Naloxone, known under the trade name Narcan, has proven effective in preventing opioid overdose fatalities if it is administered soon enough and in sufficient doses, but it is often not available when needed. Project Friend, started in 2019 in San Francisco, trains emergency medical service (EMS) workers and other first responders on its administration and enlists them in distributing free Narcan kits to opioid users and those who might witness an overdose. The main focus of the program is leaving behind naloxone to people who have experienced an opioid overdose and decline medical transport as well as their close social networks. 

As described in an evaluation of the program's development and implementation, Project Friend worked with the city's EMS base hospital, state and local EMS agencies, and the San Francisco Department of Public Health to distribute 1,200 naloxone kits to first responders in the first year of operation. First responders were trained in its administration via video presentations and in person sessions. As a street level harm reduction initiative serving an urban population of opioid users at high risk of overdose, Project Friend required relatively little in start up costs and promoted inter-agency collaboration in preventing opioid-related fatalities.

The Project Friend website provides instructional materials for first responders and hosts webinars on improving care for those with substance use disorders. Project Friend is a program of the Substance Abuse and Mental Health Services Administration’s (SAMHSA) First Responders - Comprehensive Addiction and Recovery Act Cooperative Agreement. A similar program has been described and evaluated in Maryland.