Tuesday, March 28, 2023

Is a Narcan vending machine headed to NHC?

The Forsyth Detention Center has one of seven Narcan vending machines in the state, installed for free through a court initiative. (Courtesy/Forsyth County Department of Public Health)

NEW HANOVER COUNTY — The rate of deaths related to overdoses in the county remains above the state average and has the local health department considering an accessible solution.

New Hanover County Health and Human Services is having internal discussions about installing a Narcan vending machine at its headquarters on 17th Street, according to emails obtained by Port City Daily. The medication, which provides overdose reversal, would be dispensed free of charge.

READ MORE: Tri-county anticipating an additional $30M in opioid funds

“These are a relatively new item that have been used in other parts of the globe and something staff saw as part of gathering information and doing research on methods being used to combat substance use disorders,” county spokesperson Alex Riley said.

The price per vending machine is $4,200 but New Hanover County has not identified how it would be funded yet. Riley said it could be purchased using per opioid settlement money, though the county has not reached a formal stage of considering funding yet.

“Staff will continually evaluate best practices and provide recommendations to the county/city joint opioid committee so they can make decisions regarding the settlement funds,” Riley told PCD. “Once more research is done, the vending machines could be a recommendation — but they aren’t at this point. It was just an idea generated by HHS staff to begin a conversation and explore internally.”

Overdose deaths reached a record high in the state in 2021, increasing 22% from 2020. Recent data from North Carolina Department of Health and Human Services indicates 4,243 North Carolinians were lost to preventable drug overdoses in 2022 — a 7% increase from 2021.

According to New Hanover County’s health assessment, 82.8% of overdose deaths in the county involve illicit opioids — a statistic making it the highest among peer counties Buncombe, Brunswick and Gaston.

From January to November last year, New Hanover County EMS responded to 526 overdoses. Since Jan. 30 alone it has reported 30 EMS calls related to opioid overdoses.

According to internal emails, New Hanover County HHS is proposing to partner with local organizations to ensure the vending machine remains fully stocked with Narcan, an FDA-approved medication to reverse overdoses. 

NCDHHS reports deaths due to opioid overdoses can be reduced through the use of naloxone (known by brand names Narcan and Evzio). It comes in nasal spray or as an injectable and works by binding to opioid receptors in the brain and blocking the effects of the drug for 30 to 90 minutes, reversing respiratory depression.

A 2013 state law provides criminal and civil liability protections to anyone administering naloxone to someone experiencing an overdose. The legislation was amended in 2016 to allow pharmacies to dispense the drug to anyone at risk of opioid overdose or to the family or friend of someone at risk.

The law also allows the health department to be a provider of the medication.

Narcan is considered safe, non-addictive and effective by the Centers for Disease Control and Prevention. It also states the medication restores normal breathing within 2 to 3 minutes.

According to The National Library of Medicine, objections to distributing naloxone persist, despite a lack of scientific evidence. 

“A growing body of evidence suggests that provision of naloxone does not encourage opiate users to increase their drug consumption, nor does it increase the likelihood that they will harm themselves or those around them,” the report states.

The University of Cincinnati has been studying the effectiveness of accessible medication. Just one machine, maintained by Ohio-based service organization Caracole, dispensed 3,360 doses and reversed more than 1,000 overdoses for 911 people, according to the county’s proposal for the machines, obtained by PCD.

There are about 80 machines nationwide. In North Carolina, there are seven counties — Buncombe, Cumberland, Forsyth, Guilford, Orange, Pitt and Wilkes counties — currently using vending machines. These counties were part of a regional judicial opioid initiative and received the machines free from the National Center for State Courts.

At the Forsyth County Jail, a Narcan vending machine that sits in the lobby doled out 600 kits between August and November 2022. According to a report by NC Health News, the machine was so popular, it needed to be refilled within its first week of installation.

Cumberland County’s health director reported the same: roughly 600 kits distributed from its machine within three months.

New Hanover’s vending machine would be placed outside the main entrance lobby canopy of the health and human services building at 1650 Greenfield St. It would be under video surveillance for added security but accessible 24/7.

Its location is strategic, according to the county, close to historically marginalized populations and known for high rates of opioid usage. The county’s 2022 community health assessment notes medication and drug poisoning deaths are 50% higher among Black residents than white residents.

Individuals could use the machine, which dispenses one box filled with two nasal spray doses. Two doses are dispensed since severe cases may require a second quantity of the medication.

The product will come with instructions on how to administer the medication and accompany a list of resources to combat opioid addiction. 


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