Frequently Asked Questions

NEXT Distro is an online and mail-based harm reduction program. We mail free resources to people who use drugs living in areas without an existing in-person harm reduction program. We also support the friends and family of people who use drugs by providing free naloxone and overdose reversal education.

NEXT partners with existing harm reduction programs, using our website, technology, and experience to support mail-based programs all across the country.

NEXT’s main office is located in New York City. If you live in New York state, but do not live near an in-person harm reduction program, we will pack and ship supplies to you from this office. We also ship secondary distribution supplies and naloxone from this location to people who live in states where we do not have an Affiliate Partner.

If you live outside of New York but in a state where we have an affiliate partner, our partners in your state will pack and ship supplies to you.

Not everyone who applies is eligible to receive a package from us. Eligibility varies by state and is determined by location, in-person services near you, available supplies, funding, and staffing. NEXT acknowledges the many barriers people may face to accessing in-person services by prioritizing individuals with historically marginalized identities.

A NEXT Affiliate Partner is a syringe access program, mutual aid group, or health department that has partnered with NEXT and mails free naloxone, safer injection supplies, and/or smoking supplies to people who use drugs. Presently, we do not have an affiliate partner in all 50 states.

Different Affiliate Partners offer different things. Some pack and ship everything you would find at an in-person syringe service program and others send only naloxone. The variety of supplies offered by the affiliate in your state depends on the available funding and regulations in your state.

Every Affiliate Partner has signed an agreement to protect the confidentiality of participants in our mailing program. Your privacy is extremely important to us.

The NEXT team includes paid staff, consultants, and volunteers who work to support the infrastructure of our national program. Our Affiliate Partners have their own paid staff or volunteers, too. The majority of people who work with NEXT are people with lived experience related to marginalization and drug use. Many NEXT staff members and consultants work remotely and our affiliates are located in 32 states across the country. You can learn more about our team and affiliates at nextdistro.org/team

NEXT offers three unique mail-based programs:

• Full-Service Harm Reduction: Our mission is to offer supplies, support, and education to people who use criminalized and stigmatized drugs. Monthly full-service packages are currently offered in California, Georgia, Louisiana, Michigan, Nevada, New York, and Wisconsin. If you are enrolled in our program, you can request a package including everything that would be offered at an in-person syringe access program. If you live in these states, are a person who uses drugs, and do not live near an existing harm reduction program, you can apply to receive monthly packages here.
  
  We are not currently accepting new applications for California, Georgia, Louisiana, or New York

• One-Time Packages: We have also offered one-time packages to people who use drugs and live in states where our Full-Service Harm Reduction program is not currently funded. This program is not currently operating, but you can add yourself to our wait list for a one-time package of syringes, smoking supplies, naloxone, and educational materials here. We recognize a major need for our services in many of our unfunded states, and we are always working to expand our services. Unfortunately, if you have received a one-time package from us before, we cannot send another. You will be notified if Full-Service Distro becomes available in your state.

• Naloxone By Mail: NEXT also has a separate naloxone-only mailing program. Our eligibility requirements vary from state to state, but we always prioritize sending naloxone to people who use drugs, and the people who are more likely to respond to an opioid overdose like their family, friends, roommates, and loved ones. Some, but not all, of our Naloxone By Mail programs also offer Fentanyl Test Strips and safer sex supplies.

NEXT was inspired by the work of Tracey Helton. Tracey has been mailing naloxone all over the country for over a decade. Our first goal was to formalize and expand upon the amazing mutual aid model she developed.

When NEXT was founded in 2017, we were the only harm reduction program of our kind in the United States. There are now several independent mail-based programs, including full-service programs in Alaska, Idaho and Montana.

NEXT was not the first harm reduction program to mail supplies, but we are the first that was created to specifically provide online-only harm reduction services. Harm reduction programs have mailed supplies to communities in need for over two decades. One example is our Affiliate Partner Utah Naloxone, they have been mailing naloxone statewide since 2015!

We monitor our phone and email lines Monday through Friday from 8:30AM–7PM ET. We will always try to respond to you within three business days. When contacting us, please use only one communication method at a time to prevent delay.

We are not an emergency service. If you are responding to an overdose or another medical emergency, please contact local EMS, who will be better equipped to assist you.

We reply to all messages in the order they are received — and we receive a large volume of messages! Please be patient — we will always respond.

NEXT supports people who do not have access to in-person harm reduction services. In many areas, local harm reduction programs simply do not exist, or may only be open for limited hours. Stigma, concerns about privacy, or lack of transportation also complicate access. Although we will connect you to a nearby syringe service program wherever possible, especially if you live in a metropolitan area, we are open to discussing barriers to your access and helping you find a way to get the supplies that you need! The scope of our ability to support you will always depend on the state you live in, as we have different levels of access to funding and supplies in each state.

