A vending machine with free Narcan, the opioid overdose reversal drug, is now available to the public in Kaiser Permanente’s San Rafael Park Medical Office.

The vending machine is part of an effort to decrease fatal overdoses by increasing access to the life-saving nasal spray.

“Overdose is the leading cause of death in people under age 55 in Marin County,” said Reed Kalna, outpatient pharmacy director at the San Rafael Medical Center who was instrumental in getting the vending machine placed in the medical office. “We hope the vending machine reduces the stigma involved in having to ask for Narcan at the pharmacy or in the emergency room. And by reducing stigma we will increase access.”

There is one fatal overdose each week in Marin County on average and 2 non-fatal overdoses every day, said Laura Eberhard, MD, Kaiser Permanente assistant chief of staff in San Rafael.

“These deaths are largely preventable. We feel it is important to visibly and clearly show our commitment to save lives by making Narcan free to our patients and anyone in the community,” she added.

In addition to getting the Narcan free in the vending machine, Narcan is available with a prescription from a Kaiser Permanente physician or over the counter at pharmacies for $45. It is also free in emergency rooms at all 21 medical centers in Northern California.

Kaiser Permanente’s vending machine will be the sixth in Marin County

The number of fatal overdoses in Marin County in 2023 is projected to hit 65 after the coroner finishes final investigations for that year, said Marin County Public Health Officer Matt Willis, MD, during a May presentation to the county board of supervisors on overdose prevention strategies.

Those numbers have doubled since 2018 when there were 30, Dr. Willis added. Victims continue to be overwhelmingly white (81%) and male (71%).

Following a cluster of 5 fatal overdose deaths in the county in February and a corresponding spike in fentanyl and methamphetamine found in area wastewater, the county issued its first public alert for higher than usual risk of overdose deaths.

The Kaiser Permanente Narcan vending machine is the sixth such machine placed in public spaces around Marin County, Dr. Willis said.

“We have over 1,000 Narcan kits going out through those machines each month,” he told supervisors.

Barbie Sewing of Novato, who is also a home health nurse for Kaiser Permanente, recently picked up 2 boxes of Narcan from one of the 5 other machines in the county, placed outside at a Marin County social services building.

“I have 2 kids going to college and this is definitely something they need to have to take with them,” Sewing said.

Fentanyl, the drug responsible for most opioid deaths, is increasingly found in fake prescription pills that resemble Xanax and Percocet. An emerging trend is that overdose deaths are due to mixing methamphetamine and fentanyl, Dr. Willis told supervisors.

Similar free machines could be placed in other Kaiser Permanente medical office buildings in Marin County and other Northern California locations if the vending machine is well used, said Kalna. The vending machine has scannable instructions on how to use Narcan during an overdose, and the Narcan packages have instructions inside.

Kaiser Permanente partnered with OD Free Marin, a coalition of county groups working to reduce deaths, to place the machine in the Kaiser Permanente medical office. It was paid for with state opioid lawsuit settlement funds. The Narcan is paid for by the state of California and is procured by OD Free Marin.

“Anyone can walk in and take a package of Narcan,” said Kalna. “They don’t have to be a Kaiser Permanente member. It’s a free vending machine, and the government pays for it.”

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