Shelby Salazar was blissfully unaware of fentanyl becoming one of the deadliest drugs in Oklahoma until it reached her family.
Salazar received a call from her father the day after Mother’s Day in 2020. Ty Hughes, her 22-year-old brother, had died from fentanyl poisoning. He took a pill he believed was oxycodone with a former high school classmate.
Hughes’ death left Salazar shell-shocked, but it gave her a renewed purpose to tackle a prevalent issue in Oklahoma. She started a nonprofit, Talk About Ty, and joined forces with the Oklahoma Department of Mental Health and Substance Abuse Services to educate Oklahomans on the use of fentanyl, a synthetic opioid, in the illicit drug trade.
Salazar also worked with the department to provide federally funded overdose prevention resources to communities. After a statewide naloxone vending machine program was launched in May 2023 to expand access to overdose prevention resources, she stocked machines often multiple times each week in towns east of I-35.
The machines distributed free naloxone, known as Narcan, a medication that rapidly reverses opioid overdoses, and fentanyl test strips for free. Salazar was passionate about the program; she said having naloxone on hand can mean the difference between life and death.
“Since Ty did not know that the pill he was about to take was going to kill him, he was just alone in his bed,” Salazar said. “People aren’t dying in their bed or at the club snorting a line of coke …. It does happen, but a vast majority of deaths are happening there by themselves. They don’t have this long history of drug use, so it’s not like parents or whomever they’re living with have naloxone lying around.”
The state ran the program for a little more than a year before it was canceled in late 2024. Free naloxone is still available through the OK I’m Ready mail-out program and through institutional partnerships with some police departments, healthcare centers and schools.
Organizations that have taken over what is left of the vending machine program are uncertain about how they will maintain prolonged access to overdose prevention resources. Some are depending on their own budgets while others are depending on grants. On top of financial uncertainty, House Bill 2012 died before it could renew state-registered harm reduction efforts past July 1, which is causing concern among some public health leaders.
“There are several things (changing),” said Ryane Draper, the assistant director of campus wellness at Oklahoma State University. “There's some laws that were voted on. There’s some guidelines on recommended verbiage and things you can and cannot say and ways that you can and cannot afford to ensure that those things are still able to be done.”
Education and awareness of the drug is one piece of the puzzle. But Draper said that access to harm reduction resources, such as naloxone and testing strips, directly affects the number of deaths. The vending machine program originally stemmed from the need to get ahead of an increase in fentanyl-related deaths in the state that started in 2020.
The number of illicitly manufactured fentanyl poisonings increased from 127 in 2020 to 730 in 2023, according to the Oklahoma State Department of Health. It decreased to 487 in 2024.
“Education can only go so far, especially in rural communities where their access to everything is already so limited,” Draper said. “Yes, it is incredibly important to go in and educate them, but we're only giving them so much. Basically, ‘Here's what you should do, but unfortunately we can't give you access to that final piece of it.’”
The department said the naloxone vending machine program was the largest in the United States when it was announced. More than 40 vending machines were purchased, but 18 of those never made it out of the warehouse, according to records obtained by Fox 25.
Operating only 25 of the machines cost the ODMHSAS more than $14 million, which was double the estimate. Salazar saw the demand for the resources on her trips to restock the machine in Lawton, which is in a heavy-traffic area near several highways, including I-44 and U.S. Highway 62.
“Whenever you're on your way to Lawton, there is this one McDonald's that you pass on the highway, and that one (vending machine) we were having to restock quite a bit, maybe a few times a week,” Salazar said. “It was most frequently used, which also allowed the department to say this is an area where we probably have a little bit more of an issue”
In 2024, the state pulled the machines out of their original areas. With the new data, the department was able to identify high-risk areas with an increased need for naloxone. Machines were redistributed based on data analysis and needs-based assessments, according to the ODMHSAS.
In a press release announcing the transition, the state highlighted community ownership as the cornerstone for sustainable overdose prevention. Transferring responsibility remains in the works as machines are still being redistributed this year.
East Central Oklahoma Family Health Center, Inc. received three machines from the Oklahoma Primary Care Association for its locations in Wetumka, Henryetta and Wewoka. CEO Donna Dyer said the organization will pay out of pocket for the stock.
“They did give us the first set of stock,” Dyer said. “We can request from the PCA at some point, and we will pay for those out of our program income. We'll pay for those supplies to be put back in. We’re going to keep it going, and as long as it's being used, that's the important thing.”
