Officials at Oklahoma’s mental health agency say they plan to redistribute 20 naloxone vending machines to new locations across the state, shifting the responsibility for stocking them to local partners.
In the midst of multiple investigations into agency finances, and before state lawmakers were able to discern the size of its $30 million budget shortfall, the Oklahoma Department of Mental Health and Substance Abuse Services announced the new initiative in early May.
The naloxone vending machines, which dispense boxes of the overdose-prevention medication and fentanyl test strips, have become the subject of harsh criticism by local officials and community members alike. The department spent about $300,000 to purchase 42 machines, but only some of them were ultimately deployed. On top of the money to buy them, operating 25 of the machines cost more than $14 million for about 16 months, the agency said.
The vending machines were first unveiled in 2023 as part of a major harm reduction campaign by the department. Just over a year later, they were pulled. At the time, former agency leader Allie Friesen cited budgetary concerns and operational challenges.
This time, as the department prepares to deploy the machines for a second time, things will look different, according to senior program manager Andrea Hamor Edmondson.
“That goal was an anti-stigma campaign around raising awareness,” she said. “And now what we've really moved this focus to, is making sure that we have resources placed in the highest need areas.”
Hamor Edmondson said new locations for the vending machines were chosen by analyzing state hospitalization data, overdose rates and naloxone distribution rates, among other factors.
She did not disclose where the machines would be placed, but said only a few will be in the same spots as last time.
Hamor Edmondson also said she is hopeful the majority of machines will be placed before 2026.
What’s different?
Previously, all of the vending machines were stocked and refilled by the department. It contracted with community partners, like SHRED the Stigma, to fill the machines, or staff members who lived nearby would make the commute.
“Issues such as stock shortages, machine malfunctions, and logistical difficulties strained our partners and impacted our collective mission,” Friesen said in the press release announcing the end of the program in September 2024.
A security guard at the Oklahoma County Courthouse told KOSU the building’s vending machine was often emptied by visitors almost immediately after it was filled.
Hamor Edmondson said the department’s new, decentralized approach was created with those challenges in mind.
The department will provide technical support, but will not stock the machines – that responsibility will fall to the communities where they are placed.
“Vending machines will arrive fully stocked,” agency spokesperson Maria Chaverri said in a written statement. “After that, partners will independently purchase and manage refills using their own resources.”
Chaverri said community partners will assume full ownership and oversight of the machines through a no-cost transfer, formalized by a Memorandum of Understanding with the department.
Why is the department changing its approach?
Department officials say the new approach will enable local funding streams, like city or county opioid abatement grants, to be used to purchase naloxone for the vending machines. Those funds are not accessible to state agencies.
A combination of federal grants and funding from the Oklahoma Healthcare Authority pays for the department’s naloxone stock.
Hamor Edmondson said community partners will also have a better understanding of the needs of their area. She said department staff are working to establish relationships with groups in selected counties to determine the best place to put the machines. She said a variety of locations have been discussed, including hospital emergency rooms, social service organizations, food pantries, shelters and even private businesses like high-traffic gas stations.
Decline in overdose deaths
For the first time since 2019, drug overdose deaths in Oklahoma are declining. Provisional data from the CDC suggests a 28% drop in deaths since the state saw its highest peak between June 2022 and May 2023.
“This really speaks to the work of so many people,” Hamor Edmondson said. She emphasized the department’s work is not done, but it is time for its approach to change.
“We were in the middle of an absolute crisis for a very long time,” she said. “What we were really doing [was] working very, very hard to try to put out the fire. And now we've done some of that, we are seeing success, and we really want to make sure that we understand how we're successful and why we're successful.”
A single dose of brand-name naloxone has dropped to about $50 and a generic version can be bought for $30, Hamor Edmondson said. Naloxone wasn’t available over-the-counter in Oklahoma until the FDA approved Narcan in 2023.
Hamor Edmondson said the department is working to make sure its resources specifically reach people who can’t meet that cost burden themselves, which requires a more targeted approach. Wondering whether last year’s decrease in overdose deaths could have been maximized even more keeps her up at night, she said.
