Sackville will host a “vending machine,” or an interactive dispensing service, containing harm reduction supplies.
Executive Director of Ensemble Moncton, Debby Warren, says she was amazed by the machines at a national conference in Ottawa in 2019.
Now, almost exactly a year later, Ensemble is the proud owner of two interactive dispensing service machines.
The first is installed in Moncton, with the second one to arrive in Sackville, New Brunswick.
Meg Cunningham: I’m talking to you today about the harm reduction vending machines that you got recently because of a $45,000 grant, the COVID-19 relief grant for nonprofits. Before we get to that, I’m wondering if you can tell me a little bit about Ensemble, for those who might not have heard of you.
Debby Warren: Okay, so some may have heard of us under the name of AIDS Moncton. We have been serving Westmorland-Albert county since 1989. So we’re not new, even though our name appears to be new. In the past, we did a lot of work around HIV prevention, and support for those who are living with HIV and AIDS. We’re still about HIV, hepatitis C, sexually transmitted and blood borne infections. That is the premise behind the work that we do. There are populations that are at greater risk for that. Our priority populations now are people who use substances, [they] certainly fall in that category. We focus our harm reduction approach, we’ve always done harm reduction. Harm reduction is when you get in your car today, and you put your seatbelt on, or if you use a condom to protect yourself from sexually transmitted infections. So we’ve always been focused on harm reduction, non-judgmental, and meeting people where they’re at.
MC: Okay, fabulous. Now, I’m wondering if you can tell me about these vending machines you got, because I do believe you got two of them.
DW: Yeah, so we actually call them interactive dispensing services, so IDS machines. I named them that [because] people don’t quite get the concept when we use “vending machine,” they think of chocolate bars and chips and that type of thing. So a year ago, this past November, I was in Ottawa at a conference, the Canadian drug use and addictions Association had a national conference. As I was visiting the exhibit area, I came across this interactive dispensing service. How it really caught my eye is that the group was Ankors, that’s an AIDS organization and Nelson BC that we had partnered with on an LGBTQ project a number of years ago, so I was very familiar with them. So of course, I go over to find out about this machine. I can remember going back into the main area with the other folks I was at a conference with and I went, “We just have to get ourselves one of those, that is just such a great service for the folks that we serve.” Because we’re not able to give 24 hour service, or seven day a week service. That was November 25 that I saw the machine, in 2019, and on November 25, 2020 it was delivered to our front door. So along came COVID[-19], I was able to access funding. Fortunately the people reviewing my application saw that it was innovative, and a way to provide 24/7 service to a very marginalized community. So the reason we call it the IDS is it does more than just give folks the harm reduction supplies that we pass out at our desk. It helps connect them to the community. We want people to stop coming to our office, we want to interact with them and help connect them to the community. We limit the content that they can take [to] two of the same items at a time, but it really is making sure that they know we’re there to help, to continue to connect them. The machine will also help them to stay connected because there’s a map, and we have all kinds of community services that are available to them. They can go and select on the map, they can find the locations, eventually we’ll be able to do direct referrals through the machine, or the machine also has educational components. For example, we distribute Naloxone kits. For people who don’t know what a naloxone kit is, it’s to help to reverse an overdose so that people don’t people don’t die on us. We encourage people [to have it], anyone using opiates, it’s for opiate overdose. There’s even an issue across the country, seniors overdose. Seniors, as we age, and I put myself in that category because I am a senior, we tend to have more medications. If we’re on opiates, and sometimes we forget, we all have a routine but sometimes I find myself saying “Gee, did I take that pill today?” What happens is seniors tend to overdose as well on their opiates because they maybe took them twice, or didn’t take them at the right time. So everyone should have that kit by their first aid kit at home if there’s opioid use happening. We actually have a video. The BC Centre for Excellence has a harm reduction branch, and Dr. Jane Buxton with whom I serve on a national committee with, graciously gave us permission to use their creative resources. So you see how to use it on the machine, it helps you to know the other signs of an overdose and other steps that you take when you do come across someone who is in an overdose situation. So it has that educational component as well.
