When we think of vending machines, we tend to think of candy bars, soda, and chips. But in Rhode Island, through the AIDS Care Ocean State (ACOS) Prevention Center, vending machines dispense harm reduction supplies. These supplies help reverse overdoses and reduce the spread of diseases like Hepatitis C and HIV. Through these machines, people can access free naloxone (Narcan®), rapid tests for STDs (sexually transmitted diseases), sterile syringes, fentanyl test strips, hygiene, and wound care kits 24/7.
Harm Reduction Vending Machines
ACOS’s harm reduction vending machines provide easy accessibility for people who want to avoid direct contact with healthcare personnel and maintain anonymity when getting access to the medication. These factors explain the need for harm reduction vending machines, and the need is more than ever before.
Listen to ACOS’s interview with Rhode Island’s Department of Health on the Public Health Out Loud podcast here.
Caracole, an AIDS/HIV service organization, has installed a ‘harm reduction vending machine’ outside their headquarters that offers free fentanyl test strips, Narcan – a drug reversing overdoses, and safe use supplies. The vending machine’s phone number also connects to Caracole’s harm reduction service coordinators.
Over 107,000 Americans died from a drug overdose in 2021, highlighting the necessity of evidence-based interventions. The University of Cincinnati undertook new research in partnership with Caracole, which showed a self-service vending machine for harm reduction supplies such as Naloxone helped prevent overdoses and contributed to the reduction of Hamilton County’s overdose deaths in 2021. Furthermore, research by Daniel Arendt, Doctor of Pharmacy at the University of Cincinnati was released in the Journal of the American Pharmacists Association on November 11, 2021.
Harm Reduction Strategy
According to Arendt, harm reduction theorizes with drug and addiction education that assumes people are always seen consuming drugs. However, harm reduction does not enable or support drug use. Instead, it aims to meet people empathetically during their drug use habit and helps empower them to take action and minimize the dangers linked to its use.
Arendt explained that harm reduction includes distributing naloxone and other supplies such as fentanyl test strips, bandages, tourniquets, and sterile syringes. “You would never tell someone who has wildly uncontrolled diabetes to get their blood sugar in check before we will help them or give them insulin.”
He then went on to say, “So it is critical to recognize that substance use is not a moral failing, and it’s not this thing that should be stigmatized. Instead, we can acknowledge that drug use is becoming increasingly risky, and we can use that recognition to help spur the development of new, innovative methods of providing people with the care, services, and support that they need, no strings attached.”
An Effective Approach
Arendt was introduced to Suzanne Bachmeyer and her colleagues at a meeting regarding the Hamilton County Addiction Response Coalition. Suzanne Bachmeyer is the director of prevention at Caracole, an HIV/AIDS service organization located in Cincinnati. At the meeting, Arendt reflects on how he and Bachmeyer immediately began discussing the implementation of a harm reduction supply vending machine. During their discussion Bachmeyer said, “A cornerstone of harm reduction is to help people who use drugs stay as healthy as possible.” She also said, “Vending machines provide 24/7 ready access to lifesaving and disease prevention supplies, so people feel empowered to take control of their health. People can’t get healthy or seek treatment if they aren’t alive.”
For decades, self-service syringe vending machines have been utilized in other parts of the world resulting in a positive impact. However, Arendt said that harm reduction vending machines in the United States were only located in Puerto Rico and Las Vegas prior to their initiative. Arendt also stated, “So our thought process was why not here, why not us, why not Cincinnati. Just because this hasn’t been done in the U.S. doesn’t mean it can’t be done in the U.S., so let’s bring it here and show that this is not just something that works in Europe, but this is something that works here.”
How Harm Reduction Vending Machines Work
Harm reduction vending machines work this way: The program participants call Caracole, enroll, and then complete an anonymous survey. Next, they receive an access code that is valid for 90 days. To continue using the machine, re-enrolling can take place every 90 days after first joining the program.
During the enrollment process, harm reduction counselors offer more information on topics including Hepatitis C and HIV testing and prevention, counseling, local housing programs, prenatal care, and substance use disorder medical treatment.
Each person with the access code can dispense two nasal spray naloxone doses, two doses of naloxone injections, a safer smoking kit, a safer injection kit, a container to dispose of sharp objects such as needles, a safer sex kit, a PPE (personal protective equipment) kit, a bandage box, and a pregnancy test from the vending machine every seven days.
Final Thoughts – The Need for Harm Reduction Vending Machines
Based on a study, harm reduction vending machines increase access to harm reduction products and services. The research on harm reduction vending machines in Hamilton County, found that since installation, 637 people registered for the program. Out of the 637 registered people, 12% of them had not used harm reduction services before.
In the first year of installation, the vending machine dispensed 10,155 fentanyl test strips and 3,360 naloxone doses, which is more than other syringe service programs in the county. In addition, the installation of the machine was associated with a lower amount of HIV incidences and unintentional overdose deaths all over the county.
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