Narcan, safer drug use vending machine in Ohio has prevented overdoses

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  • Nearly 13,000 safer drug use items have been dispensed since March 2021.
  • Narcan from machine reversed nearly 600 overdoses.
  • Vending option draws people who smoke drugs.

 

CINCINNATI — Punch a code into the safer drug-use vending machine, and get free Narcan. Or get safer smoking products, fentanyl test strips, or other things that help keep you out of harm’s way.

Nearly 600 overdoses have been turned around with naloxone products from this machine.

Nearly 13,000 safer drug use and healthcare items, from safer-smoking pipes to personal protective equipment, have been dispensed from the vending machine outside Caracole since it opened in 2021.

Caracole, the Cincinnati region’s nonprofit devoted to fight against HIV and AIDS, operates the harm reduction vending machine. It tracks the machine’s customer base and product dispensing. A report from March 1, 2021, to Sept. 30 this year shows an “overwhelming” response to the strategy, said Caracole CEO Linda Seiter.

“We have provided life-saving supplies for persons who use drugs 24 hours a day, seven days a week,” Seiter said.

Nation’s second safer drug-use vending machine gets noticed

The safer-use machine was only the second of its kind in the country when it became available to people who use drugs, with the first harm-reduction vending program in Las Vegas. Since then, the Cincinnati-based machine has reached more than 800 individuals, and it has become an avenue for harm reduction help for a client base that isn’t always reached by such efforts: people who smoke, rather than inject, drugs. And that can include recreational drug users.

Harm reduction is the effort to give people who use drugs practical ways to minimize their health risks in a nonjudgmental manner. Syringe exchanges, which provide sterile needles to drug users to reduce the chances of getting HIV or hepatitis C and containers for used syringes for safe disposal, are among those strategies.

The region’s vending machine is a model strategy in the country for fighting overdoses and overdose deaths while helping those who use drugs stay healthy in other ways. Caracole’s prevention team has had 57 meetings with individuals from communities across the country how to do it since the machine’s inception.

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“We can share everything,” said Suzanne Bachmeyer, Caracole’s prevention director.

She’s talked to New York City and Philadelphia health departments and dozens of other community-based harm reduction groups and health officials.

Throughout the country, vending machines are becoming a sought-after way to prevent harm and death from drug use. In Kentucky’s Hardin County, a vending machine stocked with Narcan that opened to the public early in October ran out of the opioid overdose antidote in less than two days.

In central Ohio, the Franklin County commissioners and Columbus Public Health are partnering in a prevention vending pilot program as part of a comprehensive strategy to reduce overdose deaths and prevent other drug-use health risks.

So how does this machine work?

The operation at Caracole works this way: There’s a phone number on the machine for people to call (or they can walk into Caracole if it’s open). They’re given a code that’s good for 90 days of accessing the machine for up to one item per week. Those registered are asked to answer a few questions that don’t jeopardize anonymity. If they’d like to continue to use the vending machine after that 90 days, they can reregister for another three months.

The registration gives Caracole prevention staff a chance to collect a few demographics of their users, get feedback from clients, and further engage them if it makes sense to do so. As a result, Caracole has provided education about HIV, hepatitis C and referrals, when requested, for medical care to those registered, Seiter said.

Client feedback includes these details:

  • Naloxone products have been used to reverse 596 overdoses.
  • The pregnancy tests dispensed have detected 16 pregnancies (and some of the pregnant people have been connected to prenatal care).

A new client base: People who smoke drugs

One of the most engaged client bases has been people who smoke drugs, primarily cocaine and methamphetamine, Seiter said. The machine is stocked with two types of safer-smoking kits. Records show that 4,183 of the kits have been dispensed, which is almost a third of all items dispensed.

And that has encouraged the Caracole prevention staff, because people who smoke, and especially recreational drug users, don’t commonly go to safe syringes sites, which offer other safer-use items, Bachmeyer said.

Visual explainer:How to use Narcan to treat a fentanyl overdose

“The population of people who don’t use opioids … doesn’t get a lot of outreach,” she said. “It is a really low to no-barrier way to access supplies.”

Caracole in Cincinnati has a vending machine with Narcan, clean drug kits, testing kits and other items that can help with harm reduction. Leah Majesky refills the vending machine with various kits.

 

What’s particularly important with the kits now, as fentanyl overdose deaths pummel the nation, is that the safer-smoking kits provide Narcan and fentanyl test strips. Fentanyl and its analogs have been found in meth and cocaine, and the test strips let this population know if their supply is tainted.

Clients want to discard syringes safely

The demand among Caracole’s vending customers is also high for the vending machine’s safe needle disposal containers, Seiter said. More than 1,000 of these sharps containers have been dispensed.

She said that’s encouraging: Having the containers for used syringes and bringing those syringes back to exchanges for sterile ones limits the spread of infectious diseases in the general community ‒ because people aren’t haphazardly dropping used syringes.

Caracole in Cincinnati has a vending machine with Narcan, clean drug kits, testing kits and other items that can help with harm reduction.

 

The machine doesn’t provide sterile syringes, although Caracole is among several safe syringe sites in Hamilton County. It does have safer-injection kits that contain cotton, alcohol pads, cookers, or metal containers for mixing water with powder drugs and heating the solution, tourniquets and education.

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