Old newspaper vending machines deliver the opioid overdose drug Narcan instead of news

Tasha Withrow, co-founder of the harm reduction organization Project Mayday, said she was never given Narcan while she was on opioids. As a patient in recovery, she now helps place boxes of naloxone at a community distribution center where those in need can receive the life-saving drug for free.

Naloxone, a nasal spray commonly known as Narcan, is used as an emergency treatment to treat overdoses. Since the U.S. Food and Drug Administration approved the drug's sale without a prescription over a year ago, more and more naloxone distribution containers have been popping up across the country.

“People can just reach in and take what they need — that didn't exist back then,” Withrow said as he filled a container in a Hurricane, West Virginia, neighborhood earlier this week. “Now to actually see that there is some access — I'm glad we've made at least a little progress in that direction.”

Such boxes – which are located in neighborhoods, outside hospitals, health departments and supermarkets – are a way for advocates for people with substance use disorders to make Narcan, which costs about $50 over the counter, available to those who need it most. Similar to small free libraries that hand out books to anyone who wants one, the metal boxes, once used as newspaper bins, are unlocked and don't charge money. People can take as much as they feel they need.

Proponents say the containers help normalize the use of the drug – and are evidence that the stigma surrounding its use is steadily decreasing.

“It's both a blessing and a misfortune,” said Jeff Card, whose family business was known for decades for making the once-ubiquitous tin cans that people could buy newspapers in on the street. Card began making the Narcan containers more than two years ago. “For us, it's fortunate that we can build something, but it's unfortunate that we have to build this, given how bad the drug problem is in America.”

Sixty containers of Narcan were distributed in 35 states to mark Save a Life Day on Thursday, a naloxone distribution and education event launched in 2020 by a West Virginia nonprofit. The containers were purchased from Card's Texas-based Mechanism Exchange & Repair, which still serves newspaper customers but has expanded its operations to include manufacturing other products amid the decline of the newspaper industry.

Number of deaths from opioids skyrocketed during the pandemic

Opioid deaths were at record levels even before the coronavirus pandemic, but skyrocketed when the pandemic struck in early 2020. The U.S. Centers for Disease Control and Prevention estimated there were about 85,000 opioid-related deaths in the 12 months ending April 2023. But the number has since dropped. The CDC estimate for the 12 months ending April 2024 was 75,000 — still higher than at any point before the pandemic.

The reasons for the decline are not yet fully understood, but it coincides with the fact that Narcan, a drug that was difficult to obtain in some communities, is now available over the counter, as well as the increasing spending of funds from legal settlements between governments and drug manufacturers, wholesalers and pharmacies.

The U.S. Food and Drug Administration approved Narcan to treat overdoses back in 1971, but its use was limited to paramedics and hospitals for decades. Narcan nasal spray was first approved by the FDA as a prescription drug in 2015, was approved for over-the-counter sale in March, and was available in major pharmacies last September.

“That removed the barriers. And that's when we realized, 'OK, now we need to improve access. How can we get naloxone into communities?'” said Caroline Wilson, a social worker and patient in recovery from West Virginia who coordinated this year's Save a Life Day.

Last year, all 13 Appalachian states participated in the day, initiated by the West Virginia-based nonprofit Solutions Oriented Addiction Response. Community organizations in hundreds of counties distributed Narcan and fentanyl test strips in parking lots, outside churches and clinics and trained people on how to use them. They also work to educate the public about myths surrounding the drug, including that it is not safe to keep it in easily accessible places. Narcan has no effect on people who use it without opioids in their bodies.

This year, the effort expanded to 35 states under the slogan “Naloxone Everywhere.” The group sent out 2,000 emergency kits containing a dose of Narcan to be placed in places like supermarket bathrooms or parks. The 60 tin newspaper boxes – which sell for about $350 each – were purchased with grants.

Aonya Kendrick Barnett's harm reduction organization Safe Streets Wichita set up one of the first Narcan containers in Kansas in February — she calls them “Nalox boxes.” The boxes, which are now sold by various companies, can also look different. Some look like newspaper boxes, others like vending machines.

Since a Narcan container was installed on the machine – to access the medication, all you have to do is enter a zip code on the keypad – around 2,600 packages are distributed every month.

“To say, 'Hey, we have a 24-hour vending machine, come here and get what you need – no blame,' is so brave in this Bible Belt state and helps me break down the stigma,” she said.

Kendrick Barnett said there is no room for prejudice when it comes to what she calls life-saving health care: “People are going to take medication. It's not our job to judge or condone that. It's our job to make sure they get the necessary health care they need to survive.”

The Save a Life Day box her organization received will be placed outside her new clinic, which is scheduled to open in October.

Larry Tuite, a 74-year-old stained glass artist from Eerie, Pennsylvania, said he became alarmed as overdoses increased in his town. He began leaving Narcan packets on the windowsills of convenience stores in town that sell products such as pipes and rolling papers. He was shocked at how quickly they disappeared.

“No matter how many I give out, I use them up very quickly,” says Tuite, who has stacked the drug boxes against the walls of his one-room apartment.

The Save a Life Day container he was allowed to set up outside one of those stores has helped him distribute even more Narcan. At least a dozen people have been saved by the medication he distributed, he said.

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AP journalist Geoff Mulvihill contributed to this report.