On front lines of the opioid epidemic, these Narcan street warriors prevent overdose deaths

CAMDEN, New Jersey − Roz Pichardo knows how to save a life: She's done it more than 2,200 times, living and working in Philadelphia's Kensington neighborhood. She records each save, taking note of the day, time and a detail or two, in a pocket New Testament she carries with her.

"I call them 'Sunshine,' because to call them 'addict,' or 'junkie,' or 'zombie'... It's dehumanizing. It's stigmatizing," said Pichardo, who came to Camden on a cold January day to offer compassion and lessons in Narcan administration.

Pichardo is something of a super lifesaver: trained medical, police and social workers on the front lines of the opioid epidemic who may have saved thousands from fatal overdoses across the U.S.

A recent RAND study found that more than 40% of Americans know someone who's died of a drug overdose. The U.S. Drug Enforcement Agency reported that more than 11.7 million fentanyl pills have been seized so far in 2024. In 2023, the agency seized more than 78.4 million fentanyl-laced pills and nearly 12,000 pounds of fentanyl powder − more than 388.8 million lethal doses in a nation of 335 million people.

RAND noted in its report that more than 109,000 people in the U.S. died from drug overdoses in 2022 − and more than 1.1 million have died since 2000.

For Pichardo, the mission is personal. "People ask, why write them down?" she said. "It helps me humanize them and remember them. After a while, it can be traumatic so you try to put that in the back of your head, but I still want to be able to go back later and say, I saved them."

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From a survivor to a savior on Philadelphia's streets

Pichardo has survived more than her share of trauma: In 1994, a former boyfriend killed her boyfriend and nearly murdered her. Her twin sister died by suicide, and her brother was murdered in 2012, a case that remains unsolved.

After working for nonprofits including Prevention Point, which offers health care and social services in Kensington; Ceasefire PA, a gun control advocacy group; and as a trauma advocate at Temple University Hospital, Pichardo now leads Operation Save Our City.

The organization recently opened a drop-in center for unhoused people, a space where they can pick up mail and messages, make phone calls to loved ones − and take a Narcan kit with them. Operation Save Our City embraces the concept of harm reduction: prevention of overdoses and disease by providing people with clean syringes, fentanyl and xylazine testing strips, condoms, Narcan and sterile water.

Pichardo, 46, says she has saved more than 2,245 people.

"She's been doing this a long time, and she's from the neighborhood," said Shawn Westfahl, overdose prevention and harm reduction coordinator with Prevention Point, which distributed 97,000 Narcan kits last year. "She's an amazing person."

Sadly, not every Narcan administration is successful. Pichardo remembered a man who went down on the subway. Commuters callously stepped over him, some even uttering a nasty word about his addiction, as Pichardo worked to save him. A teenage girl trained in CPR helped her; they both held his hand as he died, a human connection in his final moments.

"If I don’t see them for a while, I like to think they went home," she said. "My role is to keep them alive long enough to go home. I just want them to have their next breath."

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Boston's Methadone Mile is his 'Miracle Mile'

Joshua De La Rosa doesn't keep track of how many lives he's saved, but he has given many people another chance at life.

"At least a hundred," the Boston Police detective told USA TODAY. "Probably 200. Maybe more. During the pandemic, it was pretty bad, two to three people a day."

An outreach officer assigned to patrol Boston's Methadone Mile (an area of the city with homeless encampments and open drug use), De La Rosa's job was not to arrest, but to help. A Massachusetts law, Section 35, allows for involuntary commitment for substance use disorder, so De La Rosa was sometimes tasked with picking people up on warrants.

"I'd apologize and tell them, 'I care about you,'" he said. "I'd tell them, 'You weren’t created to be a drug addict. I don’t believe that’s your heavenly identity.' Usually when I say that, they start to cry. They know they didn’t grow up to do this.

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"They'd call me every name you can think of that first day," he said. "But a week later, they'd ask forgiveness and thank me. I built so many relationships. It's been a beautiful, beautiful experience."

De La Rosa, a devout Christian, remembered one man he was able to get off the streets and into treatment. He heard he was doing well in his recovery but eventually saw him again on the streets. Though the man assured him he was well, "something didn't sit right with me."

De La Rosa had his phone on do not disturb while off-duty. Later, he saw two desperate messages from the man. No longer assigned to the area, De La Rosa reached out to officers who were, asking them to look for him.

"They found him in a building hallway. ... I took that one really hard."

He recalled a beautiful young woman from a good family who turned to sex work to support her addiction, and the agonized parents who came looking for her. De La Rosa worked with the family to have her committed.

"She ran from me, told me she hated me," he remembered. "But months later, she came to see me with her mother. She gave me a thank-you card, and now she's almost five years sober, doing amazing."

The father of five said he believes people can find their way to a better life, even in a place like Methadone Mile.

"I like to call it Miracle Mile," said De La Rosa, now a detective.

Helping in DC and San Francisco: 'A human being is a human being'

Dana McCollough is the medication assisted treatment manager at HIPS, a Washington, D.C.-based nonprofit offering harm reduction, health care and other services to sex workers, transgender people, homeless people and people with substance use disorder.

Formed in 1993, HIPS has distributed 11,000 naloxone kits and trained 3,000 people in overdose reversal.

McCollough isn't sure how many overdoses she's reversed, but it's "definitely more than 100."

"A human being is a human being, regardless of their flaws," McCollough said. "I go through ups and downs, but I try to move on to the next hour or the next day, so I can help the next person."

Amber Sheldon has reversed dozens of overdoses since she started with GLIDE in San Francisco as a volunteer in 2017, joining the paid staff a year later. She's passionate about harm reduction and said she and her team see hundreds of unhoused people in the city's Tenderloin district.

"We pass out Narcan like hotcakes," she said, in addition to offering testing strips for fentanyl and offering training in overdose reversal.

She remembered when a woman came into GLIDE's office looking for her son, whose addiction led him to the streets. Later that day, she saved a young man from an overdose: "When he came to, he started crying and apologizing, and he asked to call his mother," the woman who'd come looking for him the day before.

"The War on Drugs is a war on people," she said. Harm reduction may be controversial, but Sheldon doesn't think it should be: "Access to harm reduction gives people an opportunity for change, positive change not just within one person, but within their families. We do this for the well-being of the whole person and the whole community."

Contact Phaedra Trethan by email at ptrethan@usatoday.com, on X @wordsbyphaedra, or on Threads @by_phaedra