In an effort to expand access to the overdose reversal medication, community-based organizations can host or provide naloxone distribution sites without the previously required oversight of a pharmacy, according to an updated order from the State of Michigan.

As defined in the document, community-based organizations (CBOs) include “a public or private organization that provides health or human services to meet the needs of a community, including, but not limited to, a nonprofit organization, a social service provider, or an organization providing substance use disorder prevention, treatment, recovery, or harm reduction services.” 

Following the order update earlier this year, the Opioid Prescribing Engagement Network (OPEN), based at the University of Michigan, announced its placement of the first non-staffed indirect naloxone dispenser (a “vending machine” mechanism) in the U-M Hospital Emergency Department. 

These mechanisms are available to the general public without prescription and free of charge, overcoming key barriers to access of the medication. Those in need of the life-saving medication will receive a box with 2 doses of the naloxone nasal spray, with attached information about naloxone use and connection to treatment in Washtenaw County. Educational brochures and a QR code linking to additional resources will also be available via the machine.

OPEN, along with the Michigan Emergency Department Improvement Collaborative (MEDIC), is currently partnered with 38 hospitals throughout Michigan to distribute naloxone to patients admitted with opioid overdose or at high risk for overdose in their emergency departments. 

Using a train-the-trainer model, nurses at each hospital provide education to the nurses in their emergency department to ensure appropriate education for patients and families provided naloxone. OPEN & MEDIC provide emergency departments with education, implementation support, and a sustainable supply of naloxone rescue kits. 

With the updated language, OPEN will be able to offer the “vending machine” mechanisms to not only their existing partners, but also to other providers in multiple healthcare settings – by having expanded access to naloxone, OPEN and other CBOs aim to save lives and decrease deaths from overdose.

“Having naloxone available via these new machines means people can access the lifesaving drug with anonymity and breaks down barriers to care”, said Gina Dahlem, clinical associate professor of nursing and faculty affiliate member of U-M’s Opioid Research Institute.

“The University of Michigan is proud to host one of these mechanisms in an effort to expand care for those suffering from opioid use disorder.”  

The Standing Order Information Packet-naloxone Prescription for Opioid Overdose Prevention, issued this summer by the Michigan Department of Health and Human Services (DHHS), is intended to ensure that individuals who are at risk of experiencing an opioid overdose, or their family members, friends or others around at the time of an incident, are able to obtain and administer naloxone. 

The order recommends visible postings as well as online training resources via the DHHS website to ensure those administering any dose of naloxone follow the protocol of immediately calling 911 and understand the appropriate use for the medication. 

Pharmacies dispensing naloxone to CBOs that utilize the order are required to provide mental health and substance misuse or substance use disorder resource pamphlets to be shared with anyone experiencing or at risk of experiencing an opioid overdose. 

Those pharmacies will also work closely with each CBO to ensure proper reporting and tracking processes are followed, including the submission of a quarterly report to the Pharmacy naloxone Registration site email monitored by DHHS.

The opioid crisis is the single deadliest drug epidemic in U.S. history and affects a wide range of people,” said Chad Brummett, a board-certified anesthesiologist, pain physician and co-director of the Opioid Research Institute. 

“It’s long overdue to have naloxone available without a prescription for people in Michigan and around the country.”