Florida nonprofit scrambles to continue overdose prevention program after state cuts off funds

Three years ago, drug overdose deaths involving opioids like fentanyl — a powerful painkiller — were on the rise, here in Florida and nationwide. In 2021, more than 8,000 people died of fatal drug overdose in Florida alone, with 80 percent of those deaths involving some kind of opioid.

In response, the state began rolling out a new program to provide opioid overdose prevention kits to the public, expanding on a previous initiative focused on supplying them to Florida’s first responders.

Each overdose prevention kit contains two doses of naloxone, a non-addictive drug that can reverse an opioid overdose. The kits also contain information about addiction treatment options, overdose prevention and places to find naloxone in your community.

A year after that program’s rollout, the Florida Department of Children and Families expanded naloxone distribution efforts by contracting with the nonprofit Florida Harm Reduction Collective to deliver free naloxone to Floridians through a mail-delivery program.

This option of mail delivery allows for more anonymity — and makes it more accessible for those in rural communities, for instance, who don’t live close to a county health department or another one of the state’s more than 400 free naloxone pickup providers.

According to DCF, the mail delivery option served to “deliver this lifesaving medication to the doorsteps of Florida’s hardest-to-reach populations, along with localized educational materials and referral resources for overdose and infectious disease prevention, treatment, harm reduction, and recovery support services.”

The program’s budget allowed for the FHRC to mail at least 500 overdose kits to Floridians’ homes each month, according to state documents. A September brief from the national Opioid Response Network, highlighting Florida’s efforts to curb overdose deaths, notes that more than 9,000 naloxone kits had been mailed to Floridians since the program’s inception in early 2023, resulting in at least 109 instances of overdose reversals (or, in other words, 109 lives saved).

Staff with the FHRC, however, told Orlando Weekly in a recent interview that as of last fall, DCF abruptly terminated their funding for the program — opting not to renew it for the following year.

Tim Santamour, interim executive director of the FHRC, said they weren’t given an explanation. They can only guess at why their contract wasn’t renewed.

“There’s certainly been a little bit of hostility on the state level towards harm reduction as a concept,” Santamour told Orlando Weekly, noting that, of course, harm reduction is literally in the nonprofit’s name.

“We also tend to advocate for other marginalized communities, whether they’re trans communities or, you know, even talking about people who use drugs and the services they deserve that can easily run afoul of conservative politicians and lawmakers.”

DCF, which recently went after a reporter publicly for asking questions, did not respond to multiple attempts by Orlando Weekly to get an explanation for funding loss.

A state-run vendor portal online confirms that DCF hasn’t paid the FHRC for its services since late October.

What’s lost

The nonprofit’s state-funded mail naloxone program, the only one of its kind in Florida, had received about $250,000 in state funding annually since 2023, allowing the group to mail anywhere from 400 to more than 2,000 overdose kits to people’s homes each month.

Naloxone, also known by the brand name Narcan, can quite literally save lives. As an opioid antagonist, the medication can block the deadly effects of an opioid overdose by binding to opioid receptors in the brain.

According to a budget breakdown from DCF, the funding for the mail delivery program had helped pay for the salary and benefits of two staff members to administer the program, in addition to postage costs, the naloxone, and other operational costs.

Prior to the state contract, the FHRC had already been mailing out naloxone to Floridians in partnership with NEXTDistro, a New York-based harm reduction group. According to DCF documents, this prior experience is one of the reasons the nonprofit was chosen for the state contract. “[T]he Florida Harm Reduction Collective (FLHRC) is the only Florida-based non-profit with experience operating a mail-based naloxone distribution service,” the state agency noted in its proposal for the program.

“FLHRC’s Board of Directors includes a diverse representation of people with lived experience in substance use and professionals working at harm reduction and recovery programs across the state,” the proposal continues. “The Board is majority women; 40% people of color; 40% LGBTQ; and includes people with lived experience related to homelessness and incarceration.”

Working with those who have lived experience in these matters is generally considered a plus. They know how to reach and connect with vulnerable populations in a way that others can’t. And in this case, it’s life or death.

People with a history of drug use who have been incarcerated, for instance, are at a much higher risk of fatal overdose compared to the general population. This is particularly true in the early days following release, since a person’s ability to tolerate their former drug of choice has likely declined.

Dr. Thomas Hall, director of Orange County’s Drug-Free Community Coalition, previously Orlando Weekly last year that one in five of those who die of fatal overdose in Orange County is someone with addiction who was recently released from the jail system.

