Benefits of Harm Reduction Vending Machines
By: Lucy Connery MPH and Shelby Arena
Introduction
The first harm reduction vending machine in the United States was launched in 2009 in San Juan, Puerto Rico (Reid, Whaley, & Allen, n.d.). Since then, this innovative method of distributing health promotion and harm reduction supplies has gained popularity. In 2017, leaders in Clark County, Nevada introduced harm reduction kiosks and saw an immediate reduction in opioid overdose fatalities in just one year (Allen et al., 2022). Harm reduction vending machines provide a stigma-free avenue for community members to access lifesaving supplies like fentanyl test strips and naloxone (commonly referred to by the brand name Narcan). By improving access to these harm reduction resources, vending machines can help empower community members to act in the event of an overdose and save lives.
Benefits of Harm Reduction Vending Machines
There have been various publications demonstrating the efficacy of harm reduction vending machines in reducing the risk of fatal overdose and HIV, while also improving access to services and supports for people who use drugs (Allen et al., 2022; Arendt, 2023; Russell et al., 2023). In 2023 alone, over 100,000 overdose deaths were reported – some of which may have been prevented with improved access to naloxone, an opioid overdose-reversal medication (CDC, 2024). Individuals and organizations can order free harm reduction supplies including naloxone on the MATTERS website, but this does not address the need for these tools in the event of an overdose.
During an overdose, timeliness can save a life; therefore, it is vital for community members to have consistent, community-based access to naloxone and other harm reduction supplies. Since Narcan (4mg naloxone) was approved as an over-the-counter medication in 2023, access has increased greatly. In some stores, Narcan costs approximately $45 per box (two doses) and may require people to speak to a pharmacist in order to purchase it. MATTERS’ Chief Medical Officer Dr. Joshua Lynch shared how this may create an unnecessary barrier upon the launch of its first vending machine in Northern New York: “Many people are reluctant to access harm reduction supplies because they have to go interact with someone. That adds a layer of stigma and anxiety for some, maybe an element of embarrassment.” Bridging the gap between community members and stigma-free harm reduction resources like naloxone at no cost is an important effort to address the opioid overdose epidemic.
Studies have demonstrated the success these machines have at the local level: for example, researchers in Nevada found that implementing naloxone vending machines was associated with a 15% reduction in opioid overdose fatalities in one year alone (Allen et al., 2022). Additionally, harm reduction vending machines can also function as a way to engage community members in other health services and resources. Organizations can link individuals seeking harm reduction supplies to a robust offering of support services like housing, mental health support, substance use treatment, and beyond.
Harm reduction services help organizations meet PWUD where they are on their journey toward recovery by creating a stigma-free environment and a “no wrong door” framework. According to SAMHSA, effective systems ensure a no-wrong-door framework to enter treatment for OUD (2024). Dr. Lynch at MATTERS explains the program’s application of this framework: “Expanding into harm reduction allows us to interact with and potentially help folks who aren’t ready to take the full step to get into treatment. If we can start interacting with them by sending them 100 fentanyl test strips, that’s great. Maybe they’ll call the phone number in the box or download our app – maybe they make a telemedicine visit. That’s the reach we’re looking for – to meet people where they are, help them with what they’re ready for, but also be there when they’re ready to take the next step.”
MATTERS partners with various community-based organizations to expand its vending machine initiative. These community agencies have shared the impact that MATTERS’ harm reduction vending machines at the local level; the Director of Healing Hearts Collaborative in Cortland, New York shared “MATTERS is breaking down barriers to overdose prevention supplies. I’ve partnered with MATTERS on their harm reduction vending machine program and have seen first-hand how this initiative is saving lives in communities in Central New York and across New York State”. In 2024 alone, MATTERS vending machines dispensed over 45,000 drug testing strips and naloxone doses, demonstrating the utility of providing this service. The MATTERS team continues to expand this program throughout New York and is currently onboarding new vending machine partners.
Conclusion
Harm reduction vending machines improve access to supplies and resources for OUD by creating an anonymous and stigma-free environment for community members. The rollout of MATTERS’ vending machine program has improved community-based access to harm reduction supplies such as fentanyl test strips and naloxone across New York State. The MATTERS team has adapted to the needs of and feedback from community members and stakeholders through the redesign of the exterior wrap and strategically deploying machines in underserved neighborhoods. Through community outreach and partnership development, MATTERS has deployed 18 vending machines and aims to activate 30 more in 2025. In 2024, MATTERS dispensed over 27,000 fentanyl test strips, 22,000 xylazine test strips, and 13,000 doses of naloxone through vending machines alone. If your organization is interested in hosting a machine, please contact MATTERS at harmreduction@mattersnetwork.org or 765-MATTERS (826-8377).
References
Ahmad F.B., Cisewski J.A., Rossen L.M., Sutton P. (2025, January 15). Provisional drug overdose death counts. National Center for Health Statistics. Retrieved from: https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm
Allen S.T., O’Rourke A., Johnson J.A., Cheatom C., Zhang Y., Delise B., Watkins K., Reich K., Reich R., & Lockett C. (2022 December). Evaluating the impact of naloxone dispensation at public health vending machines in Clark County, Nevada. Annals of Medicine. 54(1) 2692-2700. doi: 10.1080/07853890.2022.2121418.
Arendt D. (2023). Expanding the accessibility of harm reduction services in the United States: Measuring the impact of an automated harm reduction dispensing machine. Journal of the American Pharmacists Association. 63(1):309-316. doi: 10.1016/j.japh.2022.10.027.
Centers for Disease Control and Prevention (2024, May 15). U.S. overdose deaths decrease in 2023, first time since 2018. National Center for Health Statistics. Retrieved from: https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2024/20240515.htm
Reid M, Whaley S., & Allen S.T. (n.d.) Harm reduction vending machines: What are they and do they work? Johns Hopkins Bloomberg School of Public Health. Retrieved 05 Feb 2025: https://opioidprinciples.jhsph.edu/harm-reduction-vending-machines-what-are-they-and-do-they-work/
Russell E., Johnson J., Kosinski Z., Kaplan C., Barnes N., Allen S., & Haroz E. (2023, March 16). A scoping review of implementation considerations for harm reduction vending machines. Harm Reduction Journal. 20(33). doi: 10.1186/s12954-023-00765-2.
Substance Abuse and Mental Health Administration. (2024, November 8). Screening and treatment of co-occurring disorders. Retrieved from: https://www.samhsa.gov/mental-health/serious-mental-illness/co-occurring-disorders