“Smart” harm reduction vending machines to improve public health: Evaluating the utilization

Background: Low-barrier methods, including vending machines (VMs), for dispensing harm reduction (HR) items have become popular in the United States. Technological advances have enabled VM's advanced features (e.g., interactive touchscreens, client registration, cloud-based data collection). This report describes the evaluation outcomes from two “smart” VMs (sVMs) in community settings with the goal of reducing harms related to substance use, especially opioids. Methods: Two sVMs, placed in central Pennsylvania's communities (one outside an urban hospital's emergency department; another inside a community organization's lobby in a small city), dispensed free HR items and provided information on, and linkages to, healthcare, social welfare, and other community services. Data on sVM utilization, collected from May 2024 to May 2025, were analyzed using descriptive statistics; test of proportions was used to compare the data across the two sites. Results: Over one year, 2321 clients accessed the two sVMs, with an additional 4472 sessions with non-registered individuals viewing items or resources. The sVMs dispensed 11,327 items to 2321 registered clients, with hygiene kits (n = 3454), wound care kits (n = 1674), and safer sex kits (n = 1553) being most common. The sVMs dispensed 2755 drug testing strips and 1906 naloxone doses. Furthermore, 396 registered clients obtained information on existing resources/services. Across a total of 14,867 sessions, significant differences in usage were noted between the two sVMs. Conclusions: Interactive sVMs can effectively dispense HR items and connect individuals to services, thereby having the potential to improve individual and public health. Contextual factors, such as location, may influence utilization.