Funding for NEXT’s service varies from state to state. In some states, like New York or California, the state health department helps fund our work. In others, our services are funded entirely by foundation grants and generous donations.

Harm reduction policies and funding vary greatly between states. Some of our Affiliate Partners have paid staff whose full-time jobs are to pack and ship supplies within their state, whereas others are run entirely by volunteers. We are always looking for more financial support including “game changing” financial contributions.

Although we have an office in New York, all of the services offered by NEXT are only available online, over the phone, and through the mail. We do not offer in-person services.

If you are in need of in-person harm reduction services and you are located in New York City, check out this directory to find a syringe service program near you.

In most states, NEXT does not have enough funding to support community distribution. We do however operate a small secondary distribution program, which supports drug user-led supply distribution. If you are interested in learning more about this program, write to secondary@nexthr.org for more information.

If you are only seeking naloxone by mail do not submit an application. Instead, visit our naloxone page at nextdistro.org/naloxone. More details on the naloxone only program can be found below.

You can join our program by submitting an application. We use applications to assess your needs, link you to existing harm reduction programs in your area, and help keep ourselves organized — we get hundreds of requests a week. We don’t use applications to determine if you “deserve” our supplies — we send supplies to as many people as our limited capacity will allow. We think everyone who uses drugs deserves to do so with dignity and autonomy.

The application process has four steps.

1. Fill out the application.

2. Fill out the handle form, which will be linked at the end of the application.

3. Your application will be reviewed within two weeks. We will contact you at the email address or phone number you provided on your handle form. We may have questions for you about your application — keep an eye on your inboxes so we can keep your application moving.

4. After we contact you about the details of the program you will be enrolled in, we will need your full name and mailing address. Please be sure that the zip code and initials you put on your application match the name and address we will be mailing to.

The application form closes for new enrollments from the second Friday through the third Sunday of each month. This gives our team time to catch up with requests and improve our systems.

NEXT uses a handle system because it allows anyone to apply for our services without associating a name or address with sensitive information related to drug use. A handle is much like a username on social media. For our Full-Service Distro and One-Time Package programs, we use your handle for enrollment and to help us recognize you when you order supplies from us. This handle system protects our participants in many ways. If you were to use a public computer to access our services, or if your information was intercepted another way, you would not be easily identified.

It is very important to type your handle accurately when placing your order. Incorrect or misspelled handles may delay your order.

A good handle helps you stay anonymous, so avoid using your real name or other identifying information, like your username on a social media site. Do your best to choose a unique handle that you will remember each time you access our services. Thousands of people use our Full-Service Distro and One-Time Package programs. If your handle is already in use, we will ask that you choose another. Please do not use a handle like John/Jane Doe or Joe/Jane Schmoe.

NEXT has no tolerance for bigotry and will not accept any handle that is associated with hate or hate speech.

We describe our mail-based syringe access program as “full-service” because harm reduction is much more than just sterile syringes to prevent HIV and other blood-borne infections. Like other syringe service programs across the country, NEXT offers a wide variety of supplies for safer injection, safer smoking, safer sex, and wound care, as well as naloxone. Participants in our monthly and one-time Distro programs also receive many educational materials from our harm reduction Resource Library.

We are accepting applications for new clients in Michigan, Nevada, and Wisconsin.

Depending on your location, we may be able to connect you to someone for direct support. In states like New York and California where our Full-Service Distro program is currently funded, NEXT offers one-on-one support services for our participants. NEXT also maintains a public online Resource Library for information related to using drugs, medication assisted treatment, at-home tapering, safe IV injection techniques, and more. Our team will do its best to answer any questions you might include on your order.

However, it is impossible for us to know about every local social service or resource available in each town or county. We suggest calling 211 for more information about publicly accessible services available to you!

Depending on where you live you can order once every 30 or 60 days. For example, in Wisconsin if you order on January 13th, you can place your next order on or after February 13th. We suggest setting an alarm on your phone or making a note on your calendar to remind you of your order date. Early orders usually cannot be processed.

We shut down shipping for five days each month, from the third Wednesday to the following Sunday. This gives us time to prep supplies for the month and catch up on our order queues. If your order date falls during one of these closures, please place your order after the closure.

You might be used to reusing your syringes — our goal is to provide you with enough syringes that you can use a new one for every shot, including extras for if you miss. The total number of syringes you can request depends on the funding and supplies available in your state. We serve hundreds of people a month — please request only what you need to last you for 4-5 weeks.