MC: Okay, it’s been advertised or spoken about as a tool for harm reduction. I’m curious to know specifically what sort of harm does it reduce for people who are using substances or who might use some machine?
DW: Sure. So right now we’re open, nine o’clock till noon, and one to four. Drug use does take place after hours, [and] if they don’t have access to new resources, they’re apt to reuse [supplies]. That increases the chances of infections, hepatitis C, HIV, and bacterial infection. So that’s an example right there that we’re reducing the harm to make sure that they have access to new resources every time they use, same as the other paraphernalia. There’s inhalation kits that they’re not sharing with their other friends, they all have their own. That naloxone kit is reducing the harm. We have condoms, which reduces the harm [of] sexually transmitted infections. We actually have hand sanitizers and surgical masks available to anybody, so we help to reduce the spread of COVID[-19]. We know what the harms of COVID[-19] can be as well. It’s really about reducing any harms that could come about, and it’s making sure that they have access to them all the time. So they’re not just using new resources between nine and four when we’re open, but even when we’re closed.
MC: Okay, and is this machine for anybody? Or is it specifically for people who use substances?
DW: Now, like I mentioned, there’s condoms there. There’s hand sanitizers, there’s feminine hygiene products in there, and there’s a naloxone kit in there. The needles that are in the machine, they’re insulin-sized needles. There’s two sizes there, but they are actually insulin needles. So it’s a community machine. It’s a place anyone if you’re looking for service, and where to access them can come up to the machine [and] can search and find it there. We’ll have other messages that run across like it’s like a little ticker tape going across the top of it. So it’s really a community machine.
MC: Okay, I’ve heard through the grapevine that one of these machines may be coming to Sackville in the new year, can you confirm if that’s in fact true?
DW: I could confirm that. That is true. We’re currently working right now trying to find a home for it, so to speak, a place where it’s hosted. I mean, it will be Ensemble’s machine, we will make sure that it’s maintained that the supplies are stocked on a regular basis because I can monitor the machine from my computer. I can change messaging, I can know the supplies that are in it, when they were taken out, I can tell you what time of day people use the machine. It’ll be our machine, we’ll make sure it’s taken care of, that people have their supplies. Again, it’s not to disconnect. The reason that we happened to choose Sackville, it was just really it just kind of happened. We had someone who called up and wanted to have some supplies at the Corner Drug Store, actually an employee at the Corner Drug Store who happens to live in Sackville, wanted to stock supplies. I had just gotten approval for the machines, and I had been thinking…What was important is more than just sticking it in some corner in a community, we need to make sure we have community partners, that the community is invested in the partner, right? We had dialogue, and we talked about “is this something that now we could get support from?” and it seemed clearly yes, that we had support for it. So we said “okay, well we’ll work towards that, to house it in the Sackville area.” I’m sure folks in little rural communities out and around Sackville, go into Sackville for their services, the grocery store, their drugstore, whatever. So it will help those folks not have to make the trek up to Moncton, because that’s a challenge Not everyone has transportation, right? We know that people do come from Sackville, we know that we have clients, but it’s a challenge for them. So we said, “let’s do one urban area.” We’re committed to making sure that it gets housed down there, and that we look after it. It’s an extension of the service that we do. Based on what we know already, I have stats in front of me from Monday, the first person on Monday to use our machine was at 1:22 in the morning, and the next one was at 5:45. Then it’s within office hours, then over the lunch hour there were three people, and then after we closed, there was another nine people. So we see that the 24/7 access, and we can tell how long they were at the machine, we can tell the number of items that were given out, we can also tell about the engagement. So we know that they’re looking around the machine at the information. Interestingly, one of the most popular parts of the machine was the COVID[-19] information. There’s a section dedicated to COVID[-19], how to do a self-assessment, and how to prevent getting infection in the first place. That’s one of the most popular spots that people visit on the machine. We want that for the folks down in the Sackville area, so they don’t have to travel, and we make sure that they have supplies and we can monitor what are the most popular supplies. It may not be the same for every area, exactly, it might be more inhalation kits than it would be needles, for example. We’ll monitor all of that and just see how it goes and, and we’ll be able to connect them and roll the data all up at once.
