Peter Davidson has been conducting research on overdose prevention since 1997.

In January 2020 the Los Angeles County Sheriff's Department implemented a naloxone-on-release program in which all inmates being released from the Los Angeles County Jail system (average nightly population 17,000) are exposed to a video training on overdose recognition and response, and are able to take as many doses of naloxone as they wish from a no-cost vending machine at the point of release. On average 30,000 doses of naloxone have been distributed per year since then, making the program the largest of its kind in the world. In addition, naloxone has been placed in all housing units in the jail system so that inmates can access and use naloxone immediately in the event of an in-jail overdose event, avoiding delays due to reluctance to call for assistance from jail staff (who are also equipped with naloxone). In this presentation we discuss challenges overcome in scaling naloxone-on-release in a system which releases over 5,000 people per month, and in instituting in-jail naloxone.