Overdose deaths decline as naloxone vending machine program continues in Linn County

Background

Last year marked the start of a new chapter in the public health approach to addiction and recovery in Eastern Iowa.

In June 2024, the Substance Misuse Committee of Linn County used a $150,000 award to the Linn County Opioid Settlements, part of nationwide settlements with drug manufacturers, to combat the problem the opioid epidemic unleashed.

Seven machines stocked with naloxone — the drug that can reverse an overdose from prescription drugs like oxycodone or fentanyl and street drugs like heroin — were installed at locations across Linn County:

From 2018 to 2020, the rate of opioid-related deaths more than doubled in Linn County, from 12.9 to 26.1 deaths per 100,000 population. That outpaced Iowa as a whole, whose rate in 2020 was 16.8 deaths per 100,000, and it closed the gap on the higher overall U.S. mortality rate, which was 30 deaths per 100,000 population in 2020.

Iowa reported 475 fatal opioid overdoses in 2021, according to the Centers for Disease Control and Prevention.

“We’ve heard multiple times about people walking into pharmacies, and the pharmacist is taking demographic information, sometimes insurance information,” Erin Foster, access center director for Linn County Mental Health Access Center, said last year. “It creates more barriers for people. The stigma for substance use is very high, and one of the reasons people don’t seek help.”

What’s Happened Since

Since machines were installed, the need has been apparent with more frequent than scheduled restocking.

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By default, machines are filled quarterly, but can be restocked more frequently as needed. The machine at CRUSH of Iowa Recovery Community Center in Cedar Rapids has been refilled four times already this year.

Each machine holds 35 boxes of naloxone, in addition to other harm reduction tools like wound care kits and condoms.

Some statistics show that they may helping. In 2024, overdose deaths in Iowa dropped from 447 to 425, according to said Dana Chappuie, operations manager at CRUSH.

In Linn County, overdose deaths dropped from 27 in 2023 to 11 as of August 2024, according to Linn County Public Health’s most recent Overdose Data Report. This continues a downward trend since 2022.

Opioid-specific overdose deaths recorded by medical examiner records in Linn County show sharp fluctuations over the last several years — 32 in 2020, 18 in 2021, 32 in 2022, 13 in 2023. Two of those years, 2020 and 2022, remain record highs since the Linn County Medical Examiner started tracking opioid-related overdose deaths.

Chappuie said the vending machines have been “heaven sent” to bridge the gap between addiction and getting into long-term treatment. But more than that, she remains hopeful for change in the mentality toward addiction with this new tool.

People using the vending machines are being practical about the needs of them and their loved ones. Some may know people who have suffered overdoses. Others are being proactive.

“We have this look in our head that (opioid users are) someone in the park with all these bags, or someone going to jail for theft,” Chappuie said. “We’re not recognizing who in society is being affected by this.”

She said victims of overdose can range from teenagers ingesting something they don’t realize contains opioids, to the elderly accidentally taking too much of their prescription pain medication.

In Linn County, opioid overdose victims ranged in age from 17 to 85 years old, with a median age of 41.

Chappuie, who also hands out naloxone at public gathering places and events, said the reaction from the public has been a mix of those embracing it and those apprehensive.

“It’s just having that conversation. It may not be for you, but it could be for your son’s best friend who accidentally took something they weren’t supposed to,” she said. “It’s just having that mentality that this is a lifesaving tool.”

Johnson County recently followed suit with the installation of six vending machines across Coralville, North Liberty and Iowa City, at the Coralville Public Library, North Liberty Library, and The Deadwood in Iowa City. An additional machine will be located outside of the Johnson County Health and Human Services building in the next few months.

Comments: Features reporter Elijah Decious can be reached at (319) 398-8340 or elijah.decious@thegazette.com.