DENTON, Texas — According to Texas Health and Human Services (HHS), the state is experiencing a drug poisoning epidemic. Included in that epidemic is a rising number of opioid overdoses. One such incident inspired a novel solution.
Chad Wither, general manager of Rubber Gloves Rehearsal Studios, a Denton nightclub, recalls a scary situation with an 18-year-old who was overdosing on opiates.
“I had a Narcan right there,” Wither said. “Pulled it, gave it to them, and they went over and administered it, and that person was, looked like, essentially brought back to life.”
The experience inspired him to put a free naloxone machine outside the club. Also known by its brand name Narcan, the nasal spray can reverse the effects of an opioid overdose.
Though it looks like a typical vending machine, this one has the potential to save lives. Just as with a standard vending machine, Narcan is dispensed by punching in a code and collecting the spray from the tray. In this case, no payment is required.
It’s the first Narcan machine issued through the statewide initiative Be Well Texas and its public health program Naloxone Texas. And it already seems to be working.
“We’ve already had to restock it twice. We’ve only had it a week so far,” Wither said.
Dr. Tara Karns-Wright directs the program throughthe University of Texas Health Science Center at San Antonio.
“We are really trying to address the opioid crisis by providing tools on the ground that will help to address things like overdoses,” Karns-Wright said.
And — though the Centers for Disease Control and Prevention data shows opioid overdose deaths were down 27% nationwide from over 83,000 to roughly 55,000 in 2024 — a state health services program called Texas Overdose Data to Action reports drug poisoning deaths including opioid overdoses have increased over 75% in the last five years in Texas.
Karns-Wright says free Narcan machines provided through state funding are part of the solution. They plan to place 112 machines around the state.
“The other really potential solutions are prevention and treatment,” she said. “And so one of the things we try to do at Naloxone Texas is link to treatment if we can.”
DENTON, Texas - A vending machine in Denton aims to prevent overdose deaths. It's filled with the life-saving drug naloxone, a medication designed to reverse opioid overdoses.
The most valuable vending machines around can save a life. Naloxone Texas is an initiative of the group, ‘Be Well Texas’ at UT Health Science Center in San Antonio.
On Tuesday, a Denton nightclub, The Rubber Gloves Rehearsal Studio, became the group's first site for this 24-hour easy-to-use, free-of-charge vending machine. A vending machine that dispenses Narcan, the brand name for the drug Naloxone, is now available without a prescription.
What they're saying: "Others do exist in the state, but this is our first vending machine we’re deploying, so we’ll have a total of 112 in Texas that we’re deploying all over," said Tara Karns-Wright with Noloxone Texas.
A presentation with a DEA special agent demonstrates how to administer the nasal pump dose to save anyone who has just overdosed. Something that happened at this club sparked the management’s decision to be a site for a naloxone machine.
"A young person, 18-years old, experienced an overdose, just took a pill. They didn’t know what it was. A patron found them and, luckily, we had Narcan behind the counter, and actually, one of the patrons administered it, and we were able to save that young person’s life," said Chad Withers of Rubber Gloves Rehearsal Studio.
"Venues like this are where people come to socialize and hang out, and drugs may be prevalent. We just want to make sure everyone knows there are things that can be done to help," said Karns-Wright.
What's next: Federal and state grant money allows for the purchase of the Narcan they fill those machines with.
A UT Health San Antonio initiative was selected to lead a major expansion of opioid use disorder and recovery support services across Texas.
Be Well Texas, an initiative of the Be Well Institute on Substance Use and Related Disorders, was awarded $256 million over four years by the Texas Health and Human Services Commission to administer medications like Naloxone for opioid use disorder treatment services and to continue offering recovery support services.
Dr. Jennifer Sharpe Potter, founding director of the Be Well Institute, said the partnership between the university and the commission is a major commitment to support solutions to the opioid crisis.
“The partnership, in and of itself, is noteworthy, because this is an opportunity for us to support the state in delivering these services,” Potter said. “The expansion is about making sure people have access. We continue to see opportunities to improve the amount of funds that go to these services statewide.”
