There is an ongoing opioid epidemic in Delaware, with high opioid-related deaths compared to the rest of the country. To combat this, Delaware has turned to harm reduction, which focuses on minimizing the negative impacts of substance use and addiction. [1] Harm reduction tools have been growing in popularity in recent years, and Delaware has recently joined the movement by launching five new harm-reduction vending machines, stocked with helpful goods for those suffering from opioid addiction, which can be accessed anonymously and free of charge.[2]
What are harm-reduction vending machines?
Vending machines for harm reduction (VMHR) provide essential supplies, information, and life-saving medication, for people suffering from drug addiction.[3][4] Globally, they have existed for over 30 years, but only in recent years have they become more prevalent in the United States.
They work the same way as traditional vending machines for snacks or sodas, but their contents differ. They are free to access and are available 24/7, allowing individuals to use them anonymously and discreetly at a time that suits them.
Supplies available in harm reduction vending machines
The contents of each vending machine can vary, but some of the items that are often included are:
- Naloxone (the opioid antidote)
- Safe sex kits
- Hygiene products
- Wound care kits
- Fentanyl test strips
- Contact information for local treatment services
- Sterile injecting equipment
- Pregnancy tests
How Delaware is implementing harm reduction vending machines
Delaware recently unveiled five new harm-reduction vending machines to target those suffering from opioid addiction specifically.[2] This decision was largely in response to the increasing opioid use and associated fatalities in the state. Items stocked in these vending machines include naloxone, various hygiene products, and safe sex kits, and are restocked by the Department of Health and Social Services (DHSS).[2] They also stock STI and HIV test kits, helping to improve public health in the state.
The vending machines are situated outside, the items are free and they’re operational 24/7, maximizing their accessibility. The machines are also quick and discreet, helping to support people who are not ready to seek formal addiction treatment yet.
The DHSS partnered with Brandywine Counseling and Community Services for this program, with four of the vending machines situated at Brandywine Counseling locations statewide.[2] It is funded by both federal and state money, alongside donations.
Delaware has a longstanding problem with opioid use and associated fatalities.[5] Currently, the mortality rate for drug overdose in Delaware is 55.3 per 100,000, with only three states having worse rates.[6] It’s hoped that the introduction of these vending machines will help to reduce these rates and combat the ongoing opioid epidemic in Delaware.
Do harm reduction vending machines actually work?
Yes, research has shown that harm-reduction vending machines generally reduce overdose deaths and disease transmission. They are noted to increase accessibility to harm-reduction goods and services, such as naloxone and fentanyl testing strips, helping to reduce the risk of overdose.[7] Additionally, a study looking specifically at Clark County, Nevada, calculated a 15% decrease in opioid overdose fatalities in the 12 months following the introduction of naloxone dispensing vending machines.[8]
Harm-reduction vending machines also help to reduce disease transmission, most notably HIV and hepatitis C, by dispensing sterile injecting equipment. Both of these diseases are known to be spread by needle sharing due to blood-to-blood transmission. While sterile equipment can be obtained from needle exchanges and pharmacies, this is not anonymous and provides a barrier to obtaining them. [9] The vending machines provide free and confidential access to sterile equipment, increasing the likelihood that individuals will use them instead of dirty needles, assisting in reducing disease transmission.
This is encouraging, and if harm-reduction programs can be further expanded, more of the population could benefit from them.
How to access harm reduction vending machines
The vending machines are designed to be as accessible as possible. They are anonymous, available 24/7, and free to use. In Delaware, the vending machines are located at:[2]
- Brandywine Counseling Wilmington, Newark, Dover, and Milford
- Georgetown Pallet Village
They are also present in several other states, including Nevada, Ohio, and Kentucky. To access the vending machine items, just follow these simple steps:[10]
- Enter your ZIP code into the machine (note that this data is not saved)
- Select the desired items, which will then fall into the collection bin at the bottom of the machine
- Take items from the collection bin
Concerns about harm reduction programs
Despite the success of harm reduction programs, it has come under some criticism. Most notably, some worry that the introduction of easily accessible harm reduction vending machines could encourage continued substance use, as it could be perceived to be safer or more socially acceptable. This, however, is a common misconception that is not backed up by any evidence, with harm reduction programs generally increasing entry to addiction treatment.
Additionally, concerns have been raised that these programs could increase crime in the area, but this is also not supported by evidence. Research has shown no increase in violent crime in the neighborhoods of supervised injection facilities.[11] It’s thought harm reduction programs may even reduce criminal activity in the area by building trust between drug users and health/social services.
Other issues include misconceptions about the effect of local house prices and the cost of running the programs, however, overall the evidence supports harm reduction programs as an effective public health strategy.
Resources for harm reduction and addiction support
Local resources in Delaware
- Brandywine counselling offers addiction treatment services, and several harm reduction vending machines are located there: https://www.brandywinecounseling.com/
- Delaware Division of Substance Abuse and Mental Health: https://dhss.delaware.gov/dhss/dsamh/
National harm reduction resources
- Narcotics Anonymous: https://na.org/
- Substance Abuse and Mental Health Service Administration: https://www.samhsa.gov/
- National Harm Reduction Coalition: https://harmreduction.org/resource-center/harm-reduction-near-you/
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