Welcome to our 2023 Annual Impact Report
Art by Shannon Knox
“A SIGH OF RELIEF” — from one of the testimonials sums up our collective experience over the past two years. Relief that the shortage has ended, relief that we narrowly avoided another one this summer, relief that this wild idea actually worked, relief that people who use drugs who we love are still breathing.
And yet, too many of our loved ones keep dying. The work that harm reduction programs, drug user unions, mutual aid groups, and (some) health departments are doing is more important than ever.
Read on to find out how our first year went and what we have planned for the future.
Much love,
Eliza, Maya, Nab and the rest of the RA/FTP Team
In our first year of operations as Remedy Alliance we sent:
- 1,639,542 doses of generic injectable naloxone to...
- 196 harm reduction projects in...
- 44 US states, DC, and Puerto Rico of which...
- 206,371 doses were provided at no-cost to...
- 138 under-resourced harm reduction projects and...
- $180,000 in unrestricted funds were re-distributed to...
- 20 under-resourced harm reduction programs and mutual aid projects through our Community Support Initiative.
Our values
Transparency
Practicing ethical and harm reduction values-based “business”
Honoring the autonomy and self-reliance of harm reduction programs and allied projects and movements
Assisting harm reduction programs in building and seizing power and control over the means of distribution/production of resources, technologies and innovations
Centering and fairly compensating the wisdom and expertise of harm reduction programs and participants
Liberating materials, technologies, and knowledge from exclusive institutions that are hostile to people who use drugs and do sex work
Photo: Nigel Brunsdon
Abundance as our guiding light
In the spirit of our generous friend and mentor Dan Bigg our primary overarching goal for our first year was to really, truly come to an abundance mindset regarding naloxone.
We have never collectively experienced abundance in 27 years harm reduction programs have been distributing naloxone.
Remedy Alliance/For The People (formerly known as the volunteer/un-incorporated OSNN Buyers Club established in 2012), incorporated as a non-profit in 2021 and launched operations on August 1, 2022. We designed Remedy Alliance to have a sustainable infrastructure to provide low-barrier, low-cost access to naloxone to harm reduction programs in the US.
Hear from our partner programs
How we got here
Our backstory: 2021 - 2022
This time was full of the preliminary work that needed to happen in order for us to get to where we are today.
Mockup: RAFTP Website
Developed our infrastructure
Generous support from Open Society Foundations, NEXT Harm Reduction, and Points of Distribution allowed us to set up our website, compensate advisors experts, secure a brick and mortar facility, and begin purchasing a small amount of naloxone.
Photo: Hikma
Secured a supply of affordable naloxone
We worked with Pfizer and Hikma Pharmaceuticals, two manufacturers of naloxone, to create unique relationships that would protect the supply of naloxone for harm reduction programs.
Screencap: John Oliver on HBO’s Last Week Tonight
Overcame regulatory barriers
Throughout late 2021 and early 2022, we held a series of meetings with federal agencies, pharmacy experts, and policy experts. During these meetings we workshopped methods to free naloxone from regulatory constraints that prevent many harm reduction programs from purchasing naloxone.
Infographic: Nabarun Dasgupta
Developed the exempt wholesale model
We proposed a novel system where Remedy Alliance could be the purchaser of naloxone from manufacturers, then act as a wholesale distributor to harm reduction programs without requiring them to produce a medical license, commercial address or 501(c)3 documentation.
August 2022
Our launch
We opened our first brick and mortar office/warehouse in Berkeley, California in August 2022. We spent July setting up the warehouse, making final changes to our website, and officially hired Maya and Eliza as co-directors.
Remedy Alliance’s California warehouse, also known as the“naloxone store.”
Left: Art by Eddie McIntosh | Right: Art by Leeway Cat
September 2022
Community art contest
In September we held a community art contest to source some logo ideas and graphics for Remedy Alliance from artists in the harm reduction community. We received many great submissions from artists in the community, and provided all “contestants” with a $595 (if you know, you know) honorarium for their work. Two of the designs we have used for stickers, shirts and other materials, by Eddie McIntosh (left) and MxLeeway (right).
Photo of Maya at the Michigan warehouse
December 2022
Remedy Alliance Middle America
In December 2022, we opened our second brick and mortar warehouse in Traverse City, Michigan where Maya is based. The Michigan-based warehouse, which we lovingly refer to as Remedy Alliance Middle America, is the primary site of operation for our assembled naloxone kit project that we launched in early 2023 (more about that and our Community Support Initiative later in this report).
The results
This year showed us that this model works. The generosity of harm reduction programs never ceases to amaze and fill us with gratitude for this resilient community
From our partners
“It's the only way we can keep up with the demand we face in SC. Our state only provides us with about 1/3 of the naloxone that we actually need. Also, our state only provides Narcan nasal spray, whereas many of our participants prefer the IM naloxone. Thousands of lives would not have been saved in South Carolina had it not been for Remedy Alliance. I don't know how to put a value on that.”
Challenges
Greenville, South Carolina
From our partners
"Yes! We are the only SSP in DC that offers the injectable naloxone, and doing the education work around how to use nonintranasal naloxone has sparked some great conversations about the nuances of overdose response, strategies for community care, and has allowed us to hear stories about community overdose reversals that we can help community first responders process. We are so grateful to be part of this network of harm reduction organizations making radical change for the world we envision. The educational work and the labor of bringing organizations from across the country together are testimonies to the spirit of Remedy Alliance, and how much they have done to enrich the national harm reduction community."
HIPS
Washington DC
From our partners
"Yes! It has helped us so much because the price of nasal Narcan is so high and many of our participants request the injectable option! Hell yeah! You gave it to me for free before I had funding and zero access to Narcan! I love you all from the bottom of my heart and appreciate all you do for communities like mine."