MC: I’ve heard that some of these machines have the ability to take your temperature. Are these machines that you have capable of doing that?
DW: It’s in the works, yes, it is in the works. Those types of things, it can be used as a hotspot. It has the capacity for a variety of things. It actually, although we do not use it, it has the capacity and will in the future, they’re developing the software, to see you and know that you don’t have a mask pn and advise you to put your mask on. It will have that capacity, whether we use it or not will be another decision down the road. But for now the camera’s not activated, it’s closed off. We don’t want people to feel that they’re being watched, so we want to assure people that there is no surveillance, that going to use it is totally anonymous. In the new year we have a new project, I’m not going to name it, but there will be some other types of new resources around sexual health that will be brand new across the country. We’re going to be in the first leg of being able to provide those as well.
MC: I said that the machine might be in Sackville in the new year, but that is as specific as I’ve been able to get. Do you have anything that’s more specific than that?
DW: Not at this time. The machine is ready and waiting to be shipped, it’s been ready for a while. It’s in Nelson BC. We just need to make sure that we find a community partner who’s able to host it that will be able to meet the needs of the people who will be accessing it. So I feel that we’re getting closer to finalizing those discussions. Then of course, it will take some time. We need to do some minor renovations to be able to accommodate the machine. That one is not major, it wouldn’t take too long. So that’s why I say I would be hopeful maybe by the end of January, we should have that in place. If it’s sooner, that’s even a bonus right?
DW: I think what’s important for people to understand is that addiction is not a behavior or a habit. You can’t just stop and say no to taking drugs. Addiction is a very complex health issue, and often its base is around trauma, and often early trauma as young people, but also as young adults. We really need to understand that people who are using drugs didn’t wake up this morning and say, “Oh, I’m going to use today.” Most often, the folks that we serve wake up and hope today will be a drug-free day. But unfortunately, it’s a chemical that controls their brain. Everyone knows who Dr. Tam is now. We are funded through that very department that Dr. Tam heads up, the Public Health Agency of Canada. Dr. Tam was at the very conference that I first saw this machine, and her words, and I have them right on my bulletin board. She just says, there were two points that I took away from her comments, is that addiction is a disease of the brain, you just have to look at an MRI to see that. The other part is we cannot arrest our way out of this crisis that we’re in. So people need to understand that we need to be more supportive, understanding. If you don’t know about addictions, then please educate yourself. Please make calls. If it’s your family member, families go through a lot of trauma themselves trying to be supportive. So that’s our biggest barrier and challenge. I know in this machine, with news coverage that we have, there were some other people on the other side of harm reduction, not maybe fully understanding it. I respect that not everybody has access to the knowledge and information, but I really just want people to understand that these are New Brunswickers. These are mothers, and fathers, and sisters, and colleagues, and aunts, and uncles. We need to have compassion for them. If you’re upset that we’re enabling them, we’re trying to keep them alive and as healthy as we can. When the general public gets on side with us and demands, not asks, but demands of the politicians to get in this game, and to make sure there’s resources for treatment. That will be a good day. I just ask people, please educate, come and visit us. We’d love to show you what we do, and you’ll soon understand. That’s the biggest message I have. The machine is wonderful. It helps us to reach them. It’s 24/7, all of those good things. But the important thing is we’re trying to save lives. Dr. Gordon Tao was in an interview with me a while back, and even he said we have two pandemics. We have COVID[-19], and we have this crisis with drug use in our country. They’re like two elephants about to collide. More people have died from the overdose crisis than COVID[-19], and we do not have the uproar from the public yet. They really need to be very agitated, and they need to demand, not ask. So that’s my biggest message today is for people to understand the complexity of this health issue. Nobody chooses this life of addiction, trust me, nobody chooses that journey.
MC: Okay, thank you very much for your time today.
DW: Always a pleasure, anytime.
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