A vending machine offers “morning after” pills in Boston in 2022.
Photo by Joseph Prezioso, courtesy AFP/Getty Images
“The main advantage of these vending machines is that they're available and accessible 24/7. They're really being used to complement existing services.”
— Philip Chan
Vending machines have long been used to offer refreshments and serve people on the go. But for Rhode Island public health workers tackling opioid abuse, the technology is helping to save lives.
Nearly a dozen public health vending machines filled with free items such as naloxone, which can reverse opioid overdoses, are spread throughout Rhode Island thanks to the state health department's partnerships with groups such as AIDS Care Ocean State, which help stock the items.
“The main advantage of these vending machines is that they're available and accessible 24/7,” Philip Chan, MD, MS, Rhode Island Department of Health's consultant medical director, told The Nation's Health. “They're really being used to complement existing services.”
Public health vending machines are another tool in a public health agency's toolbox to address immediate health care needs, whether it is toothbrushes for oral health, condoms for safe sex, or in Rhode Island's case, harm reduction materials for safer drug use. Users can discreetly select mostly free or low-cost items from the machines, which also have features to make them accessible for people with disabilities and those who speak multiple languages.
Across the U.S., state health departments, universities, American Indian tribes and more have formed partnerships to provide products. In some cases, vending machine companies help keep prices low by negotiating with product manufacturers, such as lower prices for COVID-19 tests. Community health organizations can advise health departments on items the machines should offer.
Chan, a Brown University professor of medicine, said the machines benefit people who cannot access health clinics during regular business hours. A two-year pilot study of five machines in Rhode Island found that 28% of machine use happened over the weekend and over half at night, according to research published last year in the Journal of Public Health Management and Practice. Most of the people who used the health department's in-person services also used the machines.
In New York City in 2023, Elan Quashie with Services for the UnderServed helps Rose Meredith use a vending machine that provided free hygiene kits, COVID-19 tests, naloxone and more.
Photo by Spencer Platt, courtesy Getty Images
“The results speak to the fact that we need public health funding that matches the scale and urgency of the overdose crisis.” Leah Shaw, MPH, a study author and PhD candidate at Brown University's School of Public Health, told The Nation's Health. “That means funding both human infrastructure —like outreach workers and overdose prevention specialists —as well as technological infrastructure, like the vending machines that extend access around the clock and offer this kind of very low threshold option.”
Machine vendors work with health agencies to brand machines with department logos, phone numbers and QR codes for follow-up care. The technology can also be a valuable source of data collection.
Virginia-based company LTS has deployed 350 of its Testandgo kiosks across the U.S., which have dispensed over 160,000 items since 2022. The kiosks allow departments to customize voluntary demographic questions for customers, which include the City of Somerville Health and Human Services Department in Massachusetts.
While supported by opioid-use abatement funding, city machines launched in November go beyond harm reduction. Some of the most popular items are body wipes, emergency blankets and hygiene kits, said Tina Los, MPH, the department's director of prevention services.
Users are asked standard demographic questions, as well as whether they are first time users, parents, students and more.
“This kind of really just helps us get a sense of who is accessing these resources,” Los told The Nation's Health.
Health departments, including the Sonoma County Department of Health Services in California, have used demographic data from public health vending machines to drive community decisionmaking. Since launching its Health To Go vending machines via Mullan Pharmaceuticals in April 2025, the Sonoma health department has collected data on how many items are dispensed, when they are used most and what is in demand, said Alyssa Hamilton, MPH, program planning and evaluation analyst for the department.
As of February, the county's three machines averaged 435 monthly transactions and had dispensed over 10,400 items, with personal hygiene kits, adult dental kits, socks, naloxone and COVID-19 tests the most popular choices.
When department workers learned that gun locks were not being chosen often at one of their machines, they switched them out for at-home HIV test kits, which were much more popular, particularly in a community with high HIV rates.
“Having the data allows us to adapt to the needs of what that area is telling us,” Hamilton told The Nation's Health.
Sonoma County officials are also exploring how to use their public health vending machines to use as part of response to disasters such as wildfires or floods.
Popular items inn Somerville, Massachusetts, machines include body wipes, emergency blankets and hygiene kits.
Photo courtesy City of Somerville
“We're really looking at opportunities here, especially as these vending machines begin to expand,” Ryan DeHart, public health preparedness manager for Sonoma County's Department of Health Services, told The Nation's Health.
Many of the public health vending machines used across the U.S. also have an educational component, whether it is helping users identify their health risks or playing how-to videos for dispensing naloxone, said David Wilmot, MD, FAAFP, chief medical officer of LTS. Test results provided through the machines can also lead to safer practices, he noted.
“Some of the initial studies that we looked at actually found that if people had a positive result with the fentanyl test strip, they actually could change their behavior,” Wilmot told The Nation's Health.
Organizations that receive Title X funding for family planning services often rely on Testandgo kiosks to help reach people for sexually transmitted infection screenings, said Diane Foley, MD, FAAP, chief medical officer for public health at LTS. After machine users get their results, they often visit a health provider for treatment or follow-up.
“You can actually increase the number of people you see without having to increase staff or pay for an extra clinic by using the kiosk,” Foley told The Nation's Health.
The nation's ongoing public health shortfalls mean the machines can fit into long-term public health strategies. LTS is reaching out to states funded by the Centers for Medicare and Medicaid Services' Rural Health Transformation Program. The $50 billion federal initiative helps states invest in mobile health technology, such as Testandgo's self-collection kits that can measure kidney function or blood sugar levels.
Public health vending machines can also counteract policies that are harmful to public health, such as those that limit access to reproductive health care.
The American Society for Emergency Contraception has partnered with college student groups to help campuses provide vending machines with emergency contraception such as Plan B One Step, known as the “morning-after” pill. Students form partnerships to help repair the machines and stock them with pregnancy tests and other pricier health items.
“Being able to go to a machine where it's now available for $10 or even $15 or potentially even free depending on the school's model totally eliminates that barrier,” Nicola Brogan, MSc, RN, the society's director of operations and research, told The Nation's Health.
For more information, visit www.somervillema.gov/healthkiosk, www.testandgo.com and www.ec4ec.org.
- Copyright The Nation’s Health, American Public Health Association
