SLPD Chief Darin Perrotte said the supplies in the machine are free, available with no questions asked and might make the crucial seconds in an opioid overdose count. He hopes these lifesaving items will be a more “proactive” approach to the opioid epidemic. He also said everyone should keep naloxone in their home, just like a fire extinguisher. Naloxone is the generic term for the medicine commonly known as Narcan.

“Putting this in the hands of the community can save lives,” Perrotte said.

The department got this machine at its station on the corner of Main Street and Lake Street through its partnership with the Alliance for Positive Health, a non-profit which services northeastern New York with offices in Plattsburgh. The machine itself comes from New York MATTERS (Medications for Addiction Treatment and Electronic Referrals), an opioid use disorder organization centered in Buffalo.

MATTERS Chief Medical Officer Joshua Lynch said MATTERS is distributing 15 of these vending machines around the state and Saranac Lake’s is the first to go live.

Alliance for Positive Health Harm Reduction Care Coordinator Bianca Snyde, right, and Overdose Prevention Coordinator Krista Trombley stock a new vending machine in the Saranac Lake Police Department lobby with free naloxone sprays to reverse overdoses and free test kits for fentanyl and xylazine on Tuesday. (Enterprise photo — Aaron Marbone)

“Having the first one in the North Country … an area that’s not totally rich with resources … is something that’s really important to us,” he said.

The police department already partners with APH for its sharps disposal box in the entryway and for the naloxone officers carry. Perrotte had worked with APH while a lieutenant in the Plattsburgh Police Department. He became the SLPD’s chief in February 2022 and started sourcing his officers’ naloxone through APH.

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The cost

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APH Overdose Prevention Coordinator Krista Trombley said naloxone can cost $45 per box from a store. This makes it cost-prohibitive in a time when experts are pushing for it to be free and accessible as one of the most effective ways to treat an overdose.

She said the cost and stigma behind purchasing it can keep people from seeking help.

“Many people are reluctant to access harm reduction supplies because they have to go interact with someone,” Lynch said. “That adds a layer of stigma and anxiety for some, maybe an element of embarrassment.”

The money to make these doses free comes through grant and state funding through the state Office of Addiction Services and Supports. Lynch said there’s a possibility the machine will be restocked in the future using money from recent settlements with major pharmaceutical corporations responsible for producing and selling the drugs that fuel the opioid epidemic.

The settlements the state reached with these companies let the companies not admit to wrongdoing, but required hundreds of millions of dollars in payments to the state, bringing in over $1.6 billion to New York state.

The total cost to install the machine was $14,800 and the machine itself cost $10,000.

Trombley said APH is responsible for restocking the machine, which they plan to do regularly.

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A home necessity

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Perrotte said his biggest question is, will people come to get naloxone from the police station? He understands people might be hesitant, worrying they’ll get labeled as a drug user.

“I’m sure that there will also be people that think that it’s kind of a trap,” Perrotte said. “That’s truly not the case. … We don’t want to see anyone overdose.”

The door to the lobby is unlocked from 8 a.m. to 4 p.m. on weekdays as the station now has a secretary — Julia Coffman — working the front desk. The door to the lobby was often locked in the past, but now, with the hiring of Coffman, it can stay open. During off-hours and if the door is locked, a phone outside the station can call an officer to unlock the door.

“No questions asked. We’re not taking any names,” Perrotte added. “You can literally come in here, not speak to anyone, grab things out of the machine and leave.”

He pointed out people already do this on a daily basis when they drop off used needles in the sharps container or medication drop-off box.

The machine asks for zip code and age before dispensing items, but this is strictly for record-keeping purposes for the APH, according to APH Harm Reduction Care Coordinator Bianca Snyde.

Perrotte said it is wise for everyone to have naloxone in their home.

“I equate it to having a smoke detector or a fire extinguisher. It’s in your home and it’s something that you have, God forbid something ever goes wrong,” he said. “A lot of people might want to think that it will never happen to them. The bottom line is that we don’t know that.”

