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Sitting inside Grace Lutheran Church, Scott Dion has a vivid memory of the day he fled to a downtown detox center to seek help for an overdose. He was a dope-sick addict at the time, he said, and he got what he thought was heroin earlier that day.
But as soon as the drug hit his veins, he knew that’s not what it was.
“I knew something wasn't right,” Dion said. “ I started feeling like my pores were opening up. My insides didn't feel the same way as I would when I was doing black tar heroin.”
Dion had been given fentanyl. It’s a synthetic opioid that’s up to 50 times stronger than heroin, according to the CDC. That day was his first and last encounter with it.
“My eyes were rolling back in my head, and the sound started going away, and everything started getting really dark. And that was the last thing I remember right there,” Dion said.
He woke up in the detox center where medical staff had given him Narcan. It’s a form of the medication naloxone that’s used to reverse an opioid overdose. Dion had never heard of it, but it gave him a second chance at life. He’ll celebrate five years of sobriety this month.
“I hear this still small voice in the back of my head tell me, ‘Hey, Scott, I gave you one more chance, now go make it count,’” Dion said. “And I still hear that voice today.”
Today, Dion is a harm reduction and peer recovery coach with Corazón Ministries where he helps distribute naloxone. Corazón is a local nonprofit that supports homeless and marginalized communities. They partner with the city and other local non-profits to run a day center at Grace Lutheran Church to provide people with essential resources like meals and showers.
Madelein Santibanez is the director of harm reduction at Corazón.
“Anyone that comes in through our doors can receive up to two doses of naloxone, and they can choose either the nasal spray or the injectable,” Santibanez said. “And so we see on a daily basis about 100-150 people a day.”
Corazón’s naloxone supply comes from the UT Health San Antonio School of Nursing, which distributes the medicine to organizations and individuals for free through the Texas Targeted Opioid Response (TTOR) program, an initiative from Texas Health and Human Services (HHS).
The medication is free to anyone in Texas who requests it through the TTOR website MoreNarcanPlease.com, which started in 2018. Dr. Lisa Cleveland leads the effort.
“The program has been really successful. We've distributed more than 700,000 doses of naloxone throughout the life of the program, which is pretty significant,” she said.
The program is funded by the U.S. Substance Abuse and Mental Health Services Administration, a federal agency within the United States Department of Health and Human Services that makes substance use and mental disorder information, services and research more accessible.
The Overdose Prevention Education and Naloxone budget is $5,588,225 annually. According to Texas HHS, 75% of that is allocated to naloxone products — Narcan and the injectable solution.
Part of the federal grant requirement is to ensure naloxone goes to areas with the highest risk of overdose. HHS calls it “saturation.”
Cleveland said it’s difficult for her team to track the naloxone once they ship it, but that they partner with local non-profit organizations to implement saturation at the community level in each Texas county.
“There are certain target populations where we want to make sure we're getting naloxone into their hands, such as harm reduction organizations — treatment providers who actually provide treatment services to people who are very high, high risk for an overdose death,” Cleveland said.
Santibanez said Corazón asks their clients if they use the naloxone they’re given.
“So we track. ‘Have you used this Narcan in the last week since you've seen us?’ ‘Oh, yes.’ ‘Did you use it? Did you call 911? Did they survive?’” Santibanez said.
Corazón is one of the program’s community partners for Bexar County. Other partners include St. Luke’s Baptist Church and the Bexar Area Harm Reduction Coalition. Erika Borrego, Corazón’s CEO, said the partnership stems from being in a strategic place in the community.
“Having an established trust with the individuals who are probably most vulnerable and already having connected relationships with individuals that would be directly impacted by us providing this type of service,” Borrego said.
In 2020, Bexar County saw 125 opioid-related deaths, the fourth highest out of all Texas counties. Last year, the county saw 181 deaths related just to fentanyl, according to the Texas Department of State Health Services.
Organizations like Corazón are among those who see firsthand the opioid and fentanyl crisis in San Antonio. In their experience, the West Side sees the worst of it. Santibanez said the fentanyl is rampant and that the demand for the type of work her team does has increased.
“Bexar County is super big, and our outreach team, even though we go out five days out of the week, we're still just scratching the surface of the real issue,” Santibanez said.
Corazón got naloxone from their free clinic at Travis Park Church before the partnership. The cost of Narcan at a pharmacy can range from around $50 to $130 for a box that includes two doses, according to GoodRx.com. Santibanez said the availability of the medicine for free has expanded Corazón’s clientele.
Juan Samedio is someone who benefits from free naloxone. He said he’s been homeless for two years. He visits the Corazón day center often to get fresh clothes and Narcan. As a heroin addict, he said he is the only one out on the street with Narcan sometimes. He’s administered Narcan to someone having an overdose on the West Side.
“Out there, like hardly anybody uses Narcan out there, you know,” Samedio said. “And there's been a lot of [overdoses] out there man and, like, I know because I'm one of them.”
Corazón Ministries estimated more than 1,500 lives were saved with the Narcan it distributed last year. Borrego said love, compassion and togetherness are needed to solve the city’s opioid and fentanyl crisis. She’s grateful for the opportunity for Corazón to serve the community the way it does.
“We want to be at the right table with the right people who are having those conversations to drive this,” Borrego said. “Right now for us, UT Health San Antonio School of Nursing is like the guiding light that's helping us make that change, that positive change in this community.”
For those who are dealing with addiction, Dion said recovery is only accessible if you’re alive, and Narcan gave him that.
“Being able to do his work to help people, to get another chance to live a life that they've never lived before, and to pursue dreams and goals that they haven't even taken a look at yet,” Dion said.
He wants others to have their second chance too.
