2025
ANNUAL IMPACT REPORT
Table of Contents I. Introduction (page 3) II. About NEXT (page 4) III. Affiliate Partner Highlight (page 5) IV. 2025 Impact: Naloxone by Mail (pages 6 - 7) V. 2025 Impact: Syringe Access by Mail (pages 9 - 11) VI. 2025 Impact: Peer Distribution (pages 12 - 13) VII. What’s NEXT? Goals for 2026 & Beyond (page 14) 2
Introduction In 2025, NEXT Distro welcomed Interim Executive Director Joann Gomez. Thanks to Joann’s tireless efforts, 2025 was a year of transformation of significant progress for the organization. Over the past year, we moved our New York City office space, expanded peer delivered syringe access in New York State, renewed efforts to increase privacy and security in our technical infrastructure, and recentered our sustainability and fundraising efforts. Despite drastic changes to the harm reduction funding landscape, NEXT succeeded in doing the most with limited resources by streamlining our operations to continue this life-saving work with a small, dedicated team. We did all of this while continuing to ship supplies nationally and work with 30+ affiliate partner organizations to expand drug user health services in their states. We are indebted to our program affiliates for their constant collaboration and commitment to the people we partner to serve.
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About NEXT Mission Statement
NEXT Harm Reduction (a.k.a. NEXT Distro) is a not-for-profit organization focused on expanding free harm reduction resources, supplies, and support through an online and mail-based modality of service provision. NEXT’s platform is designed to reduce opioid overdose death, prevent injection-related disease transmission, and improve the lives of people who use drugs. We do this by engaging and supporting people who are not served or are underserved by pre-existing public health infrastructure and traditional models of harm reduction.
Our Programming
Our programs directly save lives, connect people who use drugs to public health resources, and strengthen harm reduction organizing across the country. We utilize an innovative “Hub and Spoke Model” to empower existing harm reduction organizations across the United States who are already engaged in on-the-ground harm reduction efforts to expand their work through mail-based services. Naloxone by Mail: NEXT’s Naloxone by Mail Program partners with 30+ harm reduction programs who utilize our website, technology, and experience to support mail-based naloxone distribution in their communities. We’re proud to share that between ourselves and our network of affiliate organizations naloxone has been mailed to people in every US state, Washington D.C., and Puerto Rico. Syringe Access by Mail: In 2025, NEXT along with 7 affiliate partner organizations provided full-service syringe access by mail in California, Louisiana, Georgia, Michigan, Missouri, Nevada, New York and Wisconsin. Participants in this program receive the supplies you would normally be able to access at an in-person syringe service program. This includes sterile syringes, naloxone, sharps containers, wound care supplies, test strips, condoms, and more. Participant Support Services: NEXT employs a Resource Navigator who provides comprehensive participant support and community referrals to participants in our syringe access by mail program. The Resource Navigator assists participants with navigating access to health care, public benefits and harm reduction resources to help them achieve their personal goals. Peer Distribution Program: In our home-base state, New York, NEXT is funded to operate a Peer Distribution Program. Peer distributors are individuals that receive harm reduction supplies in bulk from NEXT to distribute to people who use drugs in their community.
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Affiliate Partner Highlight
In late 2025, Safe Streets Wichita became an affiliate partner of NEXT to provide free naloxone by mail to people living in Kansas. Safe Streets Wichita is an organization rooted in lived experience. They champion equity, inclusivity, and the transformative power of community-driven solutions to advance public health and public safety for people who use drugs in Kansas. Safe Streets Wichita is a coalition committed to building healthier, safer, and more connected communities throughout Wichita, Kansas. Their mission is to prevent substance misuse, reduce harm, and promote mental wellness through education, advocacy, and collaborative action. Now through their partnership with NEXT, their work extends beyond Wichita to serve folks in rural Kansas with naloxone, test strips, and safer sex supplies by mail. At the heart of their work is a commitment to addressing critical public health issues, including youth substance misuse, overdose prevention, and suicide prevention. By using evidence-based strategies, engaging community members, and breaking down stigma, they aim to empower individuals and families to make healthier choices and thrive in supportive environments. NEXT’s affiliate partners are the heart of our mission to expand naloxone by mail access across the United States. If you are inspired to make a difference, consider donating to our partners. Your support strengthens the harm reduction movement and supports access to essential public health services.
