Accessibility Compliance

1

Degree Type

Open Access Capstone

Publication Date

Spring 5-10-2026

Abstract

Fentanyl-related overdose remains a critical public health crisis in the United States and specifically in Boston, Massachusetts. It disproportionately affects individuals living in structurally marginalized communities, including those experiencing homelessness, racial and ethnic minorities, and those with limited access to healthcare resources. Fentanyl is a high-potency synthetic opioid that is commonly found in illicit drug supplies, and its presence is often undisclosed. This creates significant danger for those with substance use disorder (SUD).

Community-based naloxone distribution (CBND) programs, coupled with high-quality overdose education, have emerged as evidence-based interventions associated with reduced overdose mortality, improved community response, and enhanced health equity. There are current policies in place at the federal, state, and local levels to provide access to naloxone. However, there are significant gaps and barriers that exist throughout Boston neighborhoods, including equitable distribution, program standardization, and sustained community engagement.

Using a PRISMA-guided approach, current literature was systematically reviewed to evaluate the effectiveness, implementation strategies, and equity impacts of CBND programs. Findings indicate that CBND programs that prioritize building trust and culturally tailored resources generate increased community engagement. Robust, culturally relevant, and easily understood education surrounding naloxone distribution and administration is key to successful implementation of CBND programs.

Based on these findings, the primary recommendation is to expand and standardize CBND and overdose education programs across high-risk Boston communities and neighborhoods. There should be emphasis on equity-driven resource allocation and community partnership. In doing so, those high-risk, marginalized Boston communities and neighborhoods will see a reduction in fentanyl-related mortality and an increase in public health equity.

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