By Janet Gramza
The Buffalo News
ERIE COUNTY, N.Y. — Bright blue vending machines whose free products can help save lives are popping up around Western New York and the rest of the state.
The machines dispense Narcan, the nasal spray that can reverse an opioid overdose, and test strips to detect fentanyl and Xylazine, substances being added to drugs with lethal consequences here and across the country.
The so-called “no stigma” vending machines are the latest tool in an ongoing effort to prevent opioid deaths, which have reached historic levels due to street drugs like heroin being laced with far more dangerous substances to produce bigger and longer-lasting highs.
More than 370 people died from opioid-related overdoses in Erie County last year, about 70 more than the previous year, due to fentanyl being added not just to heroin but also to methamphetamine, pills and even cocaine, which is expensive and therefore affects an older group of users, according to the county’s Opioid Task Force.
More recently, Xylazine, a powerful synthetic opioid used by veterinarians to sedate large animals, is being added to heroin already cut with fentanyl to make it last longer, said Shelby Arena , harm reduction manager for Buffalo MATTERS, the opioid treatment network behind the vending machines.
MATTERS, which stands for “Medication for Addiction Treatment & Electronic Referrals,” was founded by UB emergency medicine Dr. Joshua Lynch in 2015. In 2019 it was adopted statewide and it’s still expanding.
The program provides treatment medication to opioid use disorder patients at emergency departments and gets them into long-term treatment at a community clinic of their choice within 48 hours. MATTERS also offers telemedicine visits for virtual evaluations, treatment medication prescriptions and referrals.
Since the fall 2022, it also distributes free Narcan and test strips to community sites, pharmacies and treatment organizations across the state as well as individuals who can request them via its website.
Arena said MATTERS mailed out 55,000 fentanyl and Xylazine test strips in 2022 and last year it sent out 6.7 million strips, for a grand total of nearly 10 million since the project began, filling orders from more than 1,500 organizations.
The vending machine project began in September and officially kicked off Monday with a public event at the Kenmore Fire Department, which is hosting a machine outside the station that’s being maintained by patient support group Save the Michaels. The project and related MATTERS outreach efforts are being supported by $8 million from the state health department and funding from its Office of Addiction Services and Supports (OASIS).
MATTERS has installed 13 of the first 15 machines so far — five in Western New York — and hopes to add 15 more in the next year, Arena said.
Since October, the machines have dispensed 3,620 Fentanyl test strips, 2,430 Xylazine test strips and 1,836 doses of Narcan, she said. A locator map of the machines can be found at mattersnetwork.org/harmreduction/vendingmachines/
Lynch, an assistant professor at UB’s Jacobs School of Medicine and Biomedical Sciences, based MATTERS on methods used by doctors at Yale University, who found that patients in opioid withdrawal who were given the medication buprenorphine in the emergency department and then provided with a clinic appointment were more likely to remain in treatment a month later and to have reduced their opioid use.
MATTERS started in 17 Buffalo emergency departments and now operates as a network whose electronic referral service is used by 105 hospitals across the state — “almost half of the hospitals in New York state and New York City ,” Lynch said. The program treats and refers hundreds of opioid users a year to treatment centers in Buffalo alone.
For users who aren’t ready for treatment, MATTERS and other organizations are working to at least reduce the potential for deadly harm that’s growing with the widespread addition of fentanyl — and now sometimes Xylazine as well — into the drugs.
MATTERS and other treatment groups have been marketing and publicizing harm reduction practices, urging people who plan to use opioids to test their product for fentanyl and Xylazine, to have Narcan on hand and to only use if there is someone else around who can administer it if the user stops breathing.
Lynch said it’s “great” that MATTERS is filling so many requests for free Narcan and test strips, “but there may be delays with places requesting it and having to wait for it to be mailed.”
MATTERS will also mail free supplies to anyone who requests them via its website but having to do so and provide a mailing address could be a barrier, Lynch said.
“With the vending machines, we put them outside so someone can be anonymous about walking up and getting what they need 24 hours a day,” he said.
People can select up to three kits at a time from the machines just by entering a code (8377), year of birth and ZIP code. Each pack of test strips contains 10 trips and each box of Narcan contains two doses.
Lynch said asking for a person’s date of birth and ZIP code will help MATTERS collect data including what times of day people are using the vending machine and whether people are traveling to access them.
“Hopefully we will get some useful data that we can share with other states who want to build their own programs,” Lynch said.
Arena said the vending machines and mail-order supplies are not just for drug users — especially when it comes to Narcan, because fentanyl is now routine in all heroin being sold in the drug market.
“Pure heroin doesn’t exist anymore,” she said. “These days it either contains Fentanyl or is 100% Fentanyl.”
For that reason, she said, the fentanyl test strips are for testing cocaine, which is increasingly being cut with fentanyl. Meanwhile, Xylazine is “finding its way into heroin as well as fentanyl because it extends the effect of fentanyl,” she said.
Even people who think they will never encounter someone suffering a drug overdose should consider keeping Narcan around just in case. Arena said one local person who keeps Narcan in her car saved the life of an addict who overdosed in a gas station parking lot while she was getting gas.
“Every first aid kit should have a box of Narcan,” she said.
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