Potter said the funding will be used to begin youth recovery services and expand outpatient opioid use disorder treatment. She said the initiative will also see an expansion of access to methadone, which is provided through opioid treatment programs.
“We are honored to be able to manage, on behalf of Texas Health and Human Services, the contracted treatment programs for methadone throughout the State of Texas,” Potter said. “We’re particularly proud that the state has seen the work that we've done and trusts us with this important delivery model.”
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Potter said youth support services are critical because they limit how long opioid use disorder is a burden on an individual and put them on a path to recovery.
“We’ve seen in Texas an increase in the number of individuals under the age of 18 who've been adversely impacted by opioids,” Potter said. “While not all of those individuals may have had an opioid use disorder, we want to be able to provide them with support related to their opioid use.”
Be Well Texas partners with local practices to provide treatment to people with opioid use disorder across the state. Potter said this funding will allow the initiative to continue working with local partners and also leverage telehealth services to ensure rural and urban communities alike have increased access to treatment.
“The most important thing is that you lean into local, community based, semi-governmental and private practice groups who can be part of the solution,” Potter said. “It’s not top-down dictates — it’s working with the local community to find a solution that makes sense.”
Potter said state funding is the backbone of the services the initiative offers, especially in Texas where some people do not have access to health insurance.
“We would not be able to do this work without the state support,” Potter said. “There would be a sizable number of individuals who would go without treatment, and that would increase the number of deaths in Texas related to addiction.”
Potter said she hopes the work the initiative does creates less stigma associated with asking for help with substance abuse in Texas. The Be Well Initiative is also a research entity that is working to support development of new treatment options.
“We hope, at the institute, to create access to even newer and better treatments, just like you would for any other disease,” Potter said. “We’re not just delivering service with treatments. We're hoping to invent, discover, and be part of providing other treatments in the future.”
SAN ANTONIO, July 16, 2025 – The Texas Health and Human Services Commission has formally announced that Be Well Texas, an initiative of the Be Well Institute on Substance Use and Related Disorders at UT Health San Antonio, has been selected to lead a major expansion of opioid use disorder and recovery support services across Texas.
Be Well Texas has been awarded funding to administer two key components of the state’s opioid response under a Needs Capacity Assessment initiative: medications for opioid use disorder treatment services and recovery support services.
This initiative is part of the broader Texas Targeted Opioid Response and Peer Support and Recovery Services strategy, aimed at reducing overdose deaths and building a lasting recovery infrastructure. The funding enables Be Well Texas and its partners across the state to expand treatment access, improve continuity of care and reach both rural and urban communities with life-saving services.
“We are honored by the trust placed in us by the Texas Health and Human Services Commission and grateful for their leadership in addressing the challenge of substance use across the state,” said Jennifer Sharpe Potter, PhD, MPH, founding director of the Be Well Institute and senior vice president for research at UT Health San Antonio. “This work would not be possible without the partnerships we’ve built with community leaders, providers and recovery organizations throughout Texas. Together, we are committed to expanding compassionate, evidence-based care for those affected by substance us.”
This award represents a unique collaboration between two state entities – HHSC and UT Health San Antonio – united by a shared vision: increasing access to high-quality, evidence-based and person-centered substance use services. As the lead agency, Be Well Texas will provide technical expertise, oversight and implementation support through a comprehensive network of treatment, recovery and provider engagement programs backed by the Be Well Institute’s deep clinical and public health experience.
“This is not just an expansion – it’s a continuation and amplification of the work Be Well Texas and its partners have been doing for years to scale effective, innovative models across Texas,” Potter said. “It reflects a growing momentum to ensure every Texan has access to care that works – wherever they are.”
Since 2021, the Be Well Texas initiative has served as a trusted partner in the state’s overdose prevention efforts, providing low-barrier clinical care, a robust statewide Provider Network, workforce training and substance use solutions at scale. The new funding will allow for even greater reach and integration of these services into Texas communities most in need.
