From Clinic to Community: Deploying Harm Reduction Vending Machines Across a Veterans Affairs System

Area of Science:

• Public Health
• Health Services Research
• Pharmacy Practice

Background:

• Harm reduction vending machines (HRVMs) offer a promising strategy to increase access to vital supplies.
• Limited practical guidance exists for implementing HRVMs in healthcare and supportive housing settings.
• Veterans Affairs (VA) settings present a unique opportunity to deploy HRVMs for improved health outcomes.

Purpose of the Study:

• To describe the clinical pharmacist practitioner-led deployment of 15 HRVMs within a VA system and supportive housing.
• To identify implementation facilitators and challenges in deploying HRVMs in diverse VA-affiliated locations.
• To assess the feasibility and acceptability of HRVMs for providing harm reduction supplies to Veterans.

Main Methods:

• A clinical pharmacist practitioner (CPP) led the project, involving site engagement, market research, and stakeholder coordination.
• Contracts were established, and HRVMs were deployed in outpatient clinics, supportive housing, and hospital locations.
• Product assortments were curated based on feedback, and a barcode-based access system was implemented.

Main Results:

• Fifteen HRVMs were successfully deployed across 7 clinics, 6 housing sites, and 2 hospitals.
• Implementation involved overcoming challenges such as staff concerns, connectivity issues, and delivery costs.
• Planning and installation required approximately 2 years, emphasizing the need for dedicated staffing and funding.

Conclusions:

• HRVMs appear feasible and acceptable in VA clinical and housing settings, enhancing anonymous access to harm reduction supplies.
• Dedicated staffing, braided funding, and standardized procurement pathways are crucial for successful scale-up.
• Further development of centralized procurement and clearer implementation guidance is recommended for broader adoption.