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Harm reduction vending machines make Narcan and fentanyl tests easy to access

MARY LOUISE KELLY, HOST:

Vending machines are one of the newest tools in the fight to reduce overdose deaths in the U.S. These specialized vending machines dispense clean syringes, pipes for smoking crack or meth, Narcan and more. From member station WBUR, Martha Bebinger reports.

MARTHA BEBINGER, BYLINE: This machine, painted with a spray of colorful triangles, sits at the entrance to an office that hands out sterile drug use supplies. But Berkshire Harm Reduction in the small, quaint city of North Adams, Massachusetts, is only open Monday through Friday, 8 a.m. to 4:30 p.m.

BRIAN: So if they're closed, I got this.

BEBINGER: A man named Brian pats the machine. Before it arrived in August, Brian was taking risks he knew he shouldn't. We're only using Brian's first name because he buys and uses illegal drugs.

BRIAN: I don't shoot up that much, but some people just 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?

BEBINGER: So Brian would try to sterilize a used needle to avoid getting hepatitis C or HIV. Now on nights and weekends, Brian can tap a code into the vending machine for free sterile needles and other items aimed at reducing the harm of drug use. Today, Brian can check for fentanyl in the crack he smokes.

BRIAN: So I want to get the fentanyl test strips. So I'll type in 100 and press pound, I think, if that's what that is (laughter).

BEBINGER: There's plenty of Narcan in the machine in case any of Brian's buddies needs to reverse an overdose. A study in the journal Annals Of Medicine suggests Narcan in vending machines reduced overdose deaths in southern Nevada by 15% in one year. In Cincinnati, analysts say 24/7 access to supplies helps slow the spread of HIV. Sarah Whaley at Johns Hopkins Bloomberg School of Public Health argues the benefits of vending machines outweigh the dangers. She says the machines do not lead to more needles littering the ground or more drug use nearby.

SARAH WHALEY: So no increase in crime rates, no increases in loitering, none of, I think, the general concerns that people have.

BEBINGER: Critics also argue that giving people needles or pipes enables or encourages drug use. Chief John Batiste, who co-chairs the Narcotics and Dangerous Drugs Committee for the International Association of Chiefs of Police, doesn't buy it.

JOHN BATISTE: People who come to these machines have already made their decision, or they're already using drugs, so I don't see how it's encouraging.

BEBINGER: What's in a harm reduction vending machine varies. Narcan and condoms are common. Pipes and syringes are not. They're banned as drug paraphernalia in 11 states. Chief Batiste does not take a position on what to offer, but he supports the vending machine option.

BATISTE: We're in a sad state of affairs as a country. I mean, we are losing thousands upon thousands of lives. So for creativity and thinking outside the norm, it has to be on the table.

BEBINGER: The machines allow clients to access supplies after hours, but they do not provide counseling or support. So Sarah DeJesus at Berkshire Harm Reduction turns the machine off when the office is open.

SARAH DEJESUS: And they have to come in and reconnect with us so that we're talking about what substances they're using, what supplies they're getting and just overall how they're doing.

BEBINGER: Federal grants and money from opioid settlements are helping boost machine sales. The company that makes the one in North Adams says it has sold hundreds across 35 states. Finding locations can be tough. Massachusetts bought 14 machines last year and has only placed one so far.

For NPR News, I'm Martha Bebinger in North Adams, Massachusetts. Transcript provided by NPR, Copyright NPR.

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