Perrotte also anticipated pushback and negative feedback to the machine when it was installed on Tuesday. Indeed, when the department posted a photo of it on Facebook that evening, many people echoed his exact predicted words: “Why are we promoting this?”

“Folks are going to say ‘Why are the police facilitating drug use?’ It’s not that we’re facilitating drug use,” he said. “Having a fire extinguisher in your house doesn’t mean go ahead and act recklessly and put all kinds of oil on your stove and start a fire. It means, in the event, you’re prepared.”

Whether it’s children ingesting pills, teens experimenting with drugs, adults using other drugs laced with opioids, regular opioid users or elderly people accidentally taking too many pills, he said there are countless ways someone can overdose.

“People’s loved ones are falling victim to this epidemic and by having this in the house, it’s a way for them to render immediate aid,” Perrotte said.

Snyde said they see an extra struggle with overdoses here because the area is so rural and there are long travel times to resources.

“We’re fortunate here in the village that we have a pretty quick response time,” Perrotte said. “But if you live out in Lake Clear or Bloomingdale, somewhere off the beaten path, and someone overdosed in your home, it could be an extended period of time that you’re waiting for first responders to get there.”

He said just because someone doesn’t use opiates doesn’t mean they aren’t ingesting it.

According to Perrotte, here in Saranac Lake, officers responded to an overdose of a high school student who used cannabis that was laced with fentanyl.

Snyde said people who say they are strict cocaine users still can have fentanyl in their system because the cocaine is being cut with fentanyl, which makes it more addictive. When people stop using, they experience harsher withdrawals and come back for more. It creates a stronger hold on them, she said.

The machine also dispenses testing kits, for testing other substances for opiates like fentanyl or xylazine. Xylazine, a sedative, is becoming a more common drug, Perrotte said.

His department gets monthly reports from the Crime Analysis Center. Perrotte said there have not been a lot of overdoses in past several months. He attributes this to enforcement — getting drugs off the street through drug busts and arrests — as well as education and putting things like naloxone out there.

In part, he said, because naloxone is becoming more prevalent, overdoses don’t always get reported. If someone reverses an overdose at home, they don’t usually report it.

Perrotte said there have been no fatal overdoses in Saranac Lake to date this year, but there were two last year and a couple the year before.

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How to use Narcan

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Perrotte keeps expired naloxone sprays at the station for demonstration purposes. The doses in the vending machine are fresh and good until 2026.

Naloxone administration can be done very fast. It took him around 15 seconds from opening the box to administering it. The bottle works just like an allergy nasal spray.

“Thumb on the bottom, two fingers on the top,” Snyde explained. “You insert it into the person’s nostril, push the red button that’s on the bottom and then all the medication will come out.”

The suggestion is to put one dose in one nostril and one in the other, in case one nostril is clogged from snorting something or another reason.

Each box is a two-pack of the medicine.

When Perrotte demonstrated it, he sprayed it into the air. There’s no danger to the person administering it, he explained.

“It’s not something that’s going to affect anyone who isn’t overdosing on an opioid,” Perrotte said.

How long it takes to work varies depending on the amount of opiates in the person’s system. Stronger opiates like fentanyl take a larger dose and more time to work.

“Whereas one or two doses might have woken someone up prior, now with fentanyl being laced into everything, it could take five or six doses, or maybe more,” Snyde said.

The average size of naloxone doses has also grown, she said, from 2 to 4 milligrams.

Naloxone binds to opiate receptors in the respiratory center of the brain, taking the opiate off the receptor by acting like a decoy. This allows the person overdosing to start breathing again. Snyde said naloxone only lasts in the system around 30 to 90 minutes while an opiate can last hours, so someone on a high dose can slip back into an overdose after being revived.

Snyde explained a few symptoms of an overdose that people should be on the lookout for.

If someone looks like they’re going to sleep in an odd place, she said, try to wake them up. If they are not responsive verbally or physically; have shallow breathing; are making gurgling or snoring noises; or have blue lips or nails, that means they’re not getting enough oxygen during an overdose.

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