This story contains graphic descriptions of overdose.
Noëlle Davis arrived at the Little Five Points Starbucks before noon, in time to lead the second shift. Before she clocked in, she went to use the restroom. The door was locked, and there was no audible response; that’s when she realized the motion-sensored restroom lights weren’t on.
Davis got the keys from her coworker and unlocked the door to find someone unconscious on the floor. “There was a needle in his arm, and obvious paraphernalia beside him,” she says. While her coworker ushered customers out of the shop, Davis called 911 and told the dispatcher she had Narcan in her backpack, the brand name of the drug naloxone, which helps reverse the effects of an overdose.
The dispatcher guided Davis as she injected the naloxone into the man’s forearm. She says there were a few minutes of quiet, but the moment the man began to come to, the police and paramedics arrived and took over.
“The paramedics told me the few minutes between the dose I gave him and [when] they arrived very likely saved his life because he wasn’t receiving oxygen to the brain,” she says. “I donated one of the two doses I had left to the store first aid kit, and told my supervisors how to use it if ever needed.”
Workers at Atlanta’s bars, clubs, and nightlife venues have been facing an additional, sobering challenge in recent years, especially with the emergency response industry spread as thin as their own — having to shoulder the burden of assisting customers in grave emergencies, such as opioid overdoses, at their establishments. Luckily, area bars and restaurants are getting help from local harm reduction organizations to better equip them with the knowledge and tools they need to save lives.
Some bars and restaurants around Atlanta have partnered with organizations such as Georgia Overdose Prevention and Georgia Harm Reduction Coalition (GHRC) on overdose prevention training. According to the Atlanta-based Centers for Disease Control and Prevention (CDC), nearly 645,000 people died nationally from overdoses involving opioids between 1999 and 2021. In 2013, the opioid crisis entered its third wave, with significant increases in overdose deaths involving synthetically created opioids. The trend is tied to the increase of illicitly manufactured fentanyl, an anesthetic originally created for cancer patients in 1959.
That wave has had a profound impact in Atlanta. According to the latest data gathered in March 2023, nearly 300 people in Fulton County die from overdose annually; in DeKalb County, the latest average of overdose-related deaths is 178; Gwinnett’s latest average was 187. In 2020, drug overdose was the leading cause of premature death for Georgians, and from 2019 to 2021, fentanyl-involved overdose deaths increased by 218 percent.
As opioid-related overdoses have proliferated, so has a life-saving antidote. Naloxone, an opioid antagonist medication that can reverse an overdose, is much easier to find in Atlanta than it was a decade ago. Narcan, a brand-name form of naloxone, is available at pharmacies for $40 to $50 per double-dose box. But thanks to a number of Atlanta-area bars, restaurants, and harm reductionists, free Narcan is more accessible than ever.
People in the service and nightlife industry are among the most exposed to substance use — you could say it comes with the territory. “Service industry workers have become first responders to this epidemic in many ways,” says Andy Gish, director of Georgia Overdose Prevention. “They are already trained to look out for community members who may have consumed too much alcohol, and overdose is an extension of that.”
Gish started equipping Atlanta bars with Narcan in 2015, starting in Little Five Points and expanding to East Atlanta Village and Edgewood Avenue — Davis obtained and learned how to use naloxone from Gish days before encountering an overdose. Gish also advocated to pass the Georgia 911 Medical Amnesty and Expanded Naloxone Access Law in 2017. “It took a lot of convincing back then,” she says. “Things are easier now but I’m grateful for the first bars that allowed me to train. Although it’s a heroic act, reversing an overdose can be startling and even traumatizing. We need to acknowledge that this is something they have had to learn how to do.”
In March 2023, the staff of Our Bar ATL on Edgewood Avenue experienced significant losses from synthetic opioid exposure. “We had a series of friends either pass away or experience overdoses from fentanyl exposure here in Atlanta,” says Our Bar partner Sarah Oak Kim. The team felt responsible to act, and wanted answers. Why was this happening, and which drugs were tainted? Was there fentanyl on Edgewood Avenue, and could their friends have survived if someone knew what to do?
By the beginning of April, Our Bar was in touch with the Georgia Harm Reduction Coalition, who sent Sarah Febres-Cordero, who has a doctorate in nursing and specializes in community health and harm reduction, to train the entire bar staff, including resident DJs and hosts. Febres-Cordero aims to instruct in a way that is informative and void of bias against people who use drugs. She worked in the industry herself, and incorporated her research on harm reduction in the service industry to the collaborative graphic novel Staying Alive in Little Five.
“The way Sarah teaches the class, it’s memorable, and mostly because you can literally imagine exactly how it could be and what helping an overdose victim looks like,” Oak Kim says. “Because of that, I’m convinced anyone that took the class could teach another five people from pure memory.”
Immediately after the class, Oak Kim approached Febres-Cordero about teaching 300 service industry professionals all over the city by 2024. After the latest class on October 17, 2023, they’re within 30 to 40 people of their goal.
Our Bar also distributes Narcan at its $5 Monday industry nights. In the past two months, it’s handed out more than 470 doses of naloxone at these events. “[It] resulted in a life saved after our second week,” Oak Kim says.
Atlanta service and hospitality worker Patrick, who asked his name be changed to protect his identity, attended Our Bar’s most recent training in October. He first encountered an overdose while driving on West Peachtree Street in 2016, when the car in front of him took a hard left, jumped the curb, and drove through a fence into a parking lot, ultimately getting stuck on a chain fence. The driver was slumped over the wheel. The tires were still spinning because the driver’s foot was on the gas.
Patrick ran to the driver’s side, opened the door, and cut off the ignition. Then, he pulled the driver out of the car — the man was sweaty, gasping for breath intermittently, his eyelids half-closed and his face a whitish blue. Patrick tried to keep the driver conscious — yelling and snapping his fingers in front of his eyes, lightly slapping his face, turning him on his side to let vomit drain from his mouth. The driver faded in and out of consciousness, never speaking, his eyes moving just a little.
“I thought he was having a heart attack,” he says. “Then the lady that was in the car with him told us he shot up heroin while driving.”
Patrick had never had any formal training in CPR, and at the time, naloxone was not easily accessible to the public. He acted purely on survivalism, keeping the man conscious and breathing until the paramedics arrived. They injected a naloxone shot, which worked almost instantly, and told Patrick they get around five calls like this daily in Atlanta.
Nightlife industry worker Alex also attended the October class at Our Bar. Alex, who routinely picks up painkillers for a relative suffering from cancer, says they’ve experienced judgmental reactions from pharmacy workers when purchasing Narcan at the same time. Events like Febres-Cordero and Gish’s classes help industry workers — and anybody else interested — obtain free Narcan and the skills necessary to use it.
Georgia Overdose Prevention did more than 1,200 training events in 2022, reaching at least 15,000 people in Georgia. Gish advises anyone worried about their community to reach out and request Narcan training through its website. GHRC offers overdose rescue kits at its locations in the Bennett Center, Parker Center, Cooper Center, and Lyla Center. There’s also harm reduction training that can be taken in person, online, and over the phone.
In addition to overdose prevention training, GHRC hosts counseling, medication-assisted treatment, and a free and confidential syringe exchange program, among other resources and volunteering opportunities.
”If [there are] bad drugs in the Atlanta party scene, the best thing we could do is hedge our bets and make sure someone in any given night club in Atlanta has Narcan on them and knows how to administer it properly,” Oak Kim says. “When it comes to saving a life, the effort won’t betray us.”