Implementing Harm Reduction Vending Machines to Reduce Opioid Overdose Risk: Description of a Centralized Implementation Model, Pros, Cons, and Lessons Learned

Context: – Efforts in the United States to address the opioid epidemic often include harm reduction approaches. Harm reduction vending machines (HRVMs) are a newer model for distributing harm reduction supplies in the United States, although they have been more widely used for decades in Europe. Objective: – The goal of the current study is to describe the programmatic details and implementation process for a potentially unique HRVM rollout in New York State (NYS), where HRVM implementation was facilitated by a centralized state program (MATTERS). We also describe evaluation data on the experiences of the agencies that agreed to host a machine through the program, to identify the pros and cons of the model and lessons learned for others considering this approach. Design: – Program description and qualitative program evaluation using interviews. Setting and Participants: – Fourteen representatives from 12 organizations, collectively hosting 15 vending machines across NYS. Main Outcome: – Description of the program structure and process, and identification of themes emerging from the qualitative interviews around the model. A rapid analysis approach was used to identify themes from the data. Results: – Findings revealed: 1) perceptions of how HRVMs fit into overall harm reduction activities; 2) pros (eg, privacy and 24/7 availability) and cons (eg, identifying partners and technological challenges); and 3) lessons learned (eg, thoughtful planning and engagement are critical) that can help inform other organizations considering taking on an HRVM and other entities considering regional or statewide rollout of HRVMs. Conclusions: – Organizations perceived HRVMs as valuable additions to their harm reduction activities and saw few challenges associated with hosting a machine. The centralized rollout process facilitated the ability of individual organizations to implement a machine. Future studies are needed to fully understand the cost-benefit of HRVMs, as well as the impact of HRVMs on key substance use and overdose outcomes.