A Naloxone vending machine at Twice Daily's 1702 West End Ave. location
Nashville got its first free naloxone vending machine in mid-April, with the project’s leaders anticipating having to refill it about once per month. During the machine’s first weeks, the Metro Public Health Department has refilled it three times per week — that’s 1,500 doses of the overdose-reversal drug, often known by the name brand Narcan, distributed per week.
As a partnership between Nashville-based national harm-reduction organization Fund Recovery and Twice Daily, the vending machine opened outside the convenience chain’s 1702 West End Ave. location on April 15. On the machine’s side is an ad for Tennessee Titans player Jeff Simmons’ “Tackle Overdose” campaign.
Nashville’s vending machine is the third in the state — Fentress County opened the first two earlier this year.
“One of the problems we have with the availability of naloxone is that it’s hard to find,” Fund Recovery board chair Ryan Cain tells the Scene. “It needs to be put in places where we all go.”
The hope is to be able to see a decrease in the number of overdose deaths with the introduction of so much naloxone to the streets, Cain says.
While over-the-counter Narcan was approved by the U.S. Food and Drug Administration in early 2023, barriers remain. Naloxone often costs money or requires training or proof of need in the Nashville area.
“The more we can get naloxone into the hands of those most at risk, or most likely to witness an overdose, the more lives we can save together,” says Anthony Jackson Jr., director of prevention and early intervention services for the Tennessee Department of Mental Health and Substance Abuse Services. “Pairing naloxone with brief training helps reduce stigma and ensures people feel seen, supported and ready to act, while also opening the door to recovery.”
The number of annual overdose deaths in Nashville has declined a bit each year since 2021. The most substantial decrease came in 2024, when the number dropped from 701 deaths to 529.
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In the first quarter of 2025, there were 112 suspected overdose deaths (72 completed and 40 pending at the time of the report), representing a 21 percent drop compared to the same period a year prior. Fentanyl, a synthetic opioid, was detected in approximately 70 percent of the cases. A newer powerful tranquilizer drug, xylazine, appeared in 46.5 percent more cases compared to the first quarter of 2024.
Nashville’s improvements fall in line with national statistics. New national numbers from the Centers for Disease Control and Prevention show a decrease of nearly 27 percent in overdose deaths from 2023 to 2024.
Naloxone can’t harm someone, Cain points out, and doesn’t necessarily require training. Directions for use are printed inside the box.
“It’s a nasal spray,” Cain says. “Put it in someone’s nose and squirt. That’s it. It’s not like we’re using a defibrillator. It’s way simpler than that. They have defibrillators in bars all over the place, and I’ve never been through training on how to use one.”
Fund Recovery’s next steps are to establish more vending machines, hopefully with the help of opioid-abatement funds, says Cain. The first Nashville vending machine was privately funded. Fund Recovery is also planning locations in Baltimore, Detroit, Phoenix and Jackson, Miss.
Opioid-abatement funds come from a $26 billion settlement paid by companies that made, distributed or sold opioid painkillers. The Tennessee Opioid Abatement Council has distributed at least $81 million statewide, including millions in Nashville. In addition, Metro Nashville has been awarded $23 million directly, which it plans to use for a recovery program.
Millions of dollars in grants were awarded for mobile clinics, indigent services, pregnancy care
When the free vending machine was covered by local television outlets last month, Cain says it brought out the worst in some commenters, who said people should not be given a second chance at life. Even on the day of the vending machine’s unveiling, he was asked, “Won’t this bring around the wrong crowd?”
Define “wrong crowd,” Cain challenges.
“This whole idea that it’s only for people that are active drug addicts is a complete misconception,” Cain says. “That’s not why we carry naloxone.
“We know it’s saving people, and we want to normalize it,” he continues. “The best example I can use is EpiPen. I have EpiPens at my house because I have kids that are allergic to nuts, but I’m not allergic to nuts. No one is going, ‘Hey, why do you have an EpiPen?’”
On the back of each naloxone box is a number to help find treatment.
“The overdose crisis has taken the lives of many Nashvillians, and carrying Narcan is one way the community can play a role in reducing the number of fatal overdoses,” the Metro Public Health Department adds in a statement. “By making it easier to obtain Narcan through initiatives like the new vending machine, we hope fewer of our family members, friends and neighbors will lose a life to an overdose, meaning a healthier and more vibrant Nashville for everyone.”
