The Massachusetts Bay Transportation Authority (MBTA) is considering handing over the management of its Narcan cabinet program to a third-party organization. This decision follows a report revealing that, despite the availability of free doses of the overdose-reversal drug naloxone at five Red Line stations, none have been reportedly used in the past year.
The MBTA made this announcement in a legislative report dated October 8, 2023. The report indicates that approximately 516 doses of naloxone were distributed among the stations at Quincy Center, Ashmont, Andrew, South Station, and Harvard between June 2024 and April 2025. Despite the distribution, the agency confirmed, “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.”
This initiative aimed to provide accessible overdose prevention resources, including signage in English, Spanish, and Chinese on recognizing an opioid overdose and administering Narcan. Yet, according to the MBTA, all doses taken from the cabinets have been reported as removed from the stations, with no indication of them being used on-site.
The total expenditure on the Narcan program amounts to approximately $55,500, drawn from a $95,000 allocation from lawmakers for this pilot initiative. The MBTA acknowledged that it lacks the necessary resources and personnel to effectively manage the program’s daily operations.
In the report, MBTA Chief of Policy and Strategic Planning, Lynsey Heffernan, stated, “As a result of this pilot, the MBTA 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.” Despite this, MBTA Transit Police Officers will continue to carry naloxone.
The agency has suggested that future efforts related to naloxone distribution be undertaken by a third-party organization. Heffernan recommended a partnership with an agency “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.”
To explore potential partnerships, the MBTA has reached out to the Department of Public Health’s Bureau of Substance Addiction Services and the Cambridge Health Alliance for suggestions on suitable public health organizations that could take over the Narcan cabinet program.
As communities continue to grapple with the opioid crisis, the MBTA’s experience highlights the challenges faced in implementing effective harm reduction strategies. The agency’s transition to a third-party management model may pave the way for more effective naloxone distribution and usage in the future.
