Stocking vending machines with needles and Narcan to curb overdose deaths | WBUR News

Nov 01, 2024

North Adams is a hub of modern art, a haven for stressed New Yorkers, and an autumn leaf peeping destination. Many visitors will drive right by an unusual vending machine. It dispenses clean syringes, pipes for smoking crack or methamphetamine, Narcan to reverse opioid overdoses, condoms and more.

The machine, painted with a spray of colorful triangles, sits just outside the entrance to Berkshire Harm Reduction, a clinic where staff members hand out those same items Monday through Friday, 8 a.m. to 4:30 p.m. But drug use continues after hours and on weekends. Some clients call the vending machine a potential life-saver.

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

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

With the vending machine, Brian can now get clean needles or pipes when he needs them, and no longer has to worry about catching an infectious disease. He can also get test strips to check for the powerful opioid fentanyl, which has been linked to hundreds of thousands of overdoses in the U.S. And he can find wound care kits to treat the skin lesions that are becoming more common with xylazine, an animal tranquilizer found in the drug supply.

Overdoses claim about 100,000 lives each year in the U.S., even as the number of deaths dropped over the last year nationwide and in Massachusetts. The rates remain higher than before the COVID pandemic, leaving many communities seeking solutions to address this and other effects of an increasingly toxic drug supply.

Replacing potato chips and candy with needles and Narcan is a relatively new strategy in an approach known as “harm reduction.” It’s a response that offers compassion, instead of condemnation.

Practitioners of harm reduction often provide supplies geared toward saving lives and reducing the spread of diseases, and they treat medical conditions to keep 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, popped up in Nevada in 2017. Since then, company officials said they’ve sold hundreds, in at least 35 states. They credit the pandemic and the availability of federal grants to address the opioid crisis with helping fuel interest in the machines.

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

The only device in use so far in the state is the one at Berkshire Harm Reduction. The machines, like harm reduction programs, face resistance.

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

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

“People who come to these machines have already made their decision or they’re already using drugs,” he said. “So I don’t see how it’s encouraging.”

Sara Whaley, an opioid policy researcher at Johns Hopkins Bloomberg School of Public Health, is among the advocates urging communities to consider using opioid settlement funds to purchase harm reduction vending machines, arguing research shows the pros outweigh any cons.

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

Whaley points to a study conducted in southern Nevada that suggested Narcan in vending machines contributed to a 15% reduction in overdose deaths in the first year of operation. In Cincinnati, research found 24/7 access to supplies was associated with a slower spread of HIV.

A report on harm reduction vending machines, prepared for the federal Centers for Disease Control and Prevention, found the machines are a cost effective way to expand access to Narcan, needles, pipes and first aid items, and draw people who had not previously been willing to enter a harm reduction office.

“A vending machine can be almost a first step,” said Caroline Davidson, a director of practice improvement and consulting at the National Council for Mental Wellbeing, which conducted the CDC-funded report. “These are a great low-barrier way to get people services.”

What’s in a harm reduction vending machine varies from state to state. Colleges and universities are installing “wellness” models with Narcan, emergency contraception, condoms and other safe sex supplies.

Machines stocked with drug use supplies like pipes and syringes are much less common. Drug paraphernalia is banned in 11 states, and some other communities don’t allow distribution via vending machines. Batiste does not take a position on what to offer, but said communities should consider the vending machine option.

“We’re at a sad state of affairs as a country,” he said. “We are losing thousands and thousands of lives so for creativity and thinking outside the norm, it has to be on the table.”

North Adams interim police chief Mark Bailey urged support for the machines, but he’s realistic about the opposition, even to naloxone — the opioid reversal medication also known by the brand name Narcan.

“A lot of times you hear people say, ‘Why give them Narcan? You should let them die,’ ” Bailey said. “That’s just ignorance talking, people that don’t care or don’t have a loved one that’s suffered. Whenever you have an ability to save a life, that’s the whole point.”

When Berkshire Harm Reduction installed its machine, some staff members worried about losing touch with clients. Sarah DeJesus, the program manager, found a compromise. She turns the machine off when the office is open. Clients who want access to the drug use supplies must register periodically with the clinic.

“People have to come in and reconnect with us and reactivate their code,” said DeJesus, “so that we're talking about what substances they're using, what supplies they're getting, and just overall how they're doing.”

Staff at Berkshire Harm Reduction placed individual limits on supplies like pipes and needles, and clients have to register to receive these items. But anyone can get Narcan, fentanyl test strips and condoms from the machine for free, without registering.

DeJesus and her team installed the machine after years of clients asking for extended hours. Brian and others said they are grateful for it. A few weeks ago, when Brian saw a guy stick his arm up through the machine's opening, trying to shake out clean needles, Brian put in his own code and gave the guy a package of needles so he’d stop.

“I don’t want it to get ruined,” Brian said, “because for myself alone it’s come in handy quite a few times.”

This segment aired on October 28, 2024.

Previous: Amsterdam's Automats: Heated Vending Machines Offering Instant Snacks - Business Insider Next: Taylor Hall welcomes new hot food vending machine -

Send inquiry

Send