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Stocking vending machines with needles and Narcan to prevent overdose deaths

Harry October 29, 2024

North Adams is a center for modern art, a haven for stressed-out New Yorkers, and a fall foliage-peeping destination. Many visitors will pass by an unusual vending machine. It hands out clean syringes, pipes for smoking crack or methamphetamine, Narcan to reverse opioid overdoses, condoms and more.

The machine, painted with colorful triangles, stands just outside the entrance to the Berkshire Harm Reduction clinic, where staff distribute the same items Monday through Friday from 8 a.m. to 4:30 p.m. However, drug use continues outside working hours. on weekends. Some customers say the vending machine is a potential life saver.

“I don’t shoot that much,” Brian said. “But someone’s going to give me something, and if it’s late at night, I don’t want to use their needle, but I really want to do it, you know. ”

Brian said he would try to clean the needles with bleach to avoid exposure to hepatitis C, a virus that can spread through intravenous drug use. WBUR and NPR agreed to identify Brian by his first name because of his purchase and use of illegal drugs.

Thanks to the vending machine, Brian can now get a clean needle or tube whenever he needs it and no longer has to worry about contracting an infectious disease. One can also buy test swabs to check for fentanyl, the powerful opioid that has been linked to hundreds of thousands of overdoses in the U.S., and wound care kits to treat skin lesions. becomes more common with xylazineAn animal tranquilizer found in the drug supply.

Overdoses kill nearly 100,000 people each year in the United States nationwide, down from last year and in massachusetts. Rates remain higher than before the COVID pandemic, and many communities are beginning to seek solutions to address this and other impacts of an increasingly toxic drug supply.

Replacing potato chips and candy with shots and Narcan is a relatively new strategy in an approach known as “harm reduction.” This is a response that offers compassion rather than condemnation.

Harm reduction practitioners often provide supplies to save lives and reduce the spread of disease, and they treat medical conditions to keep their clients healthy, whether or not they are ready to stop using drugs.

The first vending machine in the continental U.S., like the one in North Adams, made by the company IDS Vending, appeared in Nevada in 2017. Since then, company officials said, they have sold hundreds in at least 35 states. They think the pandemic and the availability of federal grants to address the opioid crisis have helped spur interest in the machines.

Harm reduction vending machines can be designed specifically for the products each program wants to dispense and can be cold or heated to preserve medications like Narcan. (Martha Bebinger/WBUR)

The Massachusetts Department of Public Health purchased 14 vending machines last year at a cost of about $15,000 each. Outdoor models are more expensive than machines placed indoors.

So far the only device used in the state is the one from Berkshire Harm Reduction. Machines face resistance, as do harm reduction programs.

Critics argue that giving people needles or tubes facilitates or encourages drug use. In some communities, residents and business owners are concerned about increased needle waste and more public drug use. Oklahoma officials recently terminated a vending program: costs were too high and the results were not as positive as they had hoped.

But many public health experts say vending machines are helpful and that fears about them are largely unfounded. Washington State Patrol Chief John Batiste, who co-chairs the International Association of Chiefs of Police Committee on Narcotics and Dangerous Drugs, questions the idea that providing safe supplies in vending machines encourages drug use.

“People who come to these machines have already made up their minds or are already using drugs,” he said. “So I don’t see how encouraging that is.”

Sara Whaley, an opioid policy researcher at the Johns Hopkins Bloomberg School of Public Health, is among the advocates I invite communities to think Using opioid settlement funds to purchase harm-reducing vending machines argues that research shows the pros outweigh the cons.

“There’s no increase in crime, there’s no increase in loitering, I think there’s none of the general concerns that people have,” he said.

The vending machine outside Berkshire Harm Reduction in North Adams, Massachusetts. (Martha Bebinger/WBUR)

Whaley points out: to work A study was conducted in Southern Nevada suggesting Narcan was available in vending machines, contributing to a 15% reduction in overdose deaths in the first year of operation. in Cincinnati, research found 24/7 access to supplies has been linked to slower spread of HIV.

A. report Research on harm reduction vending machines prepared for the federal Centers for Disease Control and Prevention found the machines were a cost-effective way to expand access to Narcan, needles, tubes and first aid supplies and attract people who previously weren’t willing to enter. Harm reduction office.

“A vending machine could almost be a first step,” said Caroline Davidson, director of practice development and consulting at the National Council on Well-Being, which conducted the CDC-funded report. “They are a great, low-barrier way for people to get services.”

What happens in harm reduction vending machines varies from state to state. Colleges and universities are establishedhealthy livingModels with Narcan, emergency contraception, condoms and other safe sex supplies.

Machines filled with drug paraphernalia such as pipes and syringes are much less common. Drug paraphernalia is banned in 11 states, and distribution through vending machines is not allowed in some other communities. Batiste isn’t taking a stance on what it might offer, but said communities should consider the vending option.

“We are in a sad situation as a country,” he said. “We’re losing thousands and thousands of lives, so that needs to be on the table for creativity and thinking outside the norm.”

North Adams interim police Chief Mark Bailey has called for support for the machines, but he’s realistic about the opposition, even about the opioid-reversing naloxone, also known by the brand name Narcan.

“A lot of times people ask, ‘Why did you give them Narcan?’ you hear him say. You have to let them die,’” Bailey said. “This is just ignorance, people who don’t care or don’t have a loved one who is suffering. “Anytime you have the ability to save a life, that’s what it’s all about.”

When Berkshire Harm Reduction installed its machine, some staff were concerned that communication with customers would be lost. Program manager Sarah DeJesus found a compromise. Turns off the machine while the office is open. Customers who want access to pharmaceutical supplies must periodically register with the clinic.

“People need to come in and reconnect with us and reactivate their code so we talk about what substances they used, what materials they took, and how they are generally doing,” DeJesus said.

Berkshire Harm Reduction staff has placed individual limits on materials such as tubing and needles, and customers must register to receive these items. But anyone can get Narcan, fentanyl test strips, and condoms from the machine for free without registering.

DeJesus and his team installed the machine after years of customers requesting long hours. Brian and others said they were grateful. A few weeks ago, when Brian saw a man put his arm through the machine’s opening and try to shake out the clean needles, Brian entered his own code and handed the man a pack of needles so he would stop.

“I don’t want this to be ruined,” Brian said, “because it’s worked so many times just for me.”