The Case for Chicago’s Public Health Vending Machines
Natalia McCormick 
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On November 2, 2023, the Chicago Department of Public Health launched its first Public Health Vending Machine at Harold Washington Library as part of a one-year pilot program aimed at providing harm reduction and opioid overdose prevention supplies. This pilot program deploys a total of five Public Health Vending Machines “in areas of high overdose[s] on the North, West, Central, and South Sides” of Chicago. These vending machines provide free supplies such as NARCAN (naloxone), Fentanyl and Xylazine test kits, general and menstrual hygiene kits, socks, and underwear. The hygiene kits include items such as “toothpaste, a toothbrush, a soap bar, condoms, deodorant and lubricant.” While all vending machines currently have the same items, specific items may change over time to address local needs. Each of these five machines cost the City $12,000 to install.
In order to access the supplies, individuals need to enter a PIN code that they receive after completing a quick online form about their most recent zip code and optional demographic information. NARCAN is even easier to access, needing only the PIN code “1234” if individuals don’t wish to or can’t fill out the form. Staff are available at some locations to assist people who are unable to fill out the form.
Free access to these supplies is essential to preventing overdoses and improving the basic needs of Chicago’s most vulnerable populations.
There is a demonstrated need for harm reduction and overdose prevention supplies in Chicago. Between November 2023 and March 2024, a total of 3,449 products were dispensed from the five vending machines, including 1,105 kits of socks and underwear, 1,055 general hygiene kits, and 567 boxes of NARCAN, an average of approximately 26 items dispensed per day. During that time, the Harold Washington Library location dispensed the most items, contributing to around 35% of the total usage across all 5 locations.
Unfortunately, most of these vending machines are not open 24/7. The Harold Washington Library location is open Monday–Thursday 9 a.m.–8 p.m., Friday–Saturday 9 a.m.–5 p.m., and Sunday 1 p.m.–5 p.m. The Public Health Vending Machine at the Garfield Community Service Center is only accessible during open hours, restricting overnight access. Only the 95th/Dan Ryan Red Line CTA Station location provides 24/7 access to the Public Health Vending Machine.
Considering non-fatal overdoses are more likely to occur in the late afternoon and evenings[1], these limited hours don’t cover the times when individuals are more likely to need the life-saving effects of NARCAN[2]. In order to provide the care that is needed at the times that it is needed; these vending machines should be placed where they can operate continuously.
Besides longer hours, Chicago also needs more of these vending machines. Despite the Centers for Disease Control and Prevention (CDC) reporting that 2024 experienced the first decrease in opioid overdose deaths since 2019, Chicago has seen a rise in opioid overdoses recently, and authorities are seizing record amounts of fentanyl. While opioid-related overdose deaths reached an all-time high of 1,400 in 2021 and have since stabilized around this range, it is still essential to create and sustain public health measures such as the Public Health Vending Machines that address this epidemic within Chicago and nationwide.
Compared to other causes of death in 2022, there were “more opioid-related overdose deaths in Chicago (1,397) than homicides and traffic crash fatalities combined.” During that same year, Chicago experienced 695 homicides and 201 traffic fatalities. Chicago still has a long way to go in finding sustainable, long-term solutions to decrease the number of fatalities due to opioid use, but the Public Health Vending Machines are a step in the right direction.
Additionally, these vending machines help in decreasing the gap in life expectancy between Black and non-Black residents of Chicago. The opioid epidemic disproportionately affects Black Chicagoans, with “opioid-related overdose deaths [being] one of the primary drivers in the life-expectancy gap between Black and non-Black Chicagoans.” By providing valuable tools for decreasing deaths from opioid overdoses[3], the Public Health Vending Machines can help address this gap in life expectancy. This is especially valuable as the majority of form respondents for the vending machines self-report their race as African American/Black. Thus, the Public Health Vending Machines directly impact some of the issues that are causing the life-expectancy gap.
The locations of the Public Health Vending Machines also matter. Between 2018 and 2022, there have been around 158 opioid-related overdose deaths on the CTA, with a notable near-doubling of deaths (31 to 60) between 2021 and 2022. Despite this, 95th/Dan Ryan is the only CTA station with one of these vending machines. By adding more of these vending machines to CTA stations, there would be increased access to NARCAN as well as Fentanyl and Xylazine test kits, resulting in fewer opioid-related overdose deaths[4]. West side communities are also in need of more machines. In the last three years, 34% of all opioid-related overdose EMS responses have been in the West Side communities of Austin, Humboldt Park, North Lawndale, East Garfield Park, and West Garfield Park. By adding the Public Health Vending Machines to community areas in these neighborhoods, Chicago would likely see a significant drop in opioid-related overdoses and, thus, fewer opioid-related overdose deaths.
As a result of the ongoing national opioid settlement, Illinois has already received $199.5 million as of December 31, 2023, to address various aspects of the opioid epidemic affecting the state. Thus, with each Public Health Vending Machine costing only $12,000 to the City, Illinois has the money to install more of these vending machines in the areas of Chicago that need them most.
During their short time in Chicago, the Public Health Vending Machines have already been put to good use, providing residents of Chicago with the harm reduction and opioid overdose prevention supplies that are so desperately needed in the city. By extending the pilot and adding more of these vending machines, the Chicago Department of Public Health can directly prevent opioid-related overdose