Stabbin Wagon
Medford, Oregon
From our partners
Before Remedy Alliance we struggled to find a doctor to sign off on our Pfizer contract so that we could order naloxone. Working with Remedy Alliance totally eradicated that issue. Also we're an org with a pretty small budget, and receiving free/low cost naloxone has allowed us to free up funds to use for syringes and pipes.
SHOTS
Tulsa, Oklahoma
From our partners
"It made ALL the difference - from people who prefer IM (many of our participants) to making sure there is enough naloxone since nasal is so expensive/privileged. Secondary SAP distributors are able to reach so many more folks due to our IM access. While we haven't had a significant access issue, we always have ample supply of naloxone because of this system. We never have to worry about being out, and the State is now (finally) taking seriously the benefits of IM for the state distribution network because we are 1) the program that distributes the most and 2) always have it in stock when other members of the network are out of nasal. We love you! Thank you for ALL the things. <3"
Maine Access Points
Statewide
Hear from our partner programs
Focus on equity
We designed Remedy Alliance to be as barrier-free as possible, so that any program or group who was distributing naloxone to their community could obtain a supply– regardless of legal/incorporation status, funding, or whether or not they were operating under a standing order or institutional authorization.
We are now working with nearly 200 programs that include multiple Indigenous wellness collectives and tribal organizations, Black-led harm reduction programs and mental health collectives in the South and Appalachia, sex worker collectives in the Pacific Northwest distributing supplies to their networks, mutual aid groups working on the Mexico border, and many more.
To help guide us in our work towards equity, we partnered with doctoral student Kendall LaSane who produced a white paper entitled “For The People: Autonomy and Equity in Naloxone Distribution'' (which will be publicly available shortly).
Photo: Travis Long, AP
Climate Change & Harm Reduction
During the last weeks of our first year in operation, just as we are finalizing this report, a climate disaster occurred on July 19, 2023 destroying Pfizer’s Rocky Mount manufacturing plant, the only place the naloxone we purchase from Pfizer is manufactured.
Prior to the formation of Remedy Alliance, this might have driven us into a second naloxone shortage. However, our relationship with Pfizer allowed us to secure naloxone from their stores in another location. We also have about 700,000 doses in stock from our second manufacturer.
Remedy Alliance was established during the last naloxone shortage to make harm reduction programs more invulnerable to these types of events and here we are with our first test.
Our work to prevent fatal overdose is interwoven with climate justice.
Community Support Initiative
We all know that making kits is the eternal backdrop to any harm reduction program…and it takes up A LOT of time! Some Remedy Alliance/For The People customers don’t have the time, space, desire or know-how to pack kits themselves and want to purchase assembled naloxone kits instead of assembling the components themselves.
Our Community Support Initiative is designed to be mutually beneficial for us and for harm reduction programs. We will pay under-resourced harm reduction programs to take a bunch of supplies, wave their magic wands (labor), and return the supplies to us as assembled kits. In exchange, we will provide the program with unrestricted funds per kit packaged to use for WHATEVER THEY WANT!
This is how it works: State X buys an assembled two-dose naloxone kit for about $19 a piece (~60% cheaper than two doses of nasal). About $6 of that goes to buy the naloxone/bags/syringes/stickers/etc. We pay your program $5 per kit for assembly. The remaining $8 per kit goes to buy naloxone for un-funded programs and helps absorb huge shipping costs.
In our first six months of the Community Support Initiative, we have provided 20 under-resourced programs with $180,000 of unrestricted funds in exchange for packing 40,000 naloxone kits.
This box is revolutionary: Completed CSI Naloxone kits assembled in Oklahoma
Fiscal Transparency
One of Remedy Alliance’s core values is transparency. Working adjacent to one of the least transparent industries (the pharmaceutical one), we are actively working to subvert the opaque, profit-driven, extractive and opportunistic nature of access to medicines in the US
| Type of expense | Amount |
|---|---|
| Naloxone sent out (naloxone, packaging, shipping) | $1,590,256.90 |
| Community Support Initiative paid to underfunded programs for kit packing | $180,000.00 |
| Person power (staff, benefits, lawyers, bookkeeper, web designer, etc.) | $328,173.80 |
| Office costs (rent, supplies, utilities etc.) | $65,619.75 |
| Travel (conferences) | $32,374.34 |
| Other stuff (Insurance, Shopify/Google/other app subscriptions, merch) | $53,886.29 |
| Total | $2,250,311.08 |
Looking to 2024
What’s ahead
Photo courtesy of the DCG: FTIR
Drug Checking
Drug overdose deaths continue to rise, and the drug supply is increasingly unpredictable and treacherous. While the CDC and SAMHSA are allowing some federal funds to be used for drug checking equipment the learning curve is steep and expertise is limited. Our drug checking initiative will provide support to BIPOC and PWUD-led community based initiatives working to get their drug checking services off the ground.
Image from Harm Reduction Therapeutics website
Nasal Naloxone
In 2024 we plan to launch a nasal naloxone product with the only non-profit pharmaceutical company, Harm Reduction Therapeutics (HRT). The 3mg nasal naloxone product, RiVive, was approved by the FDA on July 28th, 2023.
Access to Other Medications
Remedy Alliance hopes to begin moving into new spaces in terms of providing no-barrier access to medicines, especially those that are stigmatized and for stigmatized people and health issues. One of the areas we are interested in is expanding access to medicines for reproductive health and justice. We are excited to partner with AIDS United and Julie to provide free emergency contraception to harm reduction programs for distribution to people who use drugs, who are doing sex work and who are unable to easily access reproductive health care in their communities.
Thank you for being a part of our first year.
If you’re looking for ways to get more involved, we encourage you to support your local harm reduction program. Not sure who to support? Contact us for a recommendation for a program in your state!