The University of Texas Health Science Center at San Antonio (UT Health San Antonio) is one of the country’s leading health science and research universities. With missions of teaching, research and patient care, its schools of medicine, nursing, dentistry, health professions, graduate biomedical sciences and public health have graduated more than 45,000 alumni who are leading change, advancing their fields and renewing hope for patients and their families throughout South Texas and the world. To learn about the many ways “We make lives better®,” visit UTHealthSA.org.
Stay connected with UT Health San Antonio on Facebook, Twitter, LinkedIn, Instagram and YouTube.
The Be Well Institute on Substance Use and Related Disorders at UT Health San Antonio is a statewide leader in advancing research, clinical care and education to address substance use and its impact on individuals, families and communities. The institute encompasses a range of initiatives, including the Be Well Clinic (offering in-person and telehealth services), Naloxone Texas (offering free statewide distribution of opioid overdose medication), the Center for Substance Use Training and Telementoring and a robust research arm dedicated to developing and scaling evidence-based solutions.
Be Well Texas, a flagship initiative of the Institute, provides compassionate, low-barrier access to treatment and recovery support through clinical care, a statewide provider network, workforce development and recovery infrastructure. Together, the institute’s programs expand access, reduce stigma and improve outcomes for Texans affected by substance use and related disorders.
SAN ANTONIO, Dec. 30, 2024 – Patients with opioid use disorder can reduce their days of opioid use and stay in treatment longer when using a smartphone app as supportive therapy in combination with medication, a new study by The University of Texas Health Science Center at San Antonio (UT Health San Antonio) shows.
The cohort study of 600 underserved patients found that those who chose to use the app – which combines contingency management behavioral therapy and recovery support from peers – and alongside medication, reduced their days of opioid use by 35% compared with those treated with medication only. Additionally, app users remained in treatment nearly 19% longer than those treated with medication alone.
“These findings suggest that augmenting medication for opioid use disorder with app-based contingency management may provide clinical benefits for underserved patients,” said Elise Marino, PhD, director of research operations at UT Health San Antonio’s Be Well Institute on Substance Use and Related Disorders. “Expanding the availability of app-based contingency management may contribute to decreasing the immense societal, economic and personal burden of opioid use.”
Marino is lead author of the study, titled, “Smartphone App-Based Contingency Management and Opioid Use Disorder Treatment Outcomes,” published in JAMA Network Open. The other authors also are with UT Health San Antonio’s Department of Psychiatry and Behavioral Sciences and the Be Well Institute.
A need to augment medication
Opioid use disorder continues to be a national crisis, contributing to substantial morbidity and mortality. Its annual societal cost in the United States hit $968.9 billion in 2018, the study notes.
Medication for opioid use disorder, or MOUD – including methadone, buprenorphine and naltrexone – is recognized as the only evidence-based treatment for the condition. This first-line treatment has been shown to significantly decrease opioid-related morbidity and mortality, and with consistent cost-saving benefits.
However, some patients still experience difficulties reducing opioid use and staying with their treatment, pointing to a need to augment MOUD. Many conditions benefit from dual treatment of medication and therapy. One therapy is contingency management, or CM, which provides financial incentives for accomplishing treatment goals.
This therapy traditionally has been delivered in clinics, with the goal of an opioid-negative finding from urine drug screens. While findings have been mixed, several reviews and studies have found that individuals treated with MOUD plus CM had better retention and fewer opioid-positive results from urine drug screens.
A long-standing limitation, however, is that patients are required to attend multiple in-person appointments per week for the therapy. With the recent COVID-19 pandemic, many were unwilling to make in-person CM visits. Additional access barriers, such as transportation, distance from the clinic and arranging child care, have supported other options like telehealth and leveraging new technologies.
There’s an app
One such technology is the WEconnect Health CM smartphone app. The app delivers evidence-based CM embedded in a recovery-oriented framework. In addition to providing substance-related behavioral targets, it permits patients to set daily goals that are personally meaningful, both substance use-related and otherwise, like attending a Narcotics Anonymous meeting, going for a walk or reading.
