MA: MBTA balks at expanding overdose prevention kiosks

MBTA officials are pouring cold water on a legislative push to make the opioid overdose reversing drug naloxone available at subway stations, citing a lack of proper staff and a shortage of funding.

The T recently wrapped up a federally funded pilot project that installed 15 kiosks with doses of the medicine — also known by its brand-name, Narcan — at several Red Line stations to help reduce fatal drug overdoses.

But in a new report to the Legislature, the cash-strapped public transit agency said it has “determined that it does not currently have sufficient resources or appropriate personnel needed to manage the day-to-day administration of such a program.”

“The MBTA recognizes and supports the importance of promoting harm reduction efforts and increasing public access to lifesaving medication that can reverse an opioid overdose,” Lynsey M. Heffernan, the T’s chief of policy & strategic planning, wrote in the report. “In the event staffing and program management can be made available from a third party, the MBTA can continue to make space available in its facilities to support the program.”

While MBTA Transit police have and will continue to carry naloxone, the T recommended that any future public access program in or near stations be “managed by a third party” whose mission “is aligned with such an important program and that has the resources and personnel to monitor and resupply naloxone as well as to manage for temperature fluctuations.”

The report comes as Beacon Hill lawmakers push passage of legislation that calls for making the pilot program permanent across the T’s subway system. The legislation, if approved, would require MBTA stations to have at least two “freestanding un-alarmed naloxone boxes” each containing two units of the overdose reversing spray available for public use.

“Frankly, I believe every bus and commuter rail car should have naloxone,” state Sen. John Kennan, a Quincy Democrat and the bill’s primary sponsor, said in testimony before the Legislature’s Committee on Transportation earlier this month. “It should be as common as fire extinguishers and light bulbs.”

MBTA General Manager Phil Eng rolled out the pilot project in 2024 after receiving federal funding from a White House harm-reduction initiative focused on public transportation. Lawmakers approved $95,000 in the state budget to cover the cost of the pilot project, but the T only spent about $56,000 to install the 15 kiosks, according to the report.

It’s not clear whether the T’s pilot project saved any lives by making the overdose reversing drug accessible on public transit. The T’s report said that was inconclusive, and that there were “no known instances” of on-site use of naloxone from the cabinets or overdoses that can be linked to the public-access naloxone.

“As far as the MBTA is aware, all doses taken from the cabinets have been carried off site,” Heffernan wrote to lawmakers.

Like other states, Massachusetts is still grappling with a deadly wave of addiction that claimed thousands of lives from overdoses, despite a declining number of deaths.

There were 2,125 confirmed or suspected opioid-related deaths in 2023, which is 232 fewer fatal overdoses than the same period in 2022, according to the latest data from the state Department of Public Health. There were more than 500 confirmed or suspected opioid-related overdose fatalities in the first three months of 2024, the agency said.

State health officials say the majority of the overdose deaths were linked to the synthetic opioid fentanyl.

Curbing opioid addiction has been a major focus on Beacon Hill for a number of years with hundreds of millions of dollars being devoted to expanding treatment and prevention efforts.

The state has set some of the strictest opioid prescribing laws in the nation, including a cap on new prescriptions in a seven-day period and a requirement that doctors consult a state prescription monitoring database before prescribing an addictive opioid.

Advocates have called on lawmakers to propose a plan for “overdose prevention centers” where drug addicts can inject drugs under the supervision of medical staff to help prevent fatal overdoses.

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