As Allegheny County grapples with the ongoing opioid epidemic, rural counties in Southwest Pennsylvania are quickly matching pace with the region’s urban center in overdose medication obtainability.
In Lawrence, Butler, Armstrong, Indiana, and Clarion counties, the anti-overdose drug naloxone is widely available for free in public spaces such as schools, hospitals, factories, and libraries.
“It’s very accessible,” said Rebecca Abramson, executive director of Lawrence County Drug and Alcohol Commission.
In 2024, 32 people died from drug overdoses, according to the Lawrence County coroner’s records. In 2022, that number sat at 85 annual fatalities, and 57 the year prior. Abramson attributes a decline in deaths to wider availability of naloxone across the county.
Billboards line the roads in Lawrence County, informing passersby that naloxone, also known by the brand name Narcan, is available for free by mail from the county drug and alcohol commission.
Lawrence County’s neighbor, Butler County, has taken a similar approach.
Over the past seven years, Thomas Brophy, medical director at the Gaiser Center in Butler, said he has seen a dramatic increase in the amount of naloxone available.
In addition to the naloxone by mail, both Butler and Lawrence have implemented “NaloxBoxes,” small wall-hanging cabinets stocked with 40 doses of free naloxone. These are typically places in high traffic areas like schools, libraries, and hospitals, Brophy said.
“It’s honestly impressive for a rural county to see how much Butler has done to get it out there for the community,” Brophy said.
Brophy said naloxone is needed everywhere, and his colleagues in Indiana, Armstrong, and Clarion counties agree.
Mike Krafick, Recovery Hub director for the Armstrong-Indiana-Clarion Drug and Alcohol Commission, said naloxone access has been a game changer for the region.
NaloxBoxes now hang in every school district in Indiana, Armstrong, and Clarion counties, Krafick said.
In 2024, Krafick’s organization distributed 5,636 naloxone kits, with two doses per kit, across the three counties.
But, Krafick said, one of the greatest successes in the fight against opioids has been naloxone vending machines, stand-up, free vending machines that can be placed outside or inside. There are currently 16 vending machines dispersed throughout the counties.
“We’re restocking more often than I expected we would,” Krafick said.
He thinks the free vending machines, particularly those located outside hospitals, are ideal for those struggling with substance abuse.
“There’s that privacy and anonymity that really works for people who need this medication,” Krafick said.
Similar machines were put up throughout Allegheny County last summer, but two of the three machines broke down soon after they were installed. The county then replaced the vending machines with 10 “newspaper style dispensers,” said Ronnie Das, a spokesperson for the Allegheny County Health Department. Naloxone continues to be available by mail in Allegheny County.
Naloxone is also available over the counter at all pharmacies in the state. However, there is usually a cost, and Krafick said it can reach up to $45 per dose — a far cry from the free doses offered throughout the region.
Indiana, Armstrong, and Clarion have also taken advantage of a recent change in state law. In 2022, PA decriminalized possession of fentanyl test strips. Previously, these strips were classified as drug paraphernalia and were illegal to carry. Now, test strips, a vital component in harm reduction practices, are also available in Indiana, Armstrong, and Clarion Counties, Krafick said.
“We can always do better, and we need to keep moving in the same direction, building upon what (the county) has done thus far and I'm hopeful and confident. Butler really seems to be trying to get ahead of this thing as much as a county of this size and these financials can,” Brophy said.
Colleen Hammond is a reporter at Next Generation Newsroom, part of the Center for Media Innovation at Point Park University. Colleen previously worked as a breaking news reporter at The News & Observer in Raleigh, N.C., where she helmed coverage on gun violence, public safety, criminal courts, and juvenile justice. Reach her at colleen.hammond@pointpark.edu.
Abigail Hakas is a reporter at Next Generation Newsroom, part of the Center for Media Innovation at Point Park University. Reach her at abigail.hakas@pointpark.edu.
NGN is a regional news service that focuses on government and enterprise reporting in Southwestern Pennsylvania. Find out more information on foundation and corporate funders here.
