What do you think of when you heard the words “vending machine?” An ice-cold Coke, a bag of chips…clean needles? That last one doesn’t seem to belong- it sounds like a work of fiction. But in Las Vegas, brand new vending machines will be installed to dispense clean needles and other safe, unused paraphernalia. The goal of the initiative is one of harm reduction, to decrease the rate of HIV and hepatitis C transmission, and to mitigate the nasty effects of an opiate epidemic.
Clean Needles as Harm Reduction
Harm reduction is a philosophy adhered to by many community activists and even government bodies. It’s the idea that because people will engage in dangerous, even illegal behavior (such as intravenous drug use or sex work) the best way to reduce the risk and medical costs associated with such activities is to focus efforts on reducing the harm caused by them. This means measures to stop the spread of bloodborne diseases, lower the rate of overdose and injury, and other such initiatives.
Harm reduction measures generally do not direct resources toward promoting abstinence, but many do have resources available for people who participate in these programs who decide that they want help in stopping their drug use. Examples of harm reduction measures include methadone maintenance programs, syringe exchanges, naloxone distribution, supervised injection sites, and the distribution of condoms and other forms of STD and pregnancy prevention.
The Debate Over Clean Needles
The distribution of clean needles is one of the most necessary yet controversial forms of harm reduction. Some people argue that these programs enable drug users to continue engaging in risky, addictive behavior. However, they have been proven effective in stopping the spread of diseases like HIV and hepatitis C, both of which can be fatal if left untreated. When someone in active addiction is infected with one of these illnesses, they can be less likely to seek treatment due to the impact of addiction on their daily lives, which can include homelessness, lack of healthcare, and financial trouble.
Those in favor of programs that offer clean needles to addicts point out that reducing HIV and hepatitis C transmission prevents illness, early death, and even mini-epidemics of these diseases. In Indiana, an HIV epidemic caused mostly by sharing used needles for drug injection was only ended when then-Governor Pence approved a temporary needle exchange in Scott County, which saw nearly 200 new cases of HIV infection in 2015 (New York Times.)
Also, because many of these programs offer outreach, counseling services, and connections to detox and rehab facilities, they can be a way for people with no other connections to get help treating their addiction. Through contact with drug users, staff and medical professionals who run these clinics are able to help some patients get sober and connect them with resources for recovery that they may not otherwise have access to.
Most syringe exchanges happen in clinic settings, where patients must register, provide demographic information, and meet with a counselor or professional in order to take part in receiving clean paraphernalia.
The new vending machines coming to Las Vegas this year are different than traditional clean needles programs. The machines will not require interaction with medical professionals. Users do still have to register to use them, and they require a special swipe card to work (to prevent children from accessing the machines.) However, users don’t have to provide any personal identification to use the vending machines. They can use them twice a week to get clean needles, disposal containers, first aid items (for caring for wounds commonly produced by injection), and even items for safe sex (Las Vegas Review Journal.)
In the county that will host the machines, there are nearly 6,000 active intravenous drug users, and those numbers are rising (Las Vegas Review Journal.) In Las Vegas, HIV rates are higher than the average rate for the United States as a whole (NBC News.) The goal of the vending machine program is to reduce that rate and combat the growing crises of intravenous drug use in the region, which is mostly comprised of heroin use.
Will it Work?
Only time will tell whether or not this initiative will work to combat HIV and hepatitis C. Many are hopeful that it will. However, one downside to this method of distributing clean needles is that there are no staff members interacting with registrants, meaning that the benefit of connecting users with resources to treat addiction, found at most needle exchange clinics, doesn’t apply. The most effective way to combat the effects of addiction and intravenous drug use is comprehensive treatment, including detox, social and vocational clinical assistance, therapy, and psychiatric care.
Fortunately, there are facilities in regions with high rates of drug use that offer such care for people who wish to get help with their addiction. One of these is Wellness Retreat Recovery. The facility does what some places don’t- offers dual diagnosis care for patients rather than just addiction therapy. With both, clients of Wellness are able to address the underlying social, environmental, and psychiatric factors that contribute to addiction. These programs are the next step after harm reduction- once the physical consequences of addiction are contained, the real work on treatment can begin. Ultimately, this offers those who want help stopping their drug use a way out. Until then, harm reduction programs aim to keep them as safe as possible, so that they can survive long enough to make it into treatment.