, Harvard Police, you know, various Harvard-based institutions. But this particular project deals with the government, the state government in Massachusetts.

With that, we're seeing, actually, a collaboration between the MBTA, the Department of Health through BCES, and our group, with most notably Senator John Keenan. And, Sajeev, I'm sure, can talk more about that as well. But because we're dealing with different institutions here, we actually have seen a much smoother process with the state government than we did with the Harvard organizational and bureaucratic issues.

Kohli: I think for this project in particular, we've been incredibly lucky, and I think very grateful to have so many different institutions and all these different kinds of facets of health and policy, you know, harm reduction and medicine, kind of come together and really work towards implementing this.

I think, you know, in initial discussions, and these discussions have been going on for almost three years now, I don't think we've ever had a conversation with someone, whether it's someone from Massachusetts General Hospital or from Pro EMS' ambulatory services or from, you know, the Mass Harm Reduction organization. I think everybody agrees that this should happen.

I think the conversations we're really just trying to delineate how to make this best happen. And I think it's really important to underscore, you know, this isn't just a couple of students who have been working on this; this is an entire community of individuals across Cambridge, across Massachusetts, and even across other states who have done similar work, you know, putting their heads together and really thinking about how best to make this happen.

I think I was particularly lucky to have, you know, one particular student, Jay Garg, who was in the group with me. He really helped kind of navigate a significant amount of those initial conversations and continues to be involved with this, you know, even today, leading it from the Harvard side.

Srinivasan: I think, you know, you see with the Narcan in AED project that our response wasn't to stop pushing for Narcan. We just had to shift our approach. Right? Think about, "Okay, we have to think bigger now." We have to think about other places, people that we can talk to, people we can ask because we're not going to stand here and take no for an answer.

Narcan availability is something that, through science and advocacy, we know to be useful and helpful. You said 94% accuracy rate here, and that's incredible. That is a lifesaving technology. And for a state that has had over 20,000 overdoses since 2011, it is a place that it's necessary. And so when push came to shove, it wasn't the end. It was just the beginning for us.

I think this is another project where, you know, it's a pilot program. We're hoping to see this be a useful program for those who need it and that this is only the beginning.

Rath: Swathi, it's been great talking with you. Thank you so much.

Srinivasan: Happy to be here.

Rath: And Sanjeev, likewise, it was really great talking to you about this work. Thank you.

Kohli: Thank you so much.