Sometimes, the most effective health policy is to acknowledge that people are going to make unhealthy decisions—and try to create an environment where those choices are a little safer.
Las Vegas health officials agree. They’re installing clean-needle vending machines at three locations in the city, according to the Las Vegas Review-Journal. These vending machines will look just like the ones that distribute snacks, except they don’t take cash. Kits with 10 new syringes, a tourniquet, and a container for used needles to be safely thrown away will be available for drug users to pick up twice a week at the end of May.
These vending machines, provided by a collaboration among the South Nevada Health District, the Nevada AIDS Research and Education Society, and Trac-B Exchange, a local nonprofit focused on harm reduction, are for heroin, crack, or crystal meth users. The machines will be in three different Trac-B locations. Users will have to have to register with the centers to get a personal card with an access code for the machines. They won’t have to provide any identifying information for these cards, but will be limited to two packs of needles per week.
Sharing needles carries the risk of spreading blood-borne diseases like HIV and hepatitis C. Although users will still be shooting up with potentially lethal drugs, they can at least avoid spreading infections. Nevada has one of the highest HIV rates in the country, with over 20 cases per 100,000 people.
The harm-reduction approach suggests that dishing out strict punishments for drug use doesn’t actually stop people from using drugs. Instead, you can assume that people will likely use drugs no matter what— and you may as well facilitate safer use. Countries like Australia have used clean needle vending machines in the past. In year-long studies, researchers didn’t find any adverse effects, like an uptick in new drug users, associated with them. Other studies have found that access to clean needles reduces the spread of disease and, in this case, if people who come pick up these needles need help with anything else—including resources for getting clean—case managers will be available to assist them.
Right now, the Nevada efforts are funded entirely by donations. It’s unclear how long this program will last without other resources, like federal support. US president Donald Trump said multiple times during his campaign that he cares deeply about the opioid crisis in America. But so far the policies he’s put forward—including proposing drastic cuts to the Substance Abuse and Mental Health Services Administration’s budget—don’t seem geared towards actually helping drug users.