The app also includes a platform for tracking patients’ progress and payment, and provides encouragement for completing their daily goals. Additionally, WEconnect offers 1-to-1 peer support and online meetings facilitated by certified peers. In contrast to traditional CM, the app permits patients to make decisions regarding their own goals for treatment and to explore recovery through peer support services available anywhere and accessible outside of normal clinic hours.
For the new research, the scientists set out to evaluate whether augmenting MOUD with app-based CM is associated with fewer days of opioid use at the end of treatment and greater retention than treatment with MOUD only.
The retrospective cohort study, which refers to research that follows a group of people over time, used data from Nov.1, 2020, to Nov. 30, 2023, collected from opioid treatment programs across Texas. The cohort included 600 individuals aged 18 years or older who were uninsured or underinsured and who chose to receive MOUD only or MOUD plus CM delivered by the WEconnect smartphone app.
Those who chose to receive MOUD plus app-based CM reported a mean duration of 8.4 days of opioid use at the end of treatment compared with 12 days for those who chose to receive MOUD only. Retention analysis showed that patients who chose to receive MOUD plus app-based CM stayed with their treatment for a mean duration of 290.2 days, compared with 236.1 days for those choosing to receive MOUD only.
“These results are promising, and they highlight the potential importance of a patient’s decision to use app-based CM,” the researchers concluded. “Despite the challenges of engaging patients in other app-based interventions, adding recovery-oriented, app-based CM may be one way to enhance clinical care and meet the growing needs of historically underserved patients taking MOUD.”
UT Health San Antonio is a world-class research university, ranking at the top 5% among institutions globally for clinical medicine according to U.S. News & World Report. It is No. 12 in the world among universities for the impact of its discoveries – in normalized citation impact, which compares the number of citations its research receives per paper to the average for similar published work, a recognized core measure of research impact.
Smartphone App-Based Contingency Management and Opioid Use Disorder Treatment Outcomes
Elise N. Marino, Tara Karns-Wright, Matthew C. Perez, Jennifer S. Potter
First published: Dec. 2, 2024, JAMA Network Open
Link to full study: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2827185
The University of Texas Health Science Center at San Antonio (UT Health San Antonio), a primary driver of San Antonio’s $44.1 billion health care and biosciences sector, is the largest academic research institution in South Texas with an annual research portfolio of $413 million. Driving substantial economic impact with its six professional schools, a diverse workforce of more than 8,500, an annual expense budget of $1.46 billion and clinical practices that provide 2.6 million patient visits each year, UT Health San Antonio plans to add more than 1,500 higher-wage jobs over the next five years to serve San Antonio, Bexar County and South Texas. To learn about the many ways “We make lives better®,” visit UTHealthSA.org.
Stay connected with The University of Texas Health Science Center at San Antonio on Facebook, Twitter, LinkedIn, Instagram and YouTube.
The Be Well Institute on Substance Use and Related Disorders at UT Health San Antonio is a comprehensive, low-barrier system of care that provides compassionate, evidence-based treatment for substance use and related mental health concerns across Texas. Through its hybrid clinic offering virtual and in-person services, a statewide provider network of more than 140 community partners and wraparound services like peer recovery support, the institute reduces barriers to treatment and supports recovery. It also leads cutting-edge research to advance treatment and conducts workforce training to disseminate best practices. Funded by federal and state sources, the institute is dedicated to expanding access, reducing stigma and improving care for individuals and families affected by substance use disorders. Go to bewelltexas.org.
It was a milestone moment for Corpus Christi native Alexandrea Villa — a small but powerful step in her journey. She bought sheets for her new bedroom set.
“I look at my apartment and wonder if I want to buy something because I won’t be there forever. And then I realize, ‘Shoot, look at that. I’m planning for the future,’” she said. “I keep having those moments the more I keep being positive. It’s cool.”
