Designing Stigma-Free Access: How Keychain Cases Increase Naloxone Use
Authored by: Dani Wilder
Naloxone works. That’s no longer controversial. What gets overlooked is how often access fails not because the medication isn’t available, but because it isn’t carried.
Naloxone, more commonly known by the brand name Narcan, is the medication used to reverse opioid overdoses. While the brand name is what most people recognize, the problem is the same either way: a medication can’t save a life if it isn’t nearby when it’s needed.
And too often, it isn’t. Despite widespread distribution, naloxone is dramatically under-carried. Research and program data consistently show that only about 10% of people who own naloxone carry it with them regularly. This gap isn’t driven by a lack of awareness or motivation. Most people who receive naloxone understand its importance. The issue is friction.
Working at the intersection of medicine, public health, and product design has made this impossible to ignore. Small design choices have an outsized impact on whether a life-saving tool stays accessible or gets left behind. When naloxone is packaged like medical equipment rather than a personal item, it creates both practical and social barriers that quietly undermine preparedness.
Design isn’t just aesthetic. In public health, it can function as infrastructure.
One of the biggest barriers to naloxone carriage is stigma. Traditional packaging is often bulky, clinical, and highly visible. Even people who strongly support harm reduction can feel uneasy carrying something that draws attention or invites assumptions. When design ignores that reality, it unintentionally limits who feels comfortable carrying naloxone in everyday life.
Reducing stigma doesn’t require changing people, but instead requires meeting them where they already are.
Everyday carry items like keys, wallets, and phones succeed because they fit seamlessly into existing routines. When naloxone is designed to live alongside those items, it stops feeling like an emergency object and starts feeling normal. That shift matters. It moves naloxone from something people mean to grab “just in case” to something they actually have when it counts.
We saw this clearly during pilot testing of a discreet naloxone keychain case. Participants were 4.5 times more likely to carry naloxone regularly when it was housed in a compact, durable, everyday-carry case compared to standard packaging. Just as important, 87% reported feeling more confident in their ability to respond to an overdose.
Nothing else changed. The medication was the same. The education was the same. The only difference was design.
That’s an uncomfortable but important truth in public health: education has a ceiling when usability is ignored. People can understand the stakes and still fail to act if the tool doesn’t fit into their lives.
Design also affects dignity. Harm reduction tools shouldn’t visually mark or categorize the person carrying them. When naloxone looks like any other everyday item, overdose response becomes a shared responsibility rather than a moral signal. That reframing expands who feels comfortable carrying it, from friends and family members to coworkers and bystanders.
The impact goes beyond individuals. In workplaces, universities, and community organizations, discreet carry options lower institutional resistance. When naloxone can be offered as a practical safety measure rather than a symbolic statement, adoption improves across a much wider range of settings.
For anyone working to expand naloxone access, a few lessons stand out.
First, form factor matters as much as distribution. If something is inconvenient or uncomfortable to carry, it won’t be carried, no matter how well-intentioned the program.
Second, stigma should be treated as a design constraint, not a messaging problem. You can’t educate your way out of an object people don’t want to be seen using.
Third, normalization is key. The more naloxone fits into everyday systems and routines, the more likely it is to be present in critical moments.
Naloxone doesn’t fail because people don’t care. It fails when systems assume that caring is enough.
Thoughtful, stigma-aware design helps close that gap by making the right action the easy one. When access moves from policy to pocket, outcomes follow.
Dani Wilder is a medical professional and the co-founder of nCase Technologies, a public health startup focused on reducing barriers to naloxone access through thoughtful, stigma-free design. She is completing the final phase of her medical school training and will begin her residency in Emergency Medicine later this year.