As of July 9, 49 naloxone kits and 50 fentanyl test strips have been distributed across the three healthcare locations since they were installed in May. Each is open 52 hours per week, and the vending machines are in the lobby for patients and community members to use. East Central serves rural communities, and Dyer said it’s critical for those populations to have naloxone, too.
“In this area and with all the small towns, Oklahoma has a very big fentanyl problem and overdose problem,” Draper said. “We want this medication to be out there and to be able to be used …. We’re going to find sources to make sure that's covered. I mean, it would be ideal if the Department of Mental Health could help with that, but I also know that there's funding concerns.”
Wetumka and Wewoka are in rural counties as defined by the state health department. Henryetta is in a metropolitan county, but is considered high risk with a 15% death rate per 100,000 people for fentanyl overdoses. A majority of the vending machine stock at the East Central sites, according to data provided by Dyer, is going to Henryetta.
Although it may cost the organization, Dyer said it’s important to be able to provide what their patients and surrounding community need, even if they need to reconsider how to maintain it.
“There’s always a concern (for finding funding) when you start thinking about what we need to do and how we need to get it done,” Dyer said. “But that's just part of providing the services that our patients need. We'll be looking at other revenue if we can find it, and go from there.”
So-called Narcan hubs, places that provide free naloxone through state partnerships, also are unsure of future stock, especially for fentanyl test strips.
The U.S. Substance Abuse and Mental Health Services Administration sent a letter to its partners at the end of April clarifying changes to federal funding after one of President Donald Trump’s executive orders declared that certain harm reduction resources and practices are facilitating illicit drug use against federal law.
The order announced that funding would no longer be approved for fentanyl test strips or any other substance test kits. Since Oklahoma passed a law in 2023 no longer identifying test strips as drug paraphernalia, organizations that fund their own stock can still include test strips but will not receive state money.
Different ownership can create an inconsistent stock for vending machines operating across the state. The vending machine on OSU’s campus is a partnership with HOPE, a nonprofit that provides free and low-cost HIV and STI testing as well as education. The machine is meant to provide several needed resources, including sexual health resources, harm reduction materials and basic necessities.
Other HOPE vending machines often include Naloxone provided by HOPE’s own private grants, but OSU’s Department of Wellness receives a majority of its overdose prevention resources from the state, Draper said. Her team stocks the machine with harm reduction kits, which include both naloxone and fentanyl testing strips, which Draper said is one of its most popular items.
“Being a Narcan hub really covers us for the most part, especially through the community wellness grants, but (having resources from the state in the future) is an up-in-the-air conversation,” Draper said. “There's some change in funding structures, but for example, the grant that I oversee is specific to opioid and stimulant misuse, and that we anticipate to be refunded next year.”
Draper is uncertain of the resources they may be able to distribute in the future as harm reduction programs are in limbo after House Bill 2012, which would extend a bill that permitted the legal operation of state-registered harm reduction programs through July 1, 2027, was passed by the House and never heard on the Senate floor. The bill died, but Rep. Daniel Pae, R-Lawton, said he plans to introduce another extension bill in the next legislative session.
Draper’s team is prepared if there is a change in their available stock, including if they no longer receive testing strips, she said. Education would shift to being the sole focus of the department’s prevention efforts, but not being able to provide certain resources would be a drawback.
“People don't feel as safe, and they don't feel as supported,” Draper said. “Words can only go so far, right? We can only tell someone this is how you should respond, or this is what you should do, but not giving them the full tool set to intervene is hard and scary.”
Naloxone will remain available at the state level through the mail-out program, but the fentanyl test strip option has since been removed from the website.
Organizations that took over the vending machines are working toward an efficient model to provide Naloxone to their communities, but uncertainty looms without guaranteed funding and the legal operation of harm reduction programs. For Salazar and others who have been touched by fentanyl-related deaths, it’s important to prevent it from happening again.
”Everybody needs to be trained in administering Narcan just like CPR,” Salazar said. “It’s not because we're supporting people that take pills that aren't prescribed to them or anything like that. It's because it’s a real thing that happens and we need to accept that as a nation and learn for the sake of just being able to look out for one another.”
Oklahoma Watch, at oklahomawatch.org, is a nonprofit, nonpartisan news organization that covers public-policy issues facing the state.
