The Opioid Crisis, Are Vending Machines the Answer?

Opioid vending machines have recently been proposed as a way to provide safe drugs to populations without access to clean medicine.

An executive in the British Columbia Centre for Disease Control in Canada, innovative prevention provider Mark Tyndall recently presented a novel idea for addressing theopioid crisis. Tyndall is a medical doctor who was trained at Harvard. His observation of the effect of AIDS and other diseases led to him providing early support for needle exchanges in his community. He also piloted trials of drug replacement therapies and other new ways to addressopioid overdose.

Tyndall has an idea to offer opioid drugs away from medical institutions by providing them in vending machines. The vending machines would allow pre-approved users with a prescription to access opioids. The veins in their hands would be scanned biometrically, and the drug would be dispensed on-site.

Many officials contend that opioids themselves are not the problem. Rather, it is the way that illegal drugs are sold as opioids when they, in fact, contain a variety of other substances. The lack of regulation of illicit drugs as well as lack of discrimination from the average drug purchaser can have fatal consequences. Synthetic hybrids and other drug compounds present a grave risk to people who regularly use drugs for nonmedical reasons.

Providing safe outlets for drug use in clean needle exchanges ofsupervised injection locationsrepresents a cultural shift in the way we approach substance abuse. People largely understand that addiction is a chronic condition that requires treatment. Government leaders and community officials support legislation that provides prevention services and increasingly avoids criminalization or other punitive measures for addressing illicit drug use.

Using Drugs to Treat Drug Addiction

Researchers at the University of Buffalo,published in the National Center for Biotechnology Information, state that expert attention is turning toward a better understanding ofopioid use disorder, with the focus shifting to risk reduction and management of the disorder.Mark Tyndall’s theoryis that drug addiction should not be addressed by law enforcement but by well-intentioned, harm-reduction techniques. Some researchers spend their time assessinghow to best coach people in supervised injection settings, such as teaching them to clean their skin before injection.

Providing clean drugs to people who, arguably, will use them either way, is a controversial approach that is gaining traction across North America. The idea is that safe sources provide people with what they need minus the risks related to questionable sources or unclean tools.

Tyndall’s idea to use vending machines addresses a few common issues with the current solutions:

• Much of the population who have no access to clean drugs or equipment are also resistant to entering a medical institution or facility to receive safer sourced drugs and sterile needles
• Removing the drug delivery process from doctors and medical facilities will provide for larger numbers of people who need help
• A mechanized approach is tamper-proof and more regulated

There has also been significant pushback to this idea. Objectors cite numerous downsides to a vending machine dispensing opioids, including:

• Anonymity and ease for abuse
• Requirement of new regulations, since dispensing would be disassociated from pharmacies
• The opportunity for diversion of drugs to other parties

The approach ofharm reductionis spreading intoother mental health fields. It is based on the principles of non-judgment and providing empowering reasons for people to change their behaviors. Harm reduction in the context of drug use measures success by decreased use, if not total abstinence.

Tyndall’s ideas may sound radical, but his ultimate motivation seems to be addressing the human element of drug abuse. Namely, people who struggle with addiction are still deserving of respect and the best care. While the goal of any intervention services is recovery, some people are not ready to enter rehabilitation or treatment. In this case, it is in society’s best interest to keep these people alive and well until they are ready to recover. Seeing Tyndall’s idea from this perspective may help the average onlooker better understand the complexity ofdrug addictionand its related public health challenges.