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Harm reduction programs around the country are looking for ways to improve access to their services, reduce costs and reduce stigma. Harm reduction supply dispensing machines, which provide a variety of health-related products and education to people who use drugs, are a relatively new way to expand the reach of such programs in the United States.
While fairly new in the U.S., this concept is not new in other parts of the world. Research studies on programs in countries such as Australia, France, Mexico and Georgia indicate that these types of machines can complement existing syringe service programs, do not create adverse consequences in the community, and are often able to reach clients that might not otherwise engage with an in-person syringe services program.
The first such machine in Greater Cincinnati was recently installed at Caracole in Cincinnati's Northside neighborhood. The pilot project is supported by Interact for Health.
The machine is accessible 24 hours per day, seven days per week. Supplies available include safer injection kits, safer smoking kits, safer sex kits, fentanyl test strips, naloxone to reverse overdoses, pregnancy tests, personal protective equipment and sharps kits. A sharps disposal container is located next to it.
While syringes are not available currently, Caracole's goal is to engage community partners in hopes of getting the buy-in necessary to provide needles, said Suzanne Bachmeyer, Associate Director of Prevention at Caracole.
Bachmeyer and Midge Hines, Director of Client Services at Caracole, presented their organization's initial work on harm reduction supply dispensing during a Feb. 25 webinar hosted by Interact for Health. More than 78 attended.
Chelsi Cheatom, Program Manager with Trac-B Exchange based in Las Vegas, also spoke during the webinar. Trac-B started in 2017 with three machines--the first in the U.S.--and currently operates eight throughout Southwest Nevada.
"Vending is a new way to tackle an old problem," Cheatom said.
Through late February, Cheatom said Trac-B's dispensing machines had more than 25,000 transactions with almost 3,000 clients. One advantage of operating the machines is that inventory can be customized based on the needs of the community. In Nevada, machines offer hormone injection kits, emergency contraception and sexually transmitted disease testing kits, in addition to the safer injection kits and naloxone.
Machines cost between $7,000 and $10,000, plus the cost of supplies.
The Caracole program and Trac-B both require clients to register in advance. Caracole is initially doing registration by phone; Trac-B offers phone-based and online registration. Clients are given a unique identifier, which allows program staff to manage when and what they access.
The harm reduction supply dispensing machines also provide a feature that's key during the COVID-19 pandemic--a contactless delivery system, and one that can continue to operate while in-person services are shut down. Cheatom said volume at the dispensing machines in Nevada increased so much during the pandemic that numbers in one year were almost equal to the three years prior.
For more information on Trac-B's programs, visit https://www.harmreductioncenterlv.com/.
Clients interested in using the dispensing machine at Caracole should call 513-399-6969. For more information on the program, contact Suzanne Bachmeyer at 513-619-1472 or sbachmeyer@caracole.org.
If you are interested in implementing a harm reduction supply dispensing machine program within Interact for Health's 20-county service area, contact Lisa Myers, Program Officer at Interact for Health, at lmyers@interactforhealth.org or 513-458-6629.
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