“I think it goes to the low support and the stigma and limited opportunities,” Hall shared in an interview in September. “Then, with the lack of social support, if somebody is not housed, if they don’t have friends, they don’t have social support of others, it’s a lot easier to relapse.”

The county, along with several others in Florida now, has been working to address the issue through jail-based treatment programs that offer medication-assisted treatment, the ‘gold standard’ treatment for opioid addiction. Medication for opioid use disorder, such as methadone and buprenorphine, can help curb cravings for opioids, and can cut the risk of overdose in half.

“Of the people who died from an overdose in 2023 and were released from jail within the prior 365 days, none of them were involved with our MAT Treatment program,” Dr. Raul Pino, director of Orange County Health Services, said in a recent statement.

Overdose deaths in Orange County (mostly tied to opioids) declined an estimated 30 percent in 2024, a feat attributed in part to efforts to get naloxone into the hands of more people. Dr. Hall, who’s leading the county’s efforts to address the overdose crisis, told Orlando Weekly in March that more than 25,000 naloxone kits were distributed throughout the county from last October through December alone.

“There’s a whole lot of people working on this,” he said. The naloxone kits that Orange County has distributed — in partnership with nonprofits like Largest Heart and Project Opioid — were paid for with funds the county received through national legal settlements with opioid manufacturers, distributed by the state.

The Florida Harm Reduction Collective’s mail delivery program — a statewide initiative — was specifically funded through Florida’s State Opioid Response Project.

That project, administered by DCF, is funded by a federal grant from the Substance Abuse and Mental Health Services Administration, an agency within the U.S. Department of Health and Human Services that is facing potential budget cuts under the Trump administration. DCF has for several years now received about $50 million for overdose prevention efforts through that SAMHSA grant annually.

According to recent transaction history, DCF reported as recently as May that their federal grant money from SAMHSA is being used in part to support the FHRC’s mail naloxone program — even though that’s not actually the case.

DCF did not respond to a request for an explanation of this discrepancy.

Still a problem

Overdose deaths involving opioids in the U.S. have been on the decline in most parts of the county over the last year, from roughly 110,000 reported overdose deaths in 2023 to about 87,000 during the one-year period that ended September 2024. Florida has seen a decrease in drug-related deaths, too, but Santamour said this decline isn’t reflected in all communities.

“Deaths are down,” he admitted, “But they’re down disproportionately across communities, especially the Black and brown communities.” That disproportionate impact, he said, has a lot to do with a number of factors around health care disparities, access and stigma around substance use. “That’s why it’s important to continue to have an anonymous, mail-based [naloxone] program,” he argued.

Naloxone was made available for over-the-counter purchase for the first time in 2023, under the Biden administration. Through the DCF-run ISaveFL initiative, the medication is also available for free pickup through more than 400 county health departments and community organizations across Florida, including the LGBT+ Center of Orlando and Recovery Connections of Central Florida.

According to state budget documents, Florida lawmakers have also allocated $250,000 from the state’ share of national opioid settlement funds this next fiscal year to supply naloxone in every residence hall owned or operated by a Florida public college or university. Lawmakers have also earmarked funds for programs to address behavioral health workforce shortages, expand access to “high-quality treatment” for substance use disorder and expand peer support recovery services.

The fate of the state’s naloxone mail delivery program, however, is unclear.

What’s next?

Santamour told Orlando Weekly that although they’re no longer receiving state funds for their mail naloxone program, the program’s not going anywhere — at least not for now.

“Demand for our kits has stayed steady for the three years we’ve run the program. The demand is not going away,” he said. “Folks still see themselves and still see their family members at risk for overdose.”

Naloxone isn’t just for those who are addicted to opioids. Fatal overdose can (and does) also occur by accident, when and if someone takes a drug they believe to be something else that actually contains a potent opioid like fentanyl. Cocaine, meth and fake prescription pills are just a few examples.

Naloxone, when given to a person quickly in the event of an overdose, can save a person’s life. Its accessibility is paramount.

For now, Santamour said the nonprofit has been paying for the cost of postage — upwards of $2,000 per month since October — to continue the program themselves. They’re currently in the process of searching for alternative funding sources to keep it going.

You can learn more about the Florida Harm Reduction Collective and donate to the organization here.

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This article appears in Jun 11-17, 2025.