Our new study, published in the Journal of Public Health Management & Practice, evaluates the two-year implementation of Rhode Island’s harm reduction vending machines (HRVMs) and their role alongside in-person harm reduction services. These machines, placed in high-need areas across the state and accessible 24/7, offered critical supplies like naloxone and safer drug use supplies at times when other services were unavailable.

Read the Article in JPHMP

We found that nearly 30% of HRVM encounters happened on weekends and over 50% occurred outside of standard business hours (ie, times when in-person services are least available). HRVMs served a somewhat younger population and often supported people with more frequent needs, including those who also used in-person services. But while vending machines increased access and convenience, they did not, and cannot, replace the full spectrum of care offered by in-person harm reduction programs. Instead, they offer a complementary approach, especially when implemented through strong partnerships between state agencies and trusted community-based organizations.

This study underscores that around-the-clock, low-barrier access to supplies is necessary. For jurisdictions looking to expand harm reduction efforts, HRVMs provide a pragmatic, scalable strategy to reach more people, more often, with the tools they need to stay safe.

Key Takeaways:

• Overnight and weekend access matters: Nearly 30% of HRVM encounters happened on weekends, and over 50% occurred outside regular hours.
• HRVMs served a different population: Users were younger on average and showed distinct usage patterns compared to in-person services.
• People move between service models: Nearly 80% of people who used both HRVMs and in-person services switched between them during the two-year study period.
• Partnerships made this possible: The pilot succeeded because of collaboration between the state health department, harm reduction organizations, and other public agencies.
• HRVMs are a complement, not a replacement: While they fill critical access gaps, HRVMs can’t provide testing, counseling, or referrals that in-person services offer.

Find the full manuscript and other recent research on our People, Place & Health Collective site!

Leah C. Shaw, MPH, is a doctoral student in the Department of Epidemiology. She has worked in community health centers on Hepatitis C and HIV teams leading research, reporting, and quality improvement. She has led research at Brown related to naloxone distribution, harm reduction practices, and overdose prevention centers, among other topics. She has also worked in syringe exchange and occupational health in the US and Latin America. She received her MPH from Tufts University.

Erin A. Brown, MPH, is a Senior Epidemiologist in the Center for HIV, Hepatitis, STD, and TB Epidemiology (CHHSTE) at the Rhode Island Department of Health (RIDOH). Ms. Brown works at the intersection of disease prevention and drug user health and has contributed and led to research related to naloxone uptake, state supported harm reduction programming, and other related topics. Ms. Brown received her MPH from the Brown University School of Public Health in 2021.

Brandon D. L. Marshall, PhD, is a Professor of Epidemiology at the Brown University School of Public Health and the Founding Director of the People, Place & Health Collective. He received a PhD in epidemiology from the University of British Columbia’s School of Population and Public Health. His research focuses on substance use epidemiology, infectious diseases, and the social, environmental, and structural determinants of health of urban populations.