Nevada Adds New Syringe Exchange Vending Machines, Building on Success

Just before the holiday, the Southern Nevada Health District (SNHD) announced it would be showcasing a newly added harm reduction vending machine to the located at the main SNHD health center on Decatur Boulevard in Las Vegas. In a year where other some jurisdictions are seeing local and state legislators push back against harm reduction programs of all sorts, the Las Vegas health entity has chosen to invest in successes already achieved and expand their vending machine program.

In 2017, Nevada became the first state in the country to offer syringe exchange services via vending machine, after the legislature passed a harm reduction measure allowing the state to fund these efforts, known as HB 410. Nevada’s syringe change program is operated by Trac-B Exchange out of a store front and the entity was one of three in which the program launched as a pilot. Sometimes called “public health” vending machines when numerous types of self-administered care supplies are offered, kits in the machine include syringes, tourniquets, a disposal container, first aid supplies, safe sex supplies, naloxone (the opioid overdose reversal medication), pregnancy tests, and hygiene kits. Health officials also highlighted how these kits might be used for “street” hormone replacement therapy, or when a transgender person is not engaged in traditional care but is still acquiring hormone medications (commentary also addressed bodybuilders for similar activities). The machines do not require cash to operate, rather a person seeking to use the machine is required to fill out a form and will receive a code and card. Identifying information is not required to receive access to the vending machines. Advocates and program operators have cited how the machines save public dollars by reducing the labor burden and keeping more people engaged in care.

In 2017, Las Vegas had at least 5,800 active injection-drug users and program staff have cited the success of the pilot as to part of why the newest vending machine was added. With nearly ten percent of Nevada’s new HIV diagnoses being attributed to illicit syringe use and the well-studied benefits to reducing Hepatitis C transmissions, SNHD’s newest addition seeks to engage a broader range of the public as the kits offered are more expansive in meeting care needs. Since the 2017 pilot launch in Nevada, other jurisdictions have considered beginning their own programs (not without opposition). Ohio, for example, launched a vending project in early 2021 (in part to reduce the risks associated with in-person care during a wave of high COVID-19 transmission), making it the second state to offer this type of access program. Those machines included “smoking” kits and their safe consumption kits also include fentanyl testing strips as options. Since the launch, more than 1300 items have been dispensed and almost 600 overdoses have been reversed in the community the vending machine serves.

Research released in June of 2022 found the anonymous nature of the vending machine programs was critical for many people using them. Researchers established a baseline of foot traffic for the machines by setting up a camera (which would identify consumers), afterwards setting up near the machine to offer services and information. While some consumers engaged with peers they recognized, many chose not to and the researchers had good indication at least a few potential consumers avoided the machine they might otherwise use because of the researchers’ presence. In an interview as part of the study, one person admitted to avoiding getting supplies they needed because of police presence near the vending machine. This presents a difficult-to-balance issue in working to ensure people using the machines are actively linked to care they need. Potential solutions include offering a QR code on the machine, reliance on drug using and former drug using peers to staff tables, information inserts in each kit, and possibly having a table staffed at regularly posted times so that consumers could chose to engage when and how they’d like. However, the issue of police presence as a deterrent to seeking care will remain a barrier and has been problematic for other syringe exchange programs across the country. Because law enforcement activity appears to be a significant barrier to engaging in harm reduction services, specifically syringe exchange programs or in reporting overdoses (the limitations of Good Samaritan laws vary by state, often with carve outs for drug users reporting a need for help for a friend), legislatures could address the conflict by passing laws which carve out certain enforcement, but prosecutors and police department leadership need to “buy-in” as well. Reducing uniformed patrol around these areas or committing to not prosecute people seeking harm reduction services and products via vending machines would go a long way to reducing law enforcement engagement with patient populations, increasing trust with affected communities (with both law enforcement and care provider entities), and increasing engagement with these critically necessary, life-saving programs.

Jen Laws, President & CEO

Jen Laws (Pronouns: He/Him/His) is the President & Founder of Policy Candy, LLC, which is a non-partisan health policy analysis firm specializing in various aspects of health care and public health policy, focusing on the needs of the HIV-affected and Transgender communities. In that capacity, Jen has served as the President & CEO of the Community Access National Network (CANN), beginning in January 2022. He previously served as the Project Director of CANN's HIV/HCV Co-Infection Watch, as well as 340B Policy Consultant.

Jen began his advocacy efforts in Philadelphia in 2005, at the age of 19, coordinating team efforts for a corporation participating in the AIDS Walk. His connection to HIV advocacy grew when partnering with Mr. Friendly, a leading anti-HIV-stigma campaign.

He began working in public health policy in 2013, as a subcontractor for Broward Regional Planning Council evaluating Marketplace plans for plan year 2014, advising and educating constituents on plan selection. Jen was a member of South Florida AIDS Network and has worked with Florida Department of Health, Broward and Miami-Dade County Health Departments, Pride Center South Florida, and other local organizations to South Florida in addressing the concerns and needs of these intersecting communities. During this time, Jen was seated on the board of directors for the ADAP Advocacy Association.

Having moved to the New Orleans area in 2019, Jen resumed his community-based advocacy as the chair of Louisiana's Ending the HIV Epidemic planning subcommittee for Data-based Policy and Advocacy, regular participation as a community member and "do-gooder" with other governmental and non-governmental planning bodies across the Louisiana, and engages with other southern state planning bodies. He continues his advocacy in governmental health care policy evaluation, which has been utilized to expand access to quality healthcare by working with RAD Remedy to deliver the nation's foremost database of trans* competent health care providers. Lending his expertise on policy matters ranging from 340B impact on RW providers and patients to strategic communications and data analysis, Jen's approach to community engagement is focused on being accessible across all stakeholder groups and centering the perspectives of PLWHA and Transgender people. He is a community ambassador alumni of the CDC's Let's Stop HIV Together campaign.

In his personal life, Jen enjoys spending his time being "ridiculously wholesome" with his partner, Aisha, and her two amazing daughters. In their personal time, when not immersed in crafts or house projects, they can be found seeking opportunities to help their neighbors, friends, and community members (who have come to rightfully expect exquisite gift baskets of Aisha's homemade jams and jellies from time to time). Jen strives to set a good example both in his personal professional life of integrating values into action and extending the kindness and care that have led him to a life he calls "extraordinarily lucky".

https://tiicann.org
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