Implementing a Statewide Harm Reduction Vending Machine Initiative
By: Shelby Arena and Lucy Connery MPH
Introduction
Medication for Addiction Treatment and Electronic Referrals (MATTERS) is a Buffalo-based initiative that has expanded across New York State and beyond since its inception in 2016. MATTERS facilitates referrals to outpatient treatment for people with opioid use disorder (OUD) and focuses on rapid access to medication for addiction treatment (MAT). However, the MATTERS team recognizes that not everyone who uses drugs is ready for treatment. In response, the program expanded to distribute free drug test strips via direct mail across New York State in August of 2022. Individuals, local businesses, hospitals, and more can visit MATTERS’ website and order free harm reduction supplies to be delivered anywhere in New York. To further reduce barriers to lifesaving overdose prevention supplies like drug testing strips and naloxone, MATTERS launched a statewide harm reduction vending machine program in 2023. By strategically placing these machines across New York State, this initiative aims to bridge the gap between community members and harm reduction tools that can save a life in the event of an overdose.
Program Implementation
In 2023 MATTERS was awarded a grant by the New York State Office of Addiction Services and Supports (OASAS) through a Substance Abuse and Mental Health Services Administration (SAMHSA) harm reduction initiative that included funds for 15 harm reduction vending machines to be placed across New York State. In 2024, the program was awarded additional funding to expand its program to include a total of 55 machines. When preparing to launch its vending machine program, the first step was to find a vendor. After researching and vetting potential organizations, MATTERS elected to work with Intelligent Dispensing Solutions (IDS) to manufacture and maintain the vending machines. IDS’ Model SD5000-R is an outdoor machine and weatherproof, which is ideal to be placed outdoors and increase accessibility. The machines are also climate-controlled in order to appropriately store products before they are dispensed. Additionally, machines are equipped with high-speed internet connectivity so that reliance on Wi-Fi at each location could be avoided. Internet-connected machines allow transaction data to be collected in real time, which then populates an online dashboard. After selecting the machine’s model, MATTERS then sent IDS its products so that they could custom-fit the machine coils to their specifications. The machines are configured to hold 144 boxes of naloxone and 432 packets of 10 drug testing strips. Finally, MATTERS designed a custom-branded wrap for the machines, which included the program’s logo and contact information for individuals using them.
Once a vendor and model were selected, the next step was to identify partners to host and manage the machines. In selecting partners, MATTERS’ goal was to place the machines in communities with the highest need for increased access to harm reduction supplies. The program also aimed to diversify the types of locations the machines were placed to reach people from all sectors of the community. MATTERS released an initial call for applications and met with dozens of interested organizations. Although interest was high, implementation proved difficult: harm reduction vending machines are still a relatively new intervention, and there was no blueprint on how to initiate such a large-scale program. Many organizations faced challenges when incorporating the procurement of a vending machine into their existing structures. Although MATTERS covers all costs related to the vending machine, the managing organizations are ultimately the owners of the machine and must coordinate directly with IDS for purchasing.
The first step to partner with MATTERS on a harm reduction vending machine is to sign a memorandum of understanding (MOU) and place an order for the machine. Once the order is placed with IDS, manufacturing takes anywhere from 2-5 months to complete. The machine then ships to its host site and must be checked by a technician before the public can access supplies. Following a best practice model, MATTERS harm reduction vending machines are accessible to the public 24/7, 365 days a year, and they collect limited demographic information from users (Russell et al., 2023). For individuals to access supplies, they enter a universal code that is displayed on the machine. After entering the code, individuals must enter their year of birth and zip code before selecting up to three items. The machines are currently stocked with naloxone, 10 packs of xylazine test strips, and 10 packs of fentanyl test strips. Although collecting demographic information from individuals using vending machines does present a barrier in terms of the time it takes to access supplies, it is invaluable for the continued evaluation and success of these kinds of initiatives.
MATTERS’ first harm reduction vending machine, launched in partnership with the Alliance for Positive Health, was installed in Saranac Lake in October 2023. Since then, the program has rapidly expanded, deploying 20 more machines and counting, across various communities. This success has been made possible through strong cross-sector partnerships, which allowed MATTERS to navigate logistical, regulatory, and operational challenges efficiently. The program has collaborated with treatment agencies, county governments, health departments, law enforcement, private businesses, and supportive housing agencies, each bringing unique successes and lessons learned. Figure 1 illustrates the rollout of the vending machine program and highlights different machine locations.
Figure 1: Vending Machine Roll-Out Timeline
Lessons Learned
One of the key lessons learned in implementing harm reduction vending machines is the importance of assessing site readiness before delivery. MATTERS encountered several logistical challenges that reinforced the need for careful pre-installation planning. In one instance, a machine was delivered, but the ground was not level enough to place it safely, requiring additional site preparation and machine storage arrangements. Another delivery attempt failed because the machine could not fit through the railings of a ramp that was necessary for access. Additionally, the MATTERS team learned that power accessibility should also be assessed and not assumed—one location had an outlet too far from the intended placement, and because extension cords cannot be used, the installation was delayed.
Beyond physical site logistics, this initiative also faced challenges with property ownership changes. One business had initially secured landlord approval to host a machine, but after the property was sold, the new landlord opposed its presence and demanded its removal within a week. Relocating the machine on short notice, especially in a rural area, proved to be a significant logistical hurdle. These experiences highlight the need for detailed site assessments, clear communication with property owners, and contingency planning to address unforeseen challenges.
Adapting to Community Feedback
MATTERS’ vending machine initiative is unique in that it spans across New York State and reaches a wide range of communities with distinct needs. Upon launching this service, one of the major goals was to improve access to harm reduction supplies – however, this couldn’t be done without building trust and rapport with community members. The first iteration of the vending machine wrap was designed to raise awareness about the services MATTERS offered so that the machines would be more easily recognizable. Over time, vending machine partners/hosts and community members shared their experiences when accessing supplies. Some community members reported not approaching the vending machines due to not knowing what was available or assuming the materials came at a cost.
In response, MATTERS worked with vending machine hosts to develop stickers and signs to provide additional information and instructions on how to dispense supplies. The program also adapted its vending machine wrap to include language on the current supplies available and highlight the fact that all materials are free. The adaptation of the vending machine wrap is illustrated in Figures 2 and 3.
Figure 2: Initial Vending Machine Wrap
Figure 3: Updated Vending Machine Wrap
Conclusion
The MATTERS program has seen great success in the implementation of its harm reduction vending machine initiative. Since its launch, MATTERS has activated 21 vending machines across New York State and has secured funding for a total of 55 machines. Bridging the gap between community members and harm reduction tools like naloxone and drug test strips is an important overdose prevention effort. MATTERS’ vending machines help to reduce barriers to harm reduction supplies as well as treatment and other resources for substance use disorder. MATTERS is actively working to onboard new vending machine partners – organizations interested in hosting and/or managing a machine should contact MATTERS’ harm reduction team by emailing harmreduction@mattersnetwork.org.
References
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