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KBIA’s latest project focuses on reducing opioid overdose deaths in Columbia and its surrounding areas. The project provides information to learn more about substance use disorders, opioid overdose deaths, recovery and tools to reverse opioid overdoses. KBIA’s mission includes communicating information and engaging with all members of our community as a public service.KBIA will continue to cover this ongoing community issue. If you have a story you would like to share, contact news@kbia.org.

One rural community's creative way to combat opioid overdoses: Narcan vending machines

A large maroon and white vending machine with boxes of Narcan inside.
Rebecca Smith
The Butler County Health Department is home to the first Narcan vending machine in the area. People can come anonymously to take the potentially life-saving medication, education on how to use it and other harm reduction tools from the Health Department lobby.

It’s a vending machine like any other. You walk up and feed some sort of payment into the machine, but instead of a candy bar or an ice-cold soda, this vending machine at the Butler County Health Department in Poplar Bluff, Missouri, dispenses boxes of Narcan.

“It's confidential. There's no signing anything. There's no giving your name. It's private. So, I just I think it's just a really, really awesome way to get it out into the community where it's truly needed,” Health Educator Amy Bland said.

Amy Bland has on a gray and black sweater and hoop earrings. She stands in front of a Narcan vending machine.
Rebecca Smith
Health Educator Amy Bland is in charge of keeping the Narcan vending machine at the Butler County Health Department stocked. She said they have been busy because "this is a good part of town for the vending machine, because we have a lot of walking traffic here."

In March, the Federal Drug Administration approved Narcan, an opioid overdose reversal medication also known as naloxone, for over-the-counter use. Despite this, Bland said it can still be a struggle to get Narcan into the hands of people who need it – those with substance use disorder, those that care for them and others.

“I think of older people that maybe have taken too much medicine and they can't remember, you know, or a little one that gets into someone else's medication,” Bland said. “There are lots of reasons for Narcan.”

Bland is responsible for keeping the Narcan vending machine stocked at the Butler County Health Department, and she said opioid overdoses are a problem in her community – especially as other drugs, like methamphetamine, are now more likely to be cut with the opioid fentanyl.

According to the Missouri Department of Health & Senior Services, Butler County is 10th in the state for number of fatal drug overdoses and seventh for all overdose-related hospital visits.

Bland said things like stigma, cost, education and transportation can all be additional barriers to Narcan access, which is where the vending machine comes in. People can vend as many boxes of Narcan as they need — there’s no limit and it’s completely free.

Lisa Martin is the mastermind behind the vending machines, which was paid for with federal grant funds.

“It looks like just any other vending machine that it's as easy as getting a bag of chips, and that's what we tell everyone: If saving a life could be as easy as getting a bag of chips, would you do it?” said Martin, the RCORP Director at Missouri Highlands Health Care – a Federally Qualified Healthcare Center in Poplar Bluff.

RCORP is the Rural Communities Opioid Response Program through the federal government’s U.S. Department of Health & Human Services (HRSA). Megan Meacham, the Director of Rural Strategic Initiatives at HRSA, said the Narcan vending machines in Poplar Bluff are the types of innovations they like to fund.

“We strive to provide flexibility through our programs to allow rural communities to address the specific and unique needs that they are facing,” Meacham said.

A "Free Vend" vending coupon is being fed into a Narcan vending machine
Rebecca Smith
"Free Vend" vending coupons and education on how to use Narcan are on the wall right next to the Narcan vending machine at the Butler County Health Department. The boxes of Narcan are free "because that's an expense that a lot of people wouldn't be able to afford," Health Educator Amy Bland said.

It’s been just about a year since the first machine went in at the Health Department, and according to both Amy Bland and Lisa Martin, it’s been a success.

In the first five months of 2022 – before the first vending machine went in – there were 21 confirmed fatal overdoses. Since the machine was put in last May, there have only been 12 confirmed fatal overdoses in the last year.

“If it saves one life, if one machine saves one life, then it's worth it,” Martin said.

So far, more than 800 boxes of Narcan, which have two doses per box, have been dispensed at the Butler County Health Department. Last September, Martin got a second machine put in at Behavioral Health Group, a local treatment center for substance use disorder.

Chris Thomason, the BHG program director in Poplar Bluff, said they’ve dispensed more than a 100 boxes of Narcan already. Recently, they've added HIV testing kits to their machine, as well.

“So, I would imagine, at some point, it saved somebody's life,” Thomason said. “And, you know, for us having to refill it and keep it restocked shows that, ‘Hey, there are [people needing Narcan] not being judged by coming here to get it either.”

"Know Your Status" HIV Test Kits in a vending machine.jpg
Rebecca Smith
Behavioral Health Group, a local treatment center for substance use disorders in Poplar Bluff, uses their Narcan vending machine to dispense the medication and HIV test kits, as well as start a conversation about what recovery could look like.

Thomason said they also see the vending machine as an opportunity to talk with people about other treatment options that are available – when they’re ready for help.

The vending machines also play a critical role in combating stigma, Lisa Martin said. In more rural communities, people may still be afraid of being seen purchasing Narcan in a pharmacy. On top of that, one box of the drug costs about $50.

“I think in an area like this, people just don't have the money to pay for that even if it's over the counter, you know, a lot of people can't afford cold medication," Martin said.

So, they plan to continue the vending machines for as long as it’s needed. Martin said she’s helped other communities in Missouri – most recently in the Lake of the Ozarks area - set up their own vending machines, and other communities have reached out to her with questions about the process.

And there are now two more Narcan vending machines available in the area.: one in Butler County, and one in neighboring Wayne County. All in the hopes of saving lives – one vend at a time.

Rebecca Smith is an award-winning reporter and producer for the KBIA Health & Wealth Desk. Born and raised outside of Rolla, Missouri, she has a passion for diving into often overlooked issues that affect the rural populations of her state – especially stories that broaden people’s perception of “rural” life.
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