Implementation of a Naloxone Vending Machine in the Public Space of an Emergency Department: A Feasibility and Acceptability Study

Abstract

Introduction

Naloxone is a lifesaving medication to prevent opioid overdose deaths. Emergency departments can provide important access points for individuals to receive naloxone. Vending machines are 1 low-barrier method of distributing naloxone. We describe the implementation of an emergency department-based naloxone vending machine and demonstrate its feasibility and acceptability among participants.

Methods

A naloxone vending machine, supplying free naloxone and educational resources via a Quick Response code affixed to the box in addition to brochures, was installed in a public hallway next to other vending machines in the emergency department. A 12-item paper survey attached to the machine queried reasons for obtaining naloxone, acceptability of emergency department-based naloxone vending machines, and an open-ended question about their experiences with the machine.

Results

From October 2023 to May 2024, 1470 boxes of naloxone were dispensed. Survey results (N = 54) indicated that nearly half of respondents (46.2%) would not have otherwise had access to naloxone. Also, 75.9% obtained naloxone to be prepared for an overdose emergency, 42.6% because it was free, and 35.2% out of concern for a family or friend. High acceptability was reported for all survey items. Qualitative themes were predominantly positive, including gratitude, desire to help others, need for increased distribution, and the personal impact of naloxone in their lives.

Discussion

Emergency department-based naloxone vending machines are an impactful, low-barrier strategy that is acceptable to the public. They provide continuous access to a life-saving medication and should be replicated widely.