Across the globe, communities are grappling with the deadly toll of opioid overdoses, but recent initiatives in Ireland and the United States are offering new hope in the fight to save lives. On August 30, 2025, Cork, Ireland, became the latest city to launch a pioneering programme aimed directly at reducing overdose deaths. According to the Irish Examiner, the HSE/NAS Alternative Prehospital Pathway (APP) team in Cork has begun providing naloxone—an emergency medicine that can reverse the effects of opioid overdoses—directly to individuals who have overdosed but decline to be transported to the hospital.
This new approach, led by a team that includes Mauro Lacovich of the HSE Cork Drugs & Alcohol Service, Dr. Daragh Mathews from Cork University Hospital, Jenny Smyth as the HSE Naloxone project lead, and Stephen O’Flaherty, a community engagement officer and advanced paramedic with the HSE National Ambulance Service, represents a shift in how emergency responders interact with opioid overdose cases. By giving naloxone directly to at-risk individuals, even when they refuse hospital care, the team aims to bridge a critical gap in the chain of survival for people experiencing opioid overdoses.
Overdose deaths have become a public health crisis in many regions, with opioids—both prescription and illicit—at the center of the storm. The Cork initiative is part of a wider movement to rethink traditional emergency responses, focusing on harm reduction and direct intervention rather than relying solely on hospital treatment. The hope is that by making naloxone more accessible, more lives will be saved, and families spared the heartbreak of preventable loss.
Meanwhile, across the Atlantic in Eastern Iowa, a different but equally innovative strategy has been underway. As reported by The Gazette, June 2024 marked a significant step forward for Linn County as the Substance Misuse Committee used a $150,000 award from nationwide opioid settlements to install seven naloxone vending machines throughout the county. These machines, located in places like the Cedar Rapids Comprehensive Treatment Center, CRUSH of Iowa Recovery Community Center, Gary’s Foods in Mount Vernon, Hiawatha Public Library, Linn County Community Service Building, Linn County Mental Health Access Center, and Marion Public Library, are stocked not only with naloxone but also with other harm reduction tools such as wound care kits and condoms.
Each vending machine holds 35 boxes of naloxone and is restocked quarterly by default. However, the demand has been so high that some machines require more frequent replenishment. The CRUSH of Iowa Recovery Community Center's machine, for instance, was refilled four times in 2025 alone. This rapid uptake highlights the acute need for easy, stigma-free access to lifesaving interventions. Erin Foster, director of the Linn County Mental Health Access Center, explained, “We’ve heard multiple times about people walking into pharmacies, and the pharmacist is taking demographic information, sometimes insurance information. It creates more barriers for people. The stigma for substance use is very high, and one of the reasons people don’t seek help.”
The impact of these efforts is already being felt. According to data from Linn County Public Health, opioid-related deaths in the county more than doubled from 12.9 to 26.1 deaths per 100,000 population between 2018 and 2020, outpacing Iowa’s statewide rate and closing in on the U.S. average, which was 30 deaths per 100,000 in 2020. The Centers for Disease Control and Prevention reported 475 fatal opioid overdoses in Iowa in 2021. However, since the vending machines were installed, overdose deaths in Iowa dropped from 447 to 425 in 2024, and in Linn County, deaths fell from 27 in 2023 to just 11 as of August 2024. This continues a downward trend that began in 2022.
Opioid-specific overdose deaths in Linn County have fluctuated: 32 in 2020, 18 in 2021, back up to 32 in 2022, and down to 13 in 2023. While the numbers can be volatile, the overall trend is encouraging. According to Dana Chappuie, operations manager at CRUSH, the vending machines have been “heaven sent” for bridging the gap between addiction and entering long-term treatment. Chappuie added, “We have this look in our head that (opioid users are) someone in the park with all these bags, or someone going to jail for theft. We’re not recognizing who in society is being affected by this.”
The reality, as Chappuie points out, is that opioid overdose victims come from all walks of life. In Linn County, the ages of overdose victims have ranged from 17 to 85 years old, with a median age of 41. Some are teenagers who unknowingly ingest drugs laced with opioids, while others are elderly individuals who accidentally take too much of their prescription medication. Chappuie, who also distributes naloxone at public events, emphasized the importance of shifting public perception: “It’s just having that conversation. It may not be for you, but it could be for your son’s best friend who accidentally took something they weren’t supposed to. It’s just having that mentality that this is a lifesaving tool.”
The success in Linn County has inspired neighboring Johnson County, which recently installed six naloxone vending machines in Coralville, North Liberty, and Iowa City, with another planned for the Johnson County Health and Human Services building. This regional expansion underscores the growing recognition that harm reduction strategies—making naloxone available without judgment or bureaucratic hurdles—are vital in the ongoing battle against opioid-related deaths.
Both the Cork and Iowa initiatives reflect a broader shift in public health thinking: rather than seeing addiction solely as a criminal or moral issue, more communities are viewing it through the lens of healthcare and compassion. By meeting people where they are—whether that’s on the street, in a library, or at a community center—these programmes aim to remove barriers and stigma, replacing them with practical, immediate help.
Of course, challenges remain. The stigma around substance use still prevents many from seeking help, and some members of the public remain apprehensive about the proliferation of harm reduction tools. But as the data from Iowa shows, when naloxone is made available and accessible, lives are saved. The Cork programme, while new, hopes to replicate this success and further demonstrate the life-saving power of direct intervention.
As communities continue to innovate and adapt in response to the opioid crisis, the lessons from Cork and Iowa are clear: saving lives sometimes means meeting people halfway, offering help without conditions, and believing that every life is worth saving. With each naloxone kit distributed and each life preserved, the tide against opioid overdose deaths may slowly be turning.
