Narcan vending machine unveiled at Tompkins County Public Library

ITHACA, N.Y. — It will now be easier to access the lifesaving opioid overdose-reversing medication naloxone, often known as Narcan, in downtown Ithaca. The Tompkins County Public Library held a ribbon cutting Wednesday for a vending machine that will dispense doses of the medication and other harm reduction materials for free. The vending machine and…

ITHACA, N.Y. — It will now be easier to access the lifesaving opioid overdose-reversing medication naloxone, often known as Narcan, in downtown Ithaca. The Tompkins County Public Library held a ribbon cutting Wednesday for a vending machine that will dispense doses of the medication and other harm reduction materials for free.

The vending machine and its contents were purchased with the help of a $37,000 grant from New York State’s 2022 landmark legal settlement with pharmaceutical companies, library director Leslie Tabor said. 

“This is a very real public health crisis, and that’s why [the library] is the perfect place and partner to focus [these efforts] on,” Tabor said at a recent board meeting. “These people are among us, and they’re in the library every day. Staff felt very strongly that it’s our job, even though it’s outside of a job description, to know about Narcan.”

Even before the vending machine was installed, library staff have been able to reverse at least four overdoses this year so far, Tabor told the library’s board of trustees.

Staff have placed the supplies on other tables and stations around the library so people can access them without stigma. Library staff have also undergone training on when and how to safely administer naloxone, with regular refresher sessions during staff meetings, Tabor said at the meeting.

Tompkins County saw a record number of calls to 9-1-1 reporting suspected overdoses this October. The county is on track to see an increase in the total number of calls compared to 2023 by the end of the year. Between 2021 and 2023, on average, roughly 6.9% of reported overdoses were fatal, analysis of county data shows.

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The machine will offer both doses of the lifesaving medication as well as test strips that can be used to test drugs for fentanyl contamination. 

Fentanyl is an opioid used legally to provide anesthesia before surgical procedures, but has also been used to adulterate illicit drugs. Fentanyl contamination can increase the likelihood of an overdose because it often has a higher potency than the drug it adulterates.

Even if you do not use illicit opioids, some experts say it is safest to test any non-prescription pills, powders or injectables before using them. Fentanyl contamination is often found in opioids but also methamphetamines, cocaine and MDMA, according to the CDC. 

The vending machine is part of the library’s larger “Information Saves Lives” campaign, which aims to destigmatize addiction and promote harm reduction practices. The campaign also included a harm reduction resources fair earlier this year.

Since 2020, libraries across the country have been increasingly stepping in to address gaps that other public agencies and organizations no longer handle.

While the Narcan vending machine is funded through an external grant, some library employees have warned high employee turnover and potential staffing cuts by the library’s board and director could affect the services available to library visitors.

Other libraries around the county also serve as distribution points for the life-saving medication and have hosted public training sessions on its use.

The medication only works on overdoses caused by opioids. It may not be effective on other types of drug overdoses, such as those caused by drugs tainted with xylazine, another common adulterant. Xylazine is an animal sedative that has increasingly been found to be tainting illicit opioids and other drugs, often in addition to fentanyl. 

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Like fentanyl, xylazine can be detected with a simple and inexpensive test. While the library’s vending machine does not yet offer xylazine test strips, they may be available through other local harm reduction advocacy groups, such as REACH Medical.

Telltale signs of an opioid overdose include unconsciousness, pinpoint pupils, slow or no breathing, gurgling sounds and changes in skin color on the lips or fingertips — people with pale skin may appear bluish, those with darker skin may look ashy.

New York State’s Good Samaritan law protects people who report a suspected overdose as well as the person who has overdosed. The law may not protect you if you have more than eight ounces of drugs on your person, have any open warrants or are on parole. If you must leave the person alone, administer naloxone if you have any, call 9-1-1 and place them on their side. 

It may take more than one dose of naloxone to reverse an overdose. Boxes typically come with two doses, which are most commonly administered as a nasal spray. The medication is non-habit forming and has little to no side effects on someone who is not experiencing an overdose. 

If you are in crisis, dial 9-8-8 to reach the National Crisis Lifeline. If anyone is in immediate danger, call 9-1-1. If you are planning to use drugs, the Never Use Alone Hotline can be reached at 877-696-1996 and will stay on the phone with you and call 9-1-1 if you are unresponsive. Information on how to identify an overdose and test for drug contamination is available here.

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