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.
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.
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
“Naloxone from Remedy Alliance allowed us to better serve laypeople at risk of overdose throughout Georgia. The affordability of vials from RAFTP enabled us to purchase many more units of naloxone which translated into an increased number of lives saved. We are so thankful for Remedy Alliance/For The People!”
Georgia Overdose Prevention
"There is no limit on the amount of naloxone we provide now. We don't have to rely on these organizationswho aren't actually doing the grassroots,community level work. There are many areas of Buffalo that need consistent access to naloxone but don't always have the means to travel to the Health Department or other organizations to get it. Remedy Alliance makes it so easy for organizations like ours, which are new and don't necessarily have the funding like larger community health organizations but are doing the community work to access naloxone and get it to the community quickly without jumping through red tape."
The Giving Back Foundation
Buffalo, New York
"We have been able to provide naloxone to our community and the rural areas around us as well! When the naloxone shortage hit during the pandemic we were scrambling. You all made us breathe a sigh of relief. We knew you would come through. Thank you from the bottom of our hearts for everything you do."
QC Harm Reduction
Quad Cities, Illinois-Iowa Border
"This gave us a small non-profit the ability to provide a resource to usually ignored smaller towns. We are extremely grateful for the chance to provide a much needed service."
Harm Reduction Community
Burlington County, New Jersey
"We were not able to easily access IM naloxone from the state, and used RAFTP's system of low barrier access as an example of how easy the state COULD make it, if they wanted to...RAFTP provides a model for low barrier access that could, and should, replace unnecessarily restrictive gatekeeping policies across the country."
New York Recovery Alliance (NYRA)
Rochester, New York
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.
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.
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.”
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
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).
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.”
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."
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."
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.
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
Hear from our partner programs
"Thanks to Remedy Alliance we are able to have a steady supply of naloxone without having to worry about securing funds for this life saving medicine. With RA's help we have been able to pass out over 2000 doses of Naloxone since we first started. Sometimes our group runs on $20 & what we can buy out of our pocket so having RA is life-saving. We have not been able to access our states bulk fund that provides free naloxone & nasal brand Narcan to groups in the state, and while our group is doing outreach on a weekly basis we have run into different barriers with accessing funds like this - thanks to Remedy Alliance we don't have to worry about that. Colfax Cats is run entirely out of our apartment, we rely on the kindness and help of groups like Remedy Alliance and SmokeWorks Boston to take care of each other and the larger community we serve. We love you guys."
"There is no limit on the amount ofnaloxone we provide now. We do notdon't have to rely on these organizationswho aren't actually doing the grassroots,community level work. There are manyareas of Buffalo that need consistentaccess to naloxone but don't always havethe means to travel to the HealthDepartment or other organizations to getit. Remedy Alliance makes it so easy fororganizations like ours, which are new anddon't necessarily have the funding likelarger community health organizations butare doing the community work to accessnaloxone and get it to the communityquickly without jumping through red tape."
The Giving Back Foundation
Buffalo, New York
"Before we became involved with Remedy Alliance, we had uncertainty surrounding the schedule & origin of upcoming naloxone shipments. The unavailability of naloxone due to SCORE's financial limitations was truly dispiriting. Yet, such obstacles didn't hinder Remedy Alliance. Their support to under-resourced programs enabled SCORE to effectively address the community's needs by obtaining naloxone. Thanks to Remedy Alliance SCORE can now effectively address the requirements of the community without having to reject anyone in need. The most remarkable outcome of enhancing naloxone accessibility is the preservation of lives across numerous communities, including our own, where access to naloxone was previously scarce. Not to mention how easy it was. Remedy Alliance serves as a vital resource for unfunded organizations like SCORE. Preventing overdoses hinges on ensuring widespread access to naloxone among drug users and their communities, a goal facilitated by Remedy Alliance's dedication to making naloxone easily obtainable. Thanks to Remedy Alliance's commitment, together we can truly make a crucial impact in overdose prevention."
South Carolina Overdose Response
and Education ("SCORE")
Myrtle Beach, South Carolina
"As far as I know, I am the only local organization that provides IM naloxone to the community at all. So I consider that to be extremely important, especially for the PWUD that are specifically asking for the IM and are being turned down from other SSPs."
Insubordination Station Harm
Dover, New Hampshire
"Wowee! Being entirely run by community donations, receiving naloxone from you all has allowed us to use our precious resources for other needs in the community. Naloxone is something we don't ever want to go without on our outreach services, and it has been amazing to always have some to offer! You're keeping our community alive! We have very little funding (just kept afloat by community donations currently). It was difficult to budget and decide what to cut so that we could ensure naloxone was available to our participants. With you all supporting our naloxone supply we haven't had to make major budget cuts that would take away from our other services we offer! Thank you for all you do! Our team and community is so grateful!!!"
Black Thistle Street Aid
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
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
|Naloxone sent out (naloxone, packaging, shipping)
|Community Support Initiative paid to underfunded programs for kit packing
|Person power (staff, benefits, lawyers, bookkeeper, web designer, etc.)
|Office costs (rent, supplies, utilities etc.)
|Other stuff (Insurance, Shopify/Google/other app subscriptions, merch)
Looking to 2024
Photo courtesy of the DCG: FTIR
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
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!