Highland Hospital has a new vending machine. But instead of soda, it has socks. Instead of chips, there’s condoms.
And it’s all free.
The “harm-reduction vending machine” launched in Highland’s emergency department this fall, offers basic supplies to anyone who needs it, with a focus on reaching those who might benefit from the substance-use services at the hospital’s Bridge program.
“We know that people who access Bridge and the emergency room need all these other things like hygiene kits, condoms, fentanyl test strips, pads and tampons, things of that sort, before we can even start talking about their substance use,” said Braunz Courtney, executive director of the HIV Education and Prevention Project of Alameda County, or HEPPAC.
“We’re meeting folks where they’re at,” he said.
Both the equipment facilitating safer drug use and the personal care items offered in the machine “can make a huge impact on health and wellbeing,” said Dr. Andrew Herring, medical director of Alameda Health System’s Bridge program.
Similar public-health vending machines are in operation around the U.S. and in other countries. The New York City Department of Health launched its first in June, in response to increasing opioid overdose deaths there.
While Alameda County has a lower opioid death rate than the rest of California and the U.S., local deaths have been increasing at a rapid clip for the past six years. Black residents and people experiencing homelessness die from and are hospitalized for overdoses at disproportionately higher rates.
HEPPAC, the organization behind the vending machine, is a 30-year-old nonprofit contracted with Alameda and Contra Costa counties to prevent the spread of HIV and Hepatitis C among people who use drugs, focused on communities of color. Each item in the Highland machine comes with a QR code for HEPPAC’s website, which has information on the Bridge program, which provides medication and counseling to treat opioid, methamphetamine, and alcohol addiction.
“Big Red,” as HEPPAC calls the machine, stands next to the traditional boxes selling food and drinks. It’s flashy, but also somewhat inconspicuous.
The location is meant to “normalize it,” said Courtney, so “as people go up to get water, juice, and snacks,” they can grab a toothbrush and deodorant too, without being singled out or stigmatized. For the same reason, the products are not prominently labeled as free.
To use the machine, a person has to enter their age, race, and gender on a keypad, and they’ll receive an access code to take as many items as they need. The demographic data is collected to track who’s being served and whether target groups are being reached, said Courtney. The data hasn’t been analyzed yet, he said.
HEPPAC received Big Red along with another vending machine from the California Department of Public Health—which were donations from Salesforce—and got funding from the department’s California Harm Reduction Initiative to run the machine through June 2024.
First, the organization tested the waters, installing small newspaper stands offering Naloxone, or Narcan, an emergency nasal spray that can treat opioid overdoses, at Highland in the early summer.
“The plan was, we’re going to start with the little box, because even as simple as it may seem, there’s a lot of politics,” Courtney said. But the fixtures were well-received, so they moved ahead with the plan for the large vending machine.
Launching the machine took several months, he said, including having a company come and program it, and getting clearance from the hospital.
In the month or so since it started, the supplies are going “like hotcakes,” Courtney said. Because of the demand, the cost of running the machine is higher than expected, he said, so HEPPAC is pursuing additional funding from the county and elsewhere.
For its second donated vending machine, HEPPAC is eyeing Contra Costa County.
“They’re a little bit more conservative and they’ve got a lot more bureaucracy and red tape,” Courtney said.
As soon as Big Red launched, HEPPAC began hearing from numerous local organizations interested in getting their own machine. Courtney said he’d love to eventually see similar services on busy street corners, at BART stations, and at event spaces like the Coliseum. But that spread would require more resources to manage the sites and deal with issues like vandalism, he said.
“My vision is that we can get it into a lot of different facilities, as a normalization of a public health standard,” he said.