On the order form we will ask you to specify how many bags of each kind of syringe you need. Please monitor your email and phone after placing an order, in case we have a question about your request. Timely responses help avoid a delay in your order.

Our packages are designed to have enough supplies for one person. If you have friends or family members who need supplies, please encourage them to apply.

The availability of pipes and other smoking supplies varies by state. In New York for example, we offer straight pipes, bubble pipes, and hammers, as well as mouthpieces, chore, lip balm, and push sticks.

We are actively working to increase our funding for purchasing these supplies. If you are able to purchase pipes, Wish.com has affordable options.

We sometimes experience shortages or out of stock items. We will always prioritize sending you syringes, smoking supplies, safer sex supplies, and naloxone.

We never automatically send a package — you must place an order if you would like one sent.

Contact us at nextdistro@pm.me or by phone at 646-389-0752 with your new contact information. It is very important to reach out with updates to your mailing address as soon as you have them — this helps us avoid delays in shipping your package. Be sure to type your new street number on your order form.

Please report using your naloxone at nextdistro.org/reverse. Naloxone usage reported here gets prioritized by our shipping team. We will send you replacement naloxone as soon as possible, before your next Full-Service order. Don’t wait until you run out to replace your naloxone!

Our Full-Service order forms close from the third Wednesday through the following Sunday of each month. If your re-order date falls within this period, please place your order after the scheduled closure. We cannot accept orders during the closure.

We try to offer one-time package to people who live in states where we do not formally operate. Our one-time program is currently closed but we are working towards reopening it soon. You can sign up to be notified when our application reopens here.

Participants in our one-time program will receive smoking supplies, syringes, safe sex supplies, fentanyl test strips, naloxone, and other safer use supplies like tourniquets, cottons, and alcohol swabs. Participants also receive educational materials from our harm reduction Resource Library.

One-time packages are shipped in a plain brown box via USPS from our office in New York City with an untraceable return address and no indication of what is inside the package. If you do not have a safe place to receive a package, let us know and we will try to find a solution.

Unfortunately we cannot send follow-up packages at this time. If you are in need of naloxone, you can always request more here.

If our Monthly Full-Service Distro Program expands to your state in the future, we will notify you using the contact information we have on file.

Secondary distributors are individuals or mutual aid groups that receive harm reduction supplies from NEXT for the purpose of distribution in their community. Access to sterile syringes and safer sex materials helps combat the HIV and Hepatitis C epidemics and provides people with the resources to make empowered decisions about their healthcare goals.

Monthly Secondary Distributors: Receive up to 15 boxes (150 bags) of syringes once a month, along with safer use and safer sex materials. These people are secondary distributors who do not have a large storage space and are distributing to their immediate circle of people.

If you are enrolled as a monthly distributor, you can place an order once every 30 days. For example, if you order on January 13th, you can place your next order on or after February 13th. 

Quarterly Wholesale Distributors: Receive up to 55 boxes (550 bags) of syringes every three months, along with additional safer use and safer sex materials. These folks are secondary distributors who have the space and capacity to receive supplies in bulk and are distributing to a regular group of participants often beyond their immediate circle. Packages will not be discreet. 

If you are enrolled as a wholesale distributor, you can place an order once every 3 months. For example, if you order on January 13th, you can place your next order on or after April 13th.

All secondary Distributors may attend quarterly cohort meetings, request off-menu supplies, as well as winter and summer kits to provide to unhoused people who use drugs. When you sign up for the program, you can decide which tier is best for you.

Currently, we are unable to accept applications for new Secondary Distributors— we hope to expand this program in 2025.

To get in touch contact our Secondary Distribution Program Coordinator at secondary@nexthr.org or (571) 520-4919

Nope! Our mission is to get harm reduction supplies to people who cannot get them any other way. We have never and will never charge anyone for the supplies we send or the postage required to send them.

Our team sends dozens of packages every month to houseless or unstably housed people. If you are concerned about where to send your package, please contact us! In many situations, we suggest USPS General Delivery, which allows you to pick up your package at a local post office after presenting a photo ID. Our team will help you find alternative solutions if General Delivery is not an option.

Our monthly package program is designed for people who use drugs to order supplies for themselves. We recognize that you may be in community with others in need, and so we encourage every individual to apply for their own packages from NEXT. We believe in personal agency for people who use drugs and we want our participants to be able to decide what kinds of supplies they would like to receive and where those supplies come from.