Donate here
nextdistro.org/affiliatedonations
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2025 Impact:
Naloxone by Mail Naloxone (commonly known by the brand name Narcan) is a life saving medication that reverses the effects of any opioid overdose including from heroin and fentanyl. At NEXT Distro we believe that everyone at risk for overdose or who is likely to respond to an overdose should have access to naloxone! Since the founding of NEXT’s Naloxone by Mail Program we have facilitated the mail-based distribution of 790,414 doses of naloxone nationwide – our efforts in 2025 account for 19% of this. In 2025, NEXT + our network of affiliate partner organizations mailed 152,658 doses of naloxone through this program; 7,863 of those naloxone doses were sent directly from NEXT’s homebase in New York.
Across NEXT and our affiliate network, a TOTAL of
218,020 doses of naloxone were distributed by mail in 2025.
Race/Ethnicity of Naloxone by Mail Participants in 2025 Reaching communities of Black, Indigenous, and People of Color (BIPOC) is a priority for NEXT’s Naloxone by Mail Program. In 2025, 19.3% of program participants disclosed a BIPOC identity. These identities include, but are not limited to Asian, Hispanic / Latinx, Black / African American, Native American, Middle Eastern / North African, and Native Hawaiian / Pacific Islander.
Unknown / Prefer Not to Repond Black, Indigenous, and People of Color
White or Caucasion
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The majority (62.8%) of naloxone by mail participants in 2025 identified as Women. This demonstrates the success of mail-based services reaching populations that are historically less likely to seek out in-person services.
Gender Identity of Naloxone by Mail Participants in 2025 Unknown / Prefer Not to Respond Transgender / Gender Non-Conforming
Men
Women
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Naloxone by Mail Participant Testimonials ”I practice harm reduction techniques both for myself and for the community I find myself in. I have not only ordered Narcan to carry myself, but also NEXT Distro is the website I recommend for others to order their own to carry. With the Naloxone I have ordered through NEXT Distro and the Florida Harm Reduction Collective, I have successfully reversed multiple overdoses and saved six lives so far in the span of two years. Six people... all of them saved by this service. These people are my friends, neighbors, even just acquaintances are still alive because of this Narcan by mail service. From the depths of my heart, thank you.”
“If it weren’t for your group & what you do, I know of at least 4 people that wouldn’t be alive right now. But thankfully you guys do exist & you do what you do, so thank you. You help more people than you could ever imagine. You don’t just help the people who are saved by using naloxone, but you help their friends, family & loved ones as well because what you do saves lives. So thank you so much.” “Living in an area where drug addiction is on a rapidly growing scale. I have witnessed friends die, struggle, and almost die because of drugs. Unfortunately, I found a transient person laying in the street suffering from what appeared to be a drug overdose. Thankfully I had naloxone [from NEXT Distro] to step in while paramedics arrived. He survived and I will always carry this on me.”
“If it weren’t for NEXT Distro, there would have been many more lives lost in my community. People know I keep Narcan, even though I am not an opiate user myself. I have many beloved friends who are addicted and because of you, I’ve kept them around. I cannot begin to tell you how thankful I am for that.”
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2025 Impact:
Syringe Access by Mail Since the founding of NEXT’s Syringe Access by Mail Program, we have facilitated mail-based distribution of 13,330,205 syringes nationwide – our efforts in 2025 account for 23% of this. In 2025, NEXT + our network of affiliate partner organizations mailed 3,058,436 syringes to 3,278 individuals across the country; 858,228 of those syringes were sent directly from NEXT’s homebase in New York. Accompanying these syringes were an additional 64,789 doses of naloxone, 11,420 sharps disposal containers, and 70,714 pipes for safer smoking. At the end of 2025, we had over 6,000 individuals on our waiting list for syringe services by mail. Ongoing changes to the availability of grant funding for harm reduction work under the current federal administration has limited our capacity to meet the growing demand for our services.
3,278 individuals served nationally
VS.
> 6,000 individuals on the waiting list In 2025, 13.9% of participants Race/Ethnicity of Syringe Access by served by the syringe service Mail Participants in 2025 program disclosed a BIPOC identity. These identities include, Black, Indigenous, but are not limited to Asian, and People of Color Hispanic / Latinx, Black / African American, Native American, Unknown/Prefer Middle Eastern / North African, Not to Respond and Native Hawaiian / Pacific Islander. We know that reaching underserved communities of Black, Indigenous, and People of Color (BIPOC) through our mailbased program can help close the gap in racial inequity in harm reduction service access.
White or Caucasian
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Unlike many in-person syringe service programs, the majority (57.7%) of participants served by our mail-based program in 2025 were women. We strive to increase the percentage of Transgender / Gender Non-Conforming individuals receiving our services because we know these communities are historically underserved despite having higher rates of drug use and HIV transmission.
