Research connects rural communities to Narcan access through vending machines

Research connects rural communities to Narcan access through vending machines

Research led by East Carolina University's Dr. Lori Ann Eldridge examines opioid overdoses and harm reduction, with the goal of empowering people with education and, ultimately, saving lives.

It's why she has had countless conversations with parents, medical professionals, students, people with lived experiences and community health liaisons, guiding the placement of public health vending machines throughout rural areas of North Carolina.

Paramedics have told her the first thing they do when someone is unresponsive from a possible overdose is administer Narcan (naloxone) nasal spray. This can quickly reverse the effects of an opioid overdose and restore normal breathing.

"It's best to be prepared," said Eldridge, assistant professor in the Department of Health Education and Promotion in the College of Health and Human Sciences. "Talking with parents and young people, what I find is that it is best to be very open about overdose risks and how to be prepared. If you have naloxone and you know how to use it, you can if you need to. Hopefully you don't have to, but if you do, it's there."

All vending machine items are free, including Narcan. Their implementation stemmed from a $300,000 grant from the Health Resources and Services Administration in a collaborative initiative to enhance public health access and awareness.

There have been 60 interviews completed with people from Carteret, Jackson, Stanly, Surry, Swain and Cabarrus counties.

Eldridge trained others to interview people in those counties who have lived experience of substance use. They were more likely to talk about details in person with someone from their community who has similar experience rather than a researcher not from their community. The information provided helped shape where the vending machines were placed and what items to stock in the machines.

"You can just walk up and use the vending machine," Eldridge said. "You don't have to register to use it. If you want Narcan and a toothbrush, you click on the items and they drop down for you. They wanted it to be accessible to everybody, especially individuals who might be at risk or known because of stigma in rural communities.

"It's not a unique situation to not be able to collect who used the Narcan and how they used it on who," Eldridge added. "Nationwide, that's an issue. What we want to know is how many boxes are going out, because that's really good to know and our goal is that everyone is prepared in case of an unintentional overdose."

The machine in Carteret County is at Carteret Community College in the student center. One of the research partners in Carteret is a two-time ECU alumnus in public health, Brooke Lane '21, '23, a post overdose response team manager for the Carteret County Health Department. She supervises five certified peer support specialists. Their team works in conjunction with EMS and other local responders, receiving real-time notification when 911 calls are coded as overdose or poisoning.

Lane had not worked previously with Eldridge, who has related grants including Pitt County Opioid Settlement funding, to expand harm reduction efforts with community partners in Greenville. Eldridge and colleague Paige Irons also mentor the ECU Team Awareness Combating Overdose student organization.

"When you're at school and working hard and just trying to get through the day-to-day, you don't think much about the connections you are making and how it can come full circle like this," Lane said. "That has been really awesome, to be able to see the impact ECU has made and be part of it after (graduating). It's been a sense of pride."

The main instructions on Narcan boxes are to give the first dose of the spray, call 911 and remain with the person until medical professionals arrive.

"Staying with them is really important," Eldridge said.

Eldridge provided Narcan to community partners in the counties for the vending machines. The other machine items, like dental kits, condoms, sunscreen, diapers and Tylenol, are stocked by local health departments, often through donations.

"Every county's sustainability plan looks a little different," Eldridge said. "Each county is a little unique, so we helped develop what was going to work in what community."

The emergence of this research project in Carteret County has created professional development opportunities for Lane and her team. That has especially surfaced for one of the peer support specialists.

"For stocking the machine and collecting data from the machine, I've assigned that to her as her project," said Lane, who recently earned the 2026 Women in Excellence Award from the Carteret County League of Women Voters. "It's given her a tool for increased responsibility and to build some leadership skills, data analysis skills and project management. It's served as a really cool opportunity for that."

Eldridge said many overdoses are not intentional, citing drug interactions and accidental dosing errors among older and younger adults as examples. Priorities listed within the U.S. Food and Drug Administration Overdose Prevention Framework include encouraging harm reduction though innovation and education, and protecting the public from unapproved, diverted or counterfeit drugs.

"It devastates families and friends," Eldridge said. "Especially for young people, it's not an intentional thing. I think the more you talk about it, it's a tool and there's less stigma. Then it allows us to talk more about fake pills and to give people knowledge. The goal isn't to get anyone in trouble. We just don't want anyone to die."