BOSTON (SHNS) - It was during a work trip to the San Diego area when Middlesex County Sheriff Peter Koutoujian realized the full harm reduction potential of having a free Narcan vending machine at a jail. A corrections officer there demonstrated how visitors to the facility could use the self-serve machine to obtain free doses of the opioid overdose reversal drug naloxone. And when the machine dispensed the kit, the officer turned to everyone observing and, rather than return the kit to the machine to be distributed outside the demo, casually asked, "Does anyone want this?" When someone took the officer up on the offer, Koutoujian said, it drove home the difference between Narcan being available for someone to go out and buy on their own (it retails for about $23 a dose at CVS) and having that potentially life-saving medication be offered for free to anyone who is interested. And that experience led Koutoujian to have a similar free naloxone vending machine installed last month at the visitor's center of the Middlesex Jail & House of Correction in Billerica. It has been used nearly 30 times by visitors and staff since, he said, and a second machine is already being planned. "It's important to have these kits in the community where they can do good. Oftentimes there might be people who might know they have a greater need for these kits in their lives for various reasons, they have family members who struggle with substance use disorder. But I realized as a citizen it would be important for me to have something, should I come across a situation," Koutoujian said. "The greater access to this, the more lives that can be saved." There were 2,125 confirmed and estimated opioid-related overdose deaths in Massachusetts in 2023, or 30.2 per 100,000 residents. That marked a 10 percent decline compared to 2022, when the epidemic claimed the lives of 2,357 Bay Staters, at a rate of 33.5 per 100,000. Public Health Commissioner Robbie Goldstein attributed the decline in overdose deaths to the expanded distribution of naloxone, among other measures. DPH said in June 2024 that it had distributed more than 196,500 naloxone kits, with each kit containing two doses, since 2023. The effort led to at least 10,206 overdose reversals, officials said. "In corrections especially, for generations, for decades, we've considered success based upon recidivism, are we able to drive down rates of recidivism? I've come to the real knowledge that -- especially with the opioid use disorder epidemic out there -- that we have to be also, more importantly, thinking in terms of harm reduction. Do we keep people alive?" Koutoujian, who has been sheriff in the state's most populous county since 2011, said. Koutoujian's office said the visitor's center at the Billerica jail is a high-traffic place, with more than 25,000 visits from family members, friends, attorneys, volunteers and other law enforcement officials over the last two calendar years. The correction officers who work at the jail have access to naloxone while on duty, including while transporting incarcerated people elsewhere, and can also access the free kits from the vending machine for use while off duty. Before the vending machine dispenses the kit with two free doses of naloxone, it plays a brief video explaining how to use the nasal injector that delivers the naloxone and what a person should do when administering it, including calling 911 and giving multiple doses if needed. It also asks to anonymously collect information from the recipient (age, gender, race and zip code) but responses are not required. The naloxone being distributed is paid for through a Comprehensive Opioid, Stimulant, and Substance Abuse Site-based Program grant and the machine is leased through the same grant funding, Koutoujian's office said. Of the people incarcerated at his facility, Koutoujian said approximately 20% to 25% receive an approved medication for opioid use disorder, with many participating in the Medication Assisted Treatment and Directed Opioid Recovery (MATADOR) program that his department runs.