Community‐based naloxone distribution through the use of vending machines

Hundreds of people die from opioid overdose in the United States every day, and people being released from incarcerated are at significant risk for fatal overdose following release. An effective method for reducing opioid overdose in the community is providing naloxone upon release from custody in county jail.  Nasal naloxone (commonly known as Narcan®) is a powerful antidote for opioid overdose, and works for any opioid, including heroin and fentanyl. Only 0.08% of reversals are unsuccessful, and the medication has no effect on an individual that does not have opioids in their system.

Getting naloxone into the hands of as many people as possible, especially people at high risk and those closest to them, is an important public health strategy for preventing overdose deaths.The CBHJ's naloxone vending machine program makes the lifesaving overdose reversal medication available in key locations, with a focus on county jails. The medication is free and anonymous, and the machines are installed at no cost to the community. 

Naloxone and vending machines are free

To make naloxone available and accessible in as many places as possible, the naloxone vending machine program places vending machines into jails and community locations across Michigan. The machines dispense naloxone for free, so anyone can get as many naloxone kits as they want without having to pay anything. Through support , the vending machines are customized and installed for free, at no cost to the county, department, or agency where the vending machine is placed. Finally, the naloxone kits are supplied for free by the Michigan Department of Health and Human Services. 

About the program

The naloxone vending machines and other naloxone distribution work at the CBHJ is a part of the opioid treatment ecosystem initiative, which aims to build community-based partnerships in order to decrease overdose deaths through prevention, treatment, harm reduction and sustained recovery. To date, 55 vending machines have been placed in jails, community treatment centers, probation/parole offices, harm reduction agencies, and other public spaces in 35 counties across Michigan. These machines have dispensed over 20,000 naloxone kits into the community. 

To date, 55 vending machines have been placed in jails, community treatment centers, probation/parole offices, harm reduction agencies, and other public spaces in 35 counties across Michigan. These machines have dispensed over 20,000 naloxone kits into the community. 

About the machines

Each vending machine is stocked with up to 150 nasal naloxone kits which contain two doses of the medication and an instruction sheet for safe use. The vending machines are new models that are programmed to dispense free naloxone kits. The machines are approximately 72” in height, 39” in width, 35” in depth, and weigh approximately 700 pounds. A high impact polycarbonate and tempered glass window is securely bolted to the front of the machine, while allowing view of the available supply. These machines require a standard 110‐volt outlet source power source.

The CBHJ will purchase the vending machine with grant funds; however, the vending machine will be the property of the partner agency
upon delivery. The vendor (Shaffer Distribution Company) has indicated they would buy back the machines from the owner if there comes a point when the machines are no longer needed.

OpiRescue

Each kit dispensed from a CBHJ naloxone vending machine includes a QR code. When scanned, the code takes individuals to the OpiRescue app, which provides critical information on how to identify and intervene in opioid overdose. The app gives step-by-step directions on how to administer naloxone and connects users to local resources for substance use treatment. Additionally, QR codes are programmed to track app usage from each site, providing data collection that will be used to evaluate program efficacy and community impact.

Get a naloxone vending machine in your community

The Center for Behavioral Health and Justice (CBHJ) is identifying agencies that are interested in a free vending machine to distribute naloxone in community common areas. Agencies with these vending machines have found them useful in jail visitation areas, shelter communal spaces, emergency department lobbies, and other communal areas. The CBHJ is offering technical assistance and the vending machine. The naloxone kits will be supplied by the Michigan Department of Health and Human Services, who is currently providing free naloxone kits to agencies to distribute to the community.

The agency will be responsible for monitoring supply levels and ordering additional naloxone kits as necessary. They will receive keys to the machine and contact information for the vendor, whom they can contact to resolve technical issues. The CBHJ will offer support to troubleshoot issues throughout the first year of implementation. There will be no cost to the agency for this vending machine.

If you are interested in learning more or seeing if your jail, probation/parole office, or treatment agency, contact the CBHJ for more information.

What is naloxone? 

Naloxone, commonly known under the name brand Narcan©, is a medication that rapidly reverses an opioid overdose. Naloxone can quickly restore normal breathing to a person if their breathing has slowed or stopped because of an opioid overdose. Naloxone works as an opioid antagonist, meaning it attaches to opioid receptors and reverses and blocks the effects of other opioids. There is no
potential for addiction or abuse and naloxone cannot harm an individual if they do not have opioids present in their system.

Additional resources

• Expanding naloxone distribution in county jails toolkit
• Medication for opioid use disorder in county jails
• Medications for opioid use disorder (MOUD)
• MOUD decision guide
• Public act pertaining to naloxone distribution
• Michigan's standing order