Wanting to see if a simple idea could help a huge problem, a Cincinnati health center filled a vending machine with overdose prevention equipment and asked a university to record its uses.

From February to November in 2021, a call center registered 637 anonymous people for the program giving them an access code to the vending machine, which then distributed 3,360 naloxone doses and 10,155 fentanyl test strips.

Located in Hamilton County, Ohio, the machine is credited for a reduction in drug overdose deaths—as well as HIV incidence—and is still operating at the Caracole HIV/AIDS treatment center.

A University of Cincinnati scientist studying its effects, Daniel Arendt, described the method as "harm reduction," which acknowledges that some people always have used drugs, and probably always will, even if they are potentially lethal in large doses.

Harm reduction, as the Univ. of Cincinnati press release describes, is a paradigm that "does not support or enable drug use, but instead aims to empathetically meet people where they are in the course of their drug use and help empower them to take steps which minimize the potential hazards associated with its use."

To this end, program participants were able to visit the vending machine 24/7, away from prying eyes and judgmental glances.

Naloxone is the drug that can counteract opioid overdoses, and the test strips can test drugs, like heroin, that can potentially contain fentanyl. The machine also has safer injection kits, tourniquets, and bandages.

The machine was first conceived, put together, and operated by Caracole, an HIV/AIDS service organization in Cincinnati with the help of their non-profit partner Interact for Health.

"If you are interested in stopping, we're here to help," said Arendt. "But if not, we aren't going to turn you away and refuse to help. We are going to work with you and help you take steps that will help keep you safe."

Some of the results are extremely encouraging. At the time the study was published, clients reported 288 overdoses were reversed with naloxone, a number which almost reached 1,000 by the time of writing. More than two-thirds of those who reenrolled after their first enrollment detected fentanyl present in the drugs they were consuming.

"You would never tell someone who has wildly uncontrolled diabetes to get their blood sugar in check before we will help them or give them insulin," Arendt said.

"So it is critical to recognize that substance use is not a moral failing, and it's not this thing that should be stigmatized. Instead, we can acknowledge that drug use is becoming increasingly risky, and we can use that recognition to help spur the development of new, innovative methods of providing people with the care, services and support that they need, no strings attached."

These sorts of vending machines have some data of their use in Europe that show they do help, and Arendt's data is the first research done in America, despite such machines being located in Las Vegas and Puerto Rico.

Editor's note: This story has been altered to correctly reflect Caracole's inception and leadership of the project, and that the machine is still where it was found during the study period. 

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