Medication Assisted Treatment (MAT)

Missouri Highlands Health Care’s Rural Communities Opioid Response Program (RCORP) grant providing Naloxone (Narcan) vending machines and/or wall boxes to local communities to help improve access to overdose prevention.

Problem:

• Butler County, MO ranked 10th in the Top 10 Missouri Counties with the Highest All Drug Overdose Mortality Rates in 2021.
• Butler County, MO was ranked 8th in the state for all drug nonfatal overdose-related hospital visits in 2020.
• In 2020, 1,095 synthetic opioid overdose deaths occurred in MO- with only 36 deaths involving heroin alone. Opioid-related overdoses accounted for all 18 of Butler County’s overdose deaths in 2020.
• Although the FDA approved over-the-counter sales of Narcan in March 2023, affordable availability is scarce for those who struggle financially.

Actions:

• Missouri Highlands Health Care installed Missouri’s first self-service Narcan vending machine in the Butler County Health Department in Poplar Bluff, MO (May 2022). The vending machine accepts free “vouchers” which are displayed near the machine. Individuals are not charged a fee to receive the product and remain anonymous. The number of doses dispensed per individual is not limited so individuals can feel free to take what they need.

• Missouri Highlands Health Care has since installed three additional vending machines in local organizations: Behavioral Health Group (Poplar Bluff, MO), Family Counseling Center’s Crisis Unit (Poplar Bluff, MO) and Family Counseling Center’s Piedmont, MO location. An additional machine has been purchased for installation at the Carter County Health Department. Missouri Highlands is working on a smaller solution for the Reynolds County Health Department, such as a newspaper vending machine or wall boxes, as their space cannot accommodate a large vending machine.

• Missouri Highlands Health Care is working with a local dispensary and area gas stations to provide Naloxone wall boxes for their facilities. The request has been sent to the facilities’ corporate offices and is awaiting approval for installation. If approved, these additional locations will expand stigma-free public access to overdose prevention by allowing individuals receive life-saving Naloxone anonymously.

Impact & Outcomes:

• Missouri Highlands Health Care has expanded access of life-saving overdose prevention to the public in the southeastern Missouri region by installing Narcan vending machines in local organizations, thereby removing common barriers to acquiring Naloxone while reducing the stigma associated with substance use.
• Through the anonymous voucher system, individuals in these communities can acquire Narcan from the vending machines regardless of financial ability, putting it in the hands of those in need free of charge.
• Additional organizations are now requesting installation of vending machines or various smaller Naloxone distribution solutions in their facilities, thereby expanding access to individuals and reducing the stigma associated with substance use.
• The number of confirmed overdose deaths in the region has decreased since the initial installation of the first Narcan vending machine.
• Implementing smaller Naloxone distribution solutions such as wall boxes in high traffic areas provides individuals quick, easy access to life-saving measures in the event of encountering someone experiencing an overdose.

Measurable Results:

• The Narcan vending machine at the Butler County Health Department has dispensed over 800 boxes (two doses per box) of Narcan since its installation in May 2022.
• From January 2022 to May 2022, 21 fatal overdose deaths were confirmed in Butler County. Since the installation of the Narcan vending machine at the Butler County Health Department, (May 2022), Bulter County has recorded only 12 confirmed fatal overdoses.