Ohio's first harm reduction vending machine helps promote safer sex, safer smoking, safer injection

Safer sex, safer smoking and safer injection kits – including the overdose-reversing drug Narcan but minus syringes – are tucked inside a new vending machine in Northside as a new way to help minimize health risks of drug use during the COVID-19 pandemic and beyond.

Caracole, the Cincinnati region’s nonprofit HIV and AIDS service organization, is offering the harm reduction supplies to anyone who comes for them. The machine is one of a handful nationwide, say the organization's officials, and likely the only one in Ohio. They're already getting inquiries about it from public health officials and advocates from as far as King County, Washington (Seattle) and as close as northeast Ohio.

The vending machine is not available on demand. The only way to retrieve supplies is to call a number on the machine, 513-399-6969, talk to a trained Caracole staff member briefly (to provide non-identifying information) and receive a personalized code

The supplies offer evidence-based, safe-use help in a nonjudgmental way, a goal of harm reduction strategies, said Caracole executive director Linda Seiter.

“We need all the options for people to get safe injection supplies, safe smoking supplies, fentanyl test strips and Narcan so they can stay alive," Seiter said. "This is a crisis."

Seiter noted that not only is Ohio one of the top states for opioid overdose deaths, but more people are suffering from overdose during the COVID-19 pandemic. In addition, Hamilton County is one of the 48 counties in the US where more than half of all new HIV diagnoses occurred in 2016 and 2017, Seiter said.

Since the pandemic started, there has been an increase in fentanyl use in Ohio and Kentucky, as identified by a recently released Signals report from Millennium Health.

The drug-testing company works with the federal Department of Health and Human Services to track changes in drug-use trends through drug testing urine samples. Ohio’s fentanyl positivity rate increased 68% during COVID-19 as compared to the same time period pre-COVID-19, the company's analyses show. Kentucky's fentanyl positivity rate increased 25% for the same period.

Caracole paid for the harm reduction machine with a $49,684 grant that Interact for Health, a health advocacy nonprofit covering 20 Cincinnati counties, awarded in September 2020.

Among supplies offered other than the specific kits are pregnancy tests, Narcan, a package of personal protection equipment (PPE), bandages and safe sharps containers (to carry syringes until they can be disposed of properly and safely).

The machine also contains information to help reduce the transmission of infectious diseases, including HIV and hepatitis C, prevent overdoses and promote long-term recovery.

"Not everyone can make it to SSP (safe syringe services). Not everyone is comfortable meeting someone face to face," said Suzanne Bachmeyer, Caracole associate director of prevention.

In addition, Seiter reminded, people who smoke meth or crack cocaine – not just those who use opioids – are at risk of fentanyl overdoses and should have access to fentanyl test strips and other safety equipment.

That's why the safer smoking kit, for example, has test strips and naloxone, as well as pipe-tip covers that can prevent both hepatitis and COVID-19.

Caracole installed the machine in February and has had a "soft opening," Bachmeyer said. She said the dispensary has had no glitches, and clients have welcomed it.