If you know someone who uses drugs, tell them about applying for our Full-Service and One-Time Package programs: nextdistro.org/getnext

If someone you know is likely to use naloxone in an opioid overdose emergency, tell them about our Naloxone By Mail program: nextdistro.org/naloxone

If you can’t remember your handle, contact us at nextdistro@pm.me or 646-389-0752
Handles are only required for our Full-Service and One-Time Package programs.

Please don’t ask us if you can pay to have a package sent faster — we do not accept payment of any kind for our services from our participants. Requests are always shipped in the order they are received.

We ship all packages via USPS. We use this carrier because they have the strongest privacy protections. You should expect to receive your package in the same place you receive all of your USPS mail. We cannot accommodate specific shipping instructions.

Our packages do not require a signature and we are unable to add a signature requirement to your shipment. If you have concerns about the security of your package, please let us know. We can usually ship a package General Delivery to your local post office for you to pick up.

Once the Postal Service has received the package from our office, we cannot make changes to the address or delivery instructions.

In our Full-Service Harm Reduction program there is space on the order form for you to request tracking information. You can request tracking via email from our third party carrier, through Protonmail, via text, or on Signal. Tracking through our third party carrier is by far the fastest way to receive your tracking information. If receiving your tracking information is critical to your package’s security, we always recommend using this option. If you select this option, please be sure that we have your current email address on file.

For our Naloxone By Mail program we do not offer tracking.

We cannot send replacement packages if your package is stolen from your porch after it is delivered. If this is a concern for you, please monitor your tracking carefully.

We try to mail Full-Service and Naloxone By Mail packages within 5 business days of your order date. Depending on your location, it may take an additional 1-5 days for your package to travel through the postal system. Usually our packages arrive much earlier than this, but sometimes it may take longer to receive your supplies because of high shipping volumes. Please understand that we are working as fast as possible for you to receive your supplies quickly.

Due to high volumes of orders, our one-time packages may take 2-3 weeks to be shipped.

If you are in a time-sensitive situation, we recommend that you seek out supplies in-person if at all possible. You can always contact us at nextdistro@pm.me with any questions or concerns.

Please double-check your shipping information! The most common reason our packages are returned is a missing apartment number or lot number in the address line. If you have sent us incorrect address information, contact us at nextdistro@pm.me.

Unless you contact us immediately after placing your order, we might not be able to cancel your shipment. If you need to cancel your order, please email us at nextdistro@pm.me and we’ll see what we can do.

What you can access from NEXT depends largely on where you live. Naloxone access in the US is unfortunately extremely inconsistent. Some states fully fund the distribution of naloxone and harm reduction supplies to individuals, while other states restrict naloxone distribution to agencies and organizations only. Your eligibility may depend on:

• If your community has pre-existing free harm reduction services

• If you have health insurance and access to a pharmacy or co-payment assistance program

• Your risk factors

While some of our naloxone affiliates are fully funded by their state health departments, others operate entirely on volunteer labor and donations. This means that they have fewer resources to distribute and will always prioritize getting naloxone to people who use drugs and their community, friends, or family, who are most likely to be present at an overdose.

Please monitor your inbox after requesting naloxone — we may send you an email referring you to existing resources in your community.

NEXT offers Naloxone By Mail at no cost, and you will never be asked to give a donation or make a payment to receive any of our supplies.

How much naloxone you receive will depend on your state and your risk factors. You will always receive at least two doses of naloxone.

Naloxone is a medicine that rapidly reverses an opioid overdose by restoring normal breathing. It is available in two common forms: 1) injectable intramuscular naloxone, and 2) nasal spray. “Narcan” is the name of the name-brand version of the nasal spray. Both forms of naloxone are effective and easy to use — the difference is mode of administration, personal preference, and cost.

Narcan is not offered by all of our Affiliate Partners due to its high cost. Intramuscular naloxone is much less expensive to obtain, and just as effective. Many people prefer the injectable form because it enters the bloodstream immediately. For people with an opioid dependency, intramuscular naloxone, which comes in a lower dosage, can help prevent painful and uncomfortable withdrawal symptoms.

The type of naloxone you can receive will also depend on the state where you live. Some states offer only Narcan nasal spray, while others offer only intramuscular naloxone, and still others even offer both. Regardless of your state, you will receive video training on how to use the type of naloxone available to you while making your request.

To receive Naloxone By Mail, we ask for your mailing address, demographic information, and reason for requesting naloxone. We are always working to get naloxone to the people who are most likely to use it in an opioid overdose emergency, so we ask questions like “Have you witnessed someone overdose in the past 12 months?” and “Have you overdosed in the past 12 months?”

We greatly value your privacy and your answers to these questions will always remain confidential.

