1. Potera, Carol


Nevada's pilot vending machine program encourages users to enter treatment programs.


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Injection drug users in Las Vegas, Nevada, can get free kits with clean needles and syringes from vending machines through a new pilot program called Trac-B Exchange started by Harm Reduction Center-Las Vegas. Health officials hope that the approach will help prevent hepatitis, HIV, and other illnesses spread by discarded dirty syringes and needles, as well as encourage participants to enter drug treatment programs.

Figure. Rick Reich, ... - Click to enlarge in new window Rick Reich, director of Trac-B Exchange, installs a needle replacement vending machine in Las Vegas, Nevada. Photo by David Becker / Zuma Wire / Alamy Live News.

Drug users first must obtain an eight-digit code (their birthday) to access a vending machine. Hospitals use similar machines to dispense medications, cardiac test kits, and other supplies and track inventory. "The company that builds inventory machines for hospitals modified their product for our needs," says Rick Reich, director of Trac-B Exchange. The term vending machine is "friendlier" than inventory control machine, adds Reich.


The vending machines dispense a free kit with 10 syringes and needles, tourniquets, bandages, alcohol, filters, and condoms. The machines confidentially monitor drug use. A registered user is allowed two kits weekly. To get another kit, clients must place the used needles in a special compartment of the vending machine. "If they don't exchange needles, they won't get a new kit," says Reich. This reduces the number of contaminated needles discarded in parks, streets, and public bathrooms that can infect other people as well as pets. The return rate of syringes, a marker of effectiveness, has been steadily increasing since the program started in February.


The vending machines have been strategically placed to date in community agencies like the Community Counseling Center of Southern Nevada, which offers counseling and disease testing. "Users come into a counseling center for free needles and syringes, and they see posters for treatment programs. That's an optimal situation," says Reich.


At the moment, there are no nurses in the program, but Reich believes nursing skills could enhance needle exchange programs. Nurses would be an asset in educating drug users on overdose prevention and "how to properly use naloxone to treat overdoses," he says. For example, some drug overdoses don't always respond to a single dose of naloxone nasal spray, and may require two to three doses.


Many homeless drug users also have mental and physical illnesses, making nurses who specialize in mental health and drug and alcohol abuse especially beneficial to programs like this one, says Reich.-Carol Potera