A bright white vending machine was recently affixed to the east brick wall of the Sunrise Homeless Navigation Center. It’s doing exactly what Em Gray had hoped — just a whole lot faster than she expected.
“Some days it’s been almost empty,” said Gray, who restocks it daily with life-saving medicine sealed in small brown packets. Even on the lighter days, she finds it about half-empty.
The machine dispenses single-use bottles of Narcan, a nasal spray that can reverse the effects of an opioid overdose. The Narcan is free for the taking. The vending machine simply keeps the naloxone medication safely stored out of the elements.
“I thought I had enough (Narcan supply) to get through a couple of months,” said Gray, organizer of The NICE Project, which stands for Narcan in Case of Emergency. “But I have pretty much blown through that in a week.”
The need is undeniable in Austin and Travis County, where the alarming number of opioid overdoses prompted officials a few months ago to declare a public health crisis. Deaths from fentanyl-laced drugs more than tripled from 2020 to 2021. Drug overdoses are now the leading cause of accidental deaths in Travis County, ahead of falls and car crashes.
Narcan could prevent many of these deaths. All of Austin’s first responders carry the medication, but it’s less accessible to members of the public. Pharmacies charge $50 to $120 a pop, and the state-run free naloxone distribution program, More Narcan Please, depleted its federal funding in January, just five months into the fiscal year.
Still, organizations in Austin have kept up their efforts to get free Narcan kits into the hands of people who can help if someone overdoses. Austin’s community health paramedics distribute between 25 and 50 kits a month, mostly while providing follow-up care to people who have experienced an overdose. Organizations like the Texas Harm Reduction Alliance, which operates a mobile clinic, hand out the medication as part of their outreach efforts.
Gray wanted to go a step further and set up free vending machines that make Narcan available anytime. The response from clients served at Sunrise, which got the first NICE Project machine just over a week ago, has been one of gratitude and relief.
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Narcan “saves lives. I’ve seen it save several lives,” Brooke Breshears told me moments after she saw the NICE machine last Thursday. She said someone recently overdosed at the motel where she’s been staying, and staff at its front desk said they wanted to find some Narcan to keep on hand, so they can try to help residents before paramedics arrive.
“It’s not readily available,” she said, “and it needs to be.”
A number of cities have Narcan vending machines, but Gray’s NICE Project established the first ones in Austin, using a $2,500 grant from Austin Mutual Aid. She bought two old vending machines — the white wall unit through Facebook Marketplace, and a larger one “like from a hospital waiting room” off of Craigslist — and fixed them up.
“One of them was not in English,” Gray said. Plus, she had to figure out how to get the machines to dispense items without anyone paying for anything, which involved retooling them using the Arduino programming language — which she had to learn.
She turned to ATX Hackerspace, an online collaborative of creators, and got a lot of help from CJ Picklesimer, who reworked the guts of the machines, and Sammy Pizzo, who solved the final snags in the computer coding. She found volunteers to help move the machines. The larger one now sits outside the Sahara Lounge in East Austin.
“I collaborated with a lot of people on this,” Gray said.
Various nonprofits and organizations, including the Texas Overdose Naloxone Initiative, provided the Narcan supply. And Gray is confident she can get more, now that word is getting out and people can see how well the Sunrise machine has been received.
“I think (The NICE Project) will expand,” she told me. “I also don’t want to act like this is anything more than a Band-Aid solution.”
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The real solutions Gray would like to see are efforts to ensure a safe drug supply, so people know exactly what they are getting, and an end to the War on Drugs, which has criminalized addiction and diverted resources away from treatment.
She’s not exactly holding her breath.
Gov. Greg Abbott gave a speech Sunday decrying the fact that “deadly drugs like fentanyl pour across President Biden’s open borders.” Combating drug smuggling has been one of Abbott’s justifications for Operation Lone Star, the state’s $4 billion effort to police the border.
Funding for overdose treatment is a different story. Months after the state’s More Narcan Please program ran out of money — owing to a surge in demand and other factors that drove up costs — Texas steered an additional $632,832 toward the program in July. The start of the new fiscal year Sept. 1 brings a new budget of nearly $5.6 million to More Narcan Please. As Abbott takes credit for the expanded investment, though, every penny comes from the federal government.
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The people on the front lines of the opioid crisis aren’t thinking about the politics, though. They’re fixated on saving lives. Lucas Hill, director of the Texas Opioid Training Initiative, told me plainly: “We need naloxone everywhere. We need it easily and freely accessible.”
Dr. John Weems, who specializes in addiction medicine at CommUnityCare Health Centers, said he hears stories on a weekly basis from people who have saved other people’s lives with Narcan. “It’s a Lazarus drug,” he said, alluding to its ability to bring someone back from the brink of death.
And now, for more and more people who need it, that miracle can be found for free in a vending machine.
For information on The NICE Project, including how to donate, visit https://linktr.ee/niceprojectatx.
Grumet is the Statesman’s Metro columnist. Her column, ATX in Context, contains her opinions. Share yours via email at bgrumet@statesman.com or via Twitter at @bgrumet. Find her previous work at statesman.com/news/columns.