“There’s absolutely no downside to this, I mean, except community opposition:” A qualitative study of the acceptability of vending machines for harm reduction

Abstract

Background Vending machines for harm reduction (VMHR) are an innovative approach to deliver life-saving materials, information, and treatment for hard-to-reach populations, particularly for persons who inject drugs. The current study explores stakeholders’ perspectives on the feasibility and acceptability of VMHR in Philadelphia. Methods From October 2021 to February 2022, we conducted 31 semi-structured interviews with potential end users, staff, and leadership at a local federally qualified health center, and community members. Trained coders extracted themes from interview transcripts across four key domains: materials and logistics, location, access, and community introduction. Results Interviewees from all stakeholder groups endorsed using VMHR to provide supplies for wound care, fentanyl test strips, naloxone, and materials to connect individuals to treatment and other services. Dispensing syringes and medications for opioid use disorder were commonly endorsed by health center staff but were more controversial among potential end users. Even within stakeholder groups, views varied with respect to where to locate the machines, but most agreed that the machine should be placed in the highest drug use areas. Across stakeholder groups, interviewees suggested several strategies to introduce and gain community acceptance of VMHR, including community education, one-on-one conversations with community members, and coupling the machine with safe disposal of syringes and information to link individuals to treatment. Conclusions Stakeholders were generally receptive to VMHR. The current study findings are consistent with qualitative analyses from outside of the USA and contribute new ideas regarding the anticipated community response and best methods for introducing these machines to a community. With thoughtful planning and design, VMHR could be a feasible and acceptable modality to reduce death and disease transmission associated with the opioid and HIV epidemics in cities like Philadelphia.

Years of life lost to drug overdose in the Latinx community during the most recent wave of overdose deaths

“…They also could provide information for individuals to connect with treatment and other services in an anonymous and non-stigmatizing way. 27 Money from the regional and national settlements with opioid manufacturers and distributors could be major source of funding for these programs. 28 To avert the projected loss of life in the near-term, particularly among young people, immediate action is necessary to expand the entire cascade of care for Latinx individuals using illicit drugs.…”

“No-one just does drugs during business hours!”: evaluation of a 24/7 primary needle and syringe program in St Kilda, Australia

“…It is well established that SDMs address many of the barriers identified above, including enhancing geographical reach in areas of low NSP coverage, affording people privacy and anonymity when accessing needles/syringes, and increasing after-hours access to needles/syringes when fixed site secondary and primary NSPs are closed [ 7 , 14 – 16 ]. For example, the study of SDMs in Melbourne between 2017 and 2020 cited above found 69% of 90,488 unique SDM presentations occurred out of NSP operating hours [ 17 ].…”