Gender Identity of Syringe Access by Mail Participants in 2025 Transgender/Gender Non-Conforming Unknown/Prefer Not to Respond
Men
Women
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Syringe Access by Mail Participant Testimonials “To be honest before [NEXT Distro] I was kind of ratchet with syringes. I’d use them until I couldn’t use them anymore and even then I’d rig it back together. And that rigged needle left me with track marks everywhere. So I can’t say enough how much [NEXT Distro] has made a difference for me and those around me.” “I supply my neighborhood with these supplies as we don’t have a needle exchange and I want people to shoot clean and safe! Since I started with [NEXT Distro] over 5 years ago I believe, it’s made an improvement in my community and there’s no longer needles laying around and people are a lot cleaner!!”
“Thank each and every one [of] you amazing humans for treating me like a human instead of trash. I love the notes you send with every package. It really makes me feel like someone cares, and I have no doubt that all of you care. Thank you.”
“Thank you so much for all you do. If there’s ever anything I might be able to do to help in any way let me know!! When literally all the pharmacists in my city won’t sell syringes, nor will most sell naloxone without prescription, the amount of gratitude i have and feel for this program and all who are apart of it… it’s not just reducing harm but it’s 100% SAVING LIVES!! thank you again…” 11
2025 Impact:
Peer Distribution In late 2025, we launched our New York State Peer Distribution Program. Our Peer distributors include people who use drugs or are in recovery from drug use and have connections to communities of people who do not otherwise have access to harm reduction supplies and drug user health resources. In late 2025 we enrolled 4 Peer Distributors in NY who collectively distributed 5,430 syringes, 573 doses of naloxone, 13,48 fentanyl testing strips and 164 sharps disposal containers. Though this program launched late in the year, our Peers successfully reached 36 individuals with supplies and harm reduction education materials in 2025. This laid the groundwork for our New York Peer Distribution program to expand in 2026. Unfortunately, in 2025 we had to stop providing supplies for Peer Distributors outside of New York due to a lack of funding. Before this funding deficit we supported 10 Peers outside of NY who were able to distribute 41,500 syringes, 1,022 doses of naloxone and 1,700 testing strips in early 2025. We hope to receive funding support in future years to resume providing this service nationwide! As with our other programs, we make it a priority to reach communities of Black, Indigenous, and People of Color (BIPOC) through Peer Distribution. In 2025, 34.3% of the participants served by our Peers identified as BIPOC.
Race/Ethnicity of Peer Distribution Participants in 2025
Unknown/Prefer Not to Respond
White or Caucasian Black, Indigenous, and People of Color
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Unlike our exclusively mail-based programs, the majority (65.7%) of participants served by the Peer Distribution program in 2025 identified as men. This difference in demographics highlights the importance of offering multiple modalities of supply distribution to effectively reach different populations of people who use drugs.
Women
Gender Identity of Peer Distribution Participants in 2025
Prefer Not to Respond Men
Peer Distributor Testimonials “Because of you the latest report I was given is 71 lives have been saved due to my distribution of products received from you. Thank you for all the lives you have saved, there are no words to say that could explain how thankful I am.”
“We provide services to a large number of houseless encampments. These are folks who are marginalized to begin with and many do not have access to transportation to make it to the one local syringe program.”
“This program has been really helpful for me and I appreciate all the support. Since I’ve started this program my entire life has been turned around in a great way it has given me a feeling of purpose in life because before I wanted to give up.” 13
What’s Next?
Goals for 2026 & Beyond By mailing life-saving harm reduction supplies directly to our program participants NEXT Distro empowers people who use drugs in underserved parts of the country to have agency over their health as it relates to drug use. This is a critical time for NEXT Distro to continue expanding operations as several in-person harm reduction programs across the country have been forced to close their doors due to political pressure and federal funding cuts. Our discreet low-barrier approach to distributing harm reduction supplies and education serves as a safety net in this challenging era for the harm reduction movement in the United States. Funding limitations have forced us to be strategic to continue providing quality services to communities of people who use drugs despite reduced staff capacity and supply inventory. At the end of 2025, we had over 6,000 individuals on our waiting list for syringe services by mail. Ongoing changes to the availability of grant funding for harm reduction work under the current federal administration has limited our capacity to meet the growing demand for our services. We strive to close this gap in funding in the upcoming years with support from new funding streams including individual donations. In 2026, we plan to hire a new Executive Director to guide NEXT Distro into a sustainable future. Our team has put in a lot of hard work, sweat, and tears over the past few years to be where we are today, but there is still so much more we can do for harm reduction, for our program participants and for everyone else out there who doesn’t know that staying alive and safer when using drugs can be as easy as going to nextdistro.org
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www.nextdistro.org P.O. Box 20317 New York, NY 10001