This fall, the Boston Public Health Commission will begin offering training to small business owners to reduce public bathroom heroin overdoses.

Between 2002 and 2011, the CDC reports, the annual number of drug poisoning deaths involving heroin doubled, from 2,089 in 2002 to 4,397 in 2011. In March, Gov. Deval Patrick declared a public health emergency in the state in response to what he called Massachusetts’ growing epidemic of heroin overdoses and opioid addiction.

The Massachusetts State Police reported there have been 185 heroin deaths between November 2013 and February of this year. This figure could be even higher, as it does not include Boston, Springfield, or Worcester, The Boston Globe reported. BPHC spokesperson McKenzie Ridings told Boston.com that EMS reports have shown that many fatal overdoses occur in public restrooms. For instance, in June, a man was found dead from an apparent overdose in the bathroom of the Green Dragon Tavern in the North End.


Ridings said BPHC’s Addictions Services team believes that in bathroom OD cases, victims are more likely to receive delayed care because they are using alone. To reduce the number of potentially fatal ODs, BPHC’s Addictions Services department is canvassing businesses in high-use areas and asking them to adopt ‘safe restroom strategies’ such as periodic bathroom checks and key coded bathroom locks.

Training will include teaching business owners, managers, and staff to know what common signs of an overdose look like — unresponsiveness, slow breathing, or a lack of breathing, and blue lips or fingertips — and what to do. Ridings said they should call 911 immediately, perform “rescue breathing,’’ and administer Narcan, a drug that can reverse an opioid overdose, if it’s on hand. Managers and staff will be able to learn how to administer Narcan, but Ridings was unsure if the city would pay for participating businesses’ supplies of the drug.

The outreach, expected to begin in the fall, will include downtown Boston, the South End, Roxbury, Dorchester, South Boston, Charlestown and East Boston. It will eventually expand to include the whole city.

Ridings said it’s hard to predict the effect the city’s new measures will have on the number of fatal bathroom ODs. “We can’t predict where the next place is going to be, but we hope to help reduce the number of fatal overdoses,’’ she said.