Michael Goetz, Margaret McGladrey, Susannah Stitzer, Carrie B Oser, Kathy Salomon, Mariya Leyderman, Patricia R Freeman, Hannah K Knudsen, Sharon L Walsh
To address postrelease overdose risk, a large urban county jail implemented an automated naloxone vending machine to provide no-cost, low-barrier naloxone at discharge. Through carceral and public health collaboration, staff installed a custom vending machine in the jail's discharge lobby to provide individuals 24/7 self-directed access to naloxone. In addition to the existing practice of providing naloxone units only to individuals clinically flagged for acute withdrawal at intake, machine-based distribution averaged 75 units monthly during the initial 4-month active phase and 100 units monthly during the 2024-2025 sustainment period. Overall, total jail-based distribution increased by 40% following implementation. These results demonstrate how interagency alignment can expand low-barrier naloxone access and support sustained distribution during community reentry.