It is important for us to know that our services are reaching people without health insurance. This information helps prove exactly why what we do is so necessary. We ask if you have health insurance, but we do not request further details about your insurance provider.

In some states, if you have health insurance and do not have other risk factors, we will ask you to attempt to access naloxone at a pharmacy before approving you for Naloxone By Mail.

In many states, all or most of the cost of naloxone is covered if you have Medicaid. We have compiled the co-pay cost per state at nextdistro.org/medicaid. However, coverage can change from year to year, so it’s important to check ahead. If you have Medicaid, we ask that you try to access naloxone from a pharmacy or local service if one exists. But if your co-pay is too much, or naloxone access is difficult for some other reason, you may request naloxone by mail.

We hope everything is okay! We’ve been there too — responding to an opioid overdose emergency can be extremely scary. Please be sure to fill out our Opioid Overdose Incident Form so that we can send you more naloxone right away. On this form you can also request a debrief with a trained overdose responder. You can also find our Overdose Responder Aftercare page here.

Many of our Affiliate Partners obtain naloxone from their state health department. Others rely on Remedy Alliance, an organization which grew from a naloxone buyers club and provides free or low-cost intramuscular naloxone for community distribution. Still others rely on donations from larger, better-resourced harm reduction organizations.

Visit the All About Naloxone page put together by our friends at Remedy Alliance! For information about using expired naloxone, check out our Mighty Naloxone page.

Naloxone is pronounced nuh-lawk-sone or nah-LOX-own. We made a video of several team members saying “naloxone” and hope it helps!

NEXT does not distribute high-dose naloxone, including Kloxxado and Zimhi. Studies have shown that when it comes to reversing opioid overdoses, high dose naloxone is no more effective than the best practice standard dosage. It does, however, cause extreme discomfort and distress for opioid dependent people, who are usually put into very uncomfortable and dangerous precipitated withdrawal with symptoms including diarrhea, vomiting, pain, and anxiety.

Our program is designed to provide low-barrier naloxone access for the people who are most likely to respond to an opioid overdose: people who use drugs and their loved ones. Unfortunately, we cannot offer bulk quantities of naloxone to other organizations for distribution.

In many states, organizations who want to distribute free naloxone can acquire it at no cost. You can learn more by contacting your local or state health department. Alternatively, naloxone can be purchased in bulk quantities online through NARCANDirect.com.

If your organization is located in NY check out nextdistro.org/newyork for more information about bulk ordering through programs available in New York State.

For mutual aid groups and community-based organizations that cannot obtain naloxone through their health department but are connected to communities of people who use drugs, we suggest contacting Remedy Alliance. Remedy Alliance may be able to provide free or low-cost intramuscular naloxone. They may also be an option for organizations that do not receive a sufficient volume of naloxone through the pre-existing naloxone resources available to them.

Ideally, naloxone should be kept at room temperature (between 59 to 86°F) and away from direct light.

However research suggests that naloxone remains effective even when not stored in perfect conditions, such as when individuals carry naloxone with them or have a kit in a vehicle.

Never! Selling information about anyone using our site or monetizing our harm reduction work is a direct violation of our values. NEXT does not use HTTP cookies on our site or track any of your online activity.

We value your privacy and take great care to package your supplies discreetly. The return address on your package will never be traceable to a syringe service program. For example, in New York we mail all packages from an untraceable PO Box. Regardless of where you live, nothing from NEXT will ever say “naloxone”, “narcan”, “syringes” or anything similar on the outside of the package; all packages are mailed in a plain brown box or mailing envelope.

We have heard anecdotal reports that using a pseudonym or “John/Jane Doe” may indicate to USPS that there is something suspicious about a package’s contents, triggering additional security checks. These additional security checks may result in shipping delays of your package. We suggest you order supplies with the same name you use to receive your other USPS mail. However, it is important that you feel safe when ordering supplies from us, and we trust that you to know what is best for your situation.

If you are receiving a package from us through USPS General Delivery you must use your legal name and present a matching photo ID at your post office to pick up your package.

If you are under the age of 18 and you are also a person who uses drugs or you are connected to people who use drugs, please make a request through our site. Each state has its own rules around youth naloxone distribution. We will reach out through email if we have any questions. Your safety and privacy are extremely important to us.

Please note that NEXT cannot provide legal protection for the supplies we send. Laws in your state can be found at nextdistro.org/policies

NEXT’s donation page is here. Please note, we have also listed the donation information for all of our Affiliate Partners.

Email us at info@nextdistro.org or send us a text at 646-389-0752. We will get back to you within 3 business days.