Since she was 17, Villa misused various substances, including cocaine, marijuana and alcohol. Extra money for purchasing new furniture and gifts for her nieces and nephews was instead used to buy drugs. And her outlook on life was far from positive.
“I would wake up, go to work and drink. That’s all I would put into my day. And now that I’m not drinking or using drugs, I have time to put into different things I want to do,” the 30-year-old said.
After the death of her father from a drug overdose over a year ago, Villa began using drugs more heavily. With the support of her family, she moved to San Antonio and entered a local rehabilitation center. As the end of her rehabilitation loomed, a counselor introduced her to Be Well Clinic, a state-supported initiative within the Be Well Institute on Substance Use and Related Disorders at UT Health San Antonio.
Launched in October 2021, the Be Well Clinic offers in-person and telehealth substance use treatment and recovery services for anyone in the state, regardless of their ability to pay. Since opening, the clinic has served over 2,580 clients. Last year, the program celebrated the grand opening of a 20,000-square-foot facility that brings together medicine specialists, behavioral health experts, researchers and recovery coaches under one roof.
“Thirty years ago, clinicians would say we need to stop the substance use before you can evaluate any other psychiatric problems such as depression or anxiety,” said Van L. King, MD, DFAPA, FASAM, medical director for the clinic. “But now we take the approach that we need to treat both problems at once. They significantly affect one another. It’s not unusual that people with substance use problems also have other mental health problems. It makes tackling one more difficult if you don’t tackle the other.”
King said anyone needing the clinic’s services will find that they will be treated with respect and have an appointment within a week. Additionally, the clinic offers free transportation through a rideshare program, a mail-order pharmacy and 24/7 live peer support to help patients access services when and where they need it. At the clinic, patients are evaluated by a psychotherapist and a physician or nurse practitioner who are experts in substance use disorder treatment.
Patients are then offered a choice of services, including a case manager, should they need help obtaining a state identification card, sober housing, or any number of social services. Patients can also arrange to meet with a peer coach through the clinic.
“Many people find they are sort of lost as to the first step. A therapist can help with that, but sometimes people feel more comfortable with people who can understand them from a more personal point of view,” King said.
Peer or recovery coaches who themselves have misused drugs and are now in recovery can relate to patients through their shared experience. King said the vast network of coaches through partnerships with other agencies is especially helpful in rural communities.
“For some people, misusing substances is their major social connection. If you are going to stop, you have a lot of time on your hands. You have to figure out what you are going to do for socializing and recreation,” said King. Peer recovery coaches can help fill the gap and offer alternatives for socializing to maintain the patient’s sobriety.
Within the peer recovery community, patients will find acceptance of the use of medications to maintain their recovery, said King, noting that patients using methadone maintenance treatment or other medications to help with their sobriety sometimes have a difficult time receiving support in the community.
“There is a stigma of being on an opioid to treat opioid use disorder, and some believe you should just be abstinent from all substances,” he said. However, it is clear from decades of research, that medication plus counseling is the most effective way to treat severe and chronic substance use disorders, King said.
“The peer recovery coaches are educated and accepting of medications. That’s going to have a significant impact on general attitudes toward medications to treat substance use problems as time goes on.” And yet, stigmas are still prevalent outside the recovery community.
“It’s clear that half of the risk for substance use problems is genetics — what you’ve inherited,” he said. “There are a lot of differences in people that folks tend to overlook when they are judging others.”
The use of telemedicine, King said, has been a game changer for the treatment of substance use disorder. With 191 of the 254 counties in Texas considered rural, telemedicine was necessary to expand the reach of the services provided.
“It may be one of the only positive things that came out of the COVID-19 pandemic is this rapid transition to making medical services, including mental health and substance use services, available more readily,” King said. “Not every patient likes to use telemedicine all the time, but it certainly is better to have it available remotely than not have anything available.”
Since inception, the clinic has served over 2,400 clients through telemedicine. King said the future of Be Well Clinic is to broaden services across the state and continue its evidence-based treatment.
“We have research projects that people can participate in to access new approaches to treatment. We have highly experienced clinicians who are academically affiliated and up on the most recent cutting-edge treatments available,” he said.
As for Villa, she sees her future very differently now. She is looking forward to maintaining her sobriety, spending time with her family, and continuing to learn more about herself.
“So far, the biggest thing I’ve learned about myself is that I am worthy,” she said.
Be Well Clinic is funded by the Texas Health and Human Services Commission through federal funding from the United States Department of Health and Human Services and the Substance Abuse and Mental Health Services Administration. To learn more, visit bewelltexasclinic.org.
The article "Hidden Killers: Inside San Antonio's struggle with fentanyl and meth addiction" discusses the sharp rise in fatal overdoses in San Antonio, largely driven by fentanyl, a potent synthetic opioid. It highlights the efforts of outreach workers, like Corazón Ministries, to provide harm reduction services and connect people to treatment. Dr. Jennifer Potter, executive director of Be Well Texas, is quoted saying, “I think we were caught a bit by surprise to have fentanyl in our midst now,” emphasizing how fentanyl's sudden presence has transformed the local drug supply into a dangerous mix."
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View full interview here
SAN ANTONIO – A handful of mothers who lost their children to fentanyl poisoning created an enormous movement, which led to a long line of local, state, and federal leaders vowing to do their part in stopping fentanyl poisoning.
“Two years ago, on June 11, 2022, I lost my youngest son Cody to illicit fentanyl poisoning. He was a beautiful young man,” said Kathy Drago.
“This is what I’m going to do. I’m going to be Jake’s voice,” said Martha Johnson, who lost her son to fentanyl poisoning.
“This is my nephew Ryan Matthew Garcia Jr. He thought he was taking a Percocet, but it was laced with fentanyl,” said Janet Zarate.
These families have taken the bravest step, sharing their pain and anger. And it didn’t take long for Texas leaders from near and far to hear their call.
In 2023, several of the mothers organized the first-ever fentanyl awareness walk, ‘Soles Walking 4 Souls.’ Hundreds of people showed up, and the leaders who jumped on board from the start were there again this year.
Texas Governor Greg Abbott offered a call to action.
“You all know about fentanyl. Far more Texans do not know about it. So, we have a tall task ahead of us to educate all Texans across the state - and if we can do that, we’re going to be far more successful in eliminating deaths,” said Abbott.
“This is not a Democrat or Republican issue,” State Rep. John Luhan said.
Each speaker echoed the same thing: that it’s about all of our futures.
“In the last three and a half years, our state troopers have seized over half a billion lethal doses of fentanyl statewide. That’s enough to kill every man, woman, and child in America,” said Texas Department of Safety Lieutenant Christopher Olivarez.
Programs at the state and local level are creating ad campaigns to display for high school and college students, those who are most at risk.
The Angel Moms join with the state’s One Pill Can Kill campaign, and alongside the Bexar Country Sheriff’s Office.
“We need to get in. Kids are dying every day,” Johnson said.
There’s already one tool, Narcan, which reverses the effects of fentanyl or other opioids. But to save lives, people must carry it and know how to use it.
“Lay them on their back. All you have do is take this, stick it in their nose, and press that red button,” said Dr. Bill Drees with UT Health San Antonio. “Then lay them on their side in the recovery position in case they vomit. If they haven’t responded in a couple minutes, take out the second nasal spray dose and spray it into their other nostril.”
Narcan is available for free in many places. You can get it through Naloxone Texas, of Be Well Texas. Be Well Texas is UT Health San Antonio’s statewide substance use treatment initiative.
You can also email or call the Angel Moms through the Soles Walking 4 Soles website and they will personally deliver it.
View the full interview here
Dr. Jennifer Potter, Senior Vice President for Research at UT Health San Antonio and founding director of the Be Well Institute on Substance Use and Related Disorders, sat down with Randy Beamer at KLRN to discuss the dangers of fentanyl and what communities need to know about substance use prevention and treatment.
