In 2017, a series of overdose deaths devastated Little Rock’s punk community. Conversations among the community about how to combat the overdose problem led local organizer Clay Kasper to found the Central Arkansas Harm Reduction Project, an overdose prevention program that provides free naloxone (trade name Narcan), a life-saving drug that can reverse an opioid overdose. The group also advocates for public health policies, programs and practices that work to reduce harm from unsafe drug use.
Kasper’s grassroots effort takes the idea of boots-on-the-ground organizing seriously — and literally. Kasper will personally deliver the drug to persons who text CAHRP’s anonymous, confidential hotline number (501-438-9158) for help and teach them how to administer it.
CAHRP also provides strips to test drugs for fentanyl, a dangerously potent synthetic opioid that has exacerbated the already staggering numbers of opioid overdose deaths in the United States. According to The New York Times, using recent data from the Centers for Disease Control and Prevention, of the 70,237 people who died from drug overdoses in the U.S. in 2017, 40 percent — 28,466 — of those deaths involved fentanyl or a similarly potent painkiller.
CAHRP also distributes overdose reversal kits, which include two doses of naloxone, two syringes and needles with which to administer the drug intramuscularly (not intravenously) in the shoulder, buttock or thigh, a packet with instructions on how to administer the drug, and the hotline number. Kasper said the kits have saved lives.
“I’ve had overdose reversals reported to me,” she said. “There have been some overdose reversal kits that we’ve distributed that have saved people’s lives. I feel very grateful that I had the resources to start the project when I did, because those people might be dead without it having been started.”
Kasper is able to distribute naloxone thanks to the Arkansas Naloxone Protocol, a state law enacted in 2017 that allows licensed pharmacists to sell the drug without a prescription to people who use opioids and those who might know someone at risk of an overdose. Kasper said this legislation was crucial to the founding of CAHRP.
“The act is what legally allowed a doctor to give a standing order to all the pharmacies in Arkansas,” Kasper said. “A standing order is something that’s been really important to our project. It’s basically a prescription for a community.”
Other key laws for CAHRP are “Good Samaritan” laws, which both protect doctors who write standing orders from being liable for civil damages for doing so and allow people who are not health care professionals to administer naloxone without legal risk.
To be able to buy the naloxone CAHRP distributes for free, Kasper got in touch with Tracey Helton, a harm reduction organizer featured in the harrowing 1999 documentary “Black Tar Heroin: The Dark End of the Street” about folks addicted to heroin in San Francisco. Helton in turn put Kasper in touch with a contact at the Harm Reduction Coalition, an agency that was able to broker a contract between CAHRP and the drug maker Pfizer. The contract allows CAHRP, which has a doctor’s standing order, to purchase individual vials — each a single dose — of naloxone directly from the manufacturer.
CAHRP is exclusively funded by community donations. But funds have been difficult to come by because of the stigma surrounding drug use and addiction, Kasper said.
“It’s really hard for us to fundraise since people with a lot of money want to hear the narrative of someone who was in college … or a child of a family with a lot of privilege,” Kasper said. “And it’s hard for them to hear a story of a homeless, gay, black sex worker who is using heroin intravenously. People don’t want to provide money to that person’s safety and survivability because they view it as being their fault.”
This kind of stigmatization is why the harm reduction element of CAHRP is important to Kasper and her team. For Kasper, harm reduction includes efforts to combat the stigma of drug use by marginalized groups such as sex workers, people experiencing homelessness, people who are HIV positive, LGBT folks and persons of color.
CAHRP is also an HIV-prevention project, and it provides free condoms. The Arkansas Department of Health recently certified Kasper to administer free rapid HIV tests through the Voluntary Counseling and Testing program. She can perform an on-the-spot test that, while not taking the place of a blood test for a medical diagnosis of HIV, is a preliminary indicator for those wishing to know their status. CAHRP is also preparing to advocate for legislative reform of state HIV-related laws.
Kasper is working to incorporate CAHRP as a 501(c)(3) nonprofit. Until CAHRP is incorporated, donations are not tax-deductible. The best way to support the project is to donate to the project’s GoFundMe campaign, or to reach out to Kasper directly. All funds will be used to continue purchasing naloxone to distribute for free, to purchase fentanyl test strips and condoms, and to buy other important supplies, Kasper said.
Kasper wants to continue providing resources to the community with as few barriers to access as possible. She hopes to attend graduate school soon to study public health, but, for now, growing CAHRP’s ability to impact the community is her priority.
Those interested in donating to or volunteering with CAHRP can contact Clay Kasper at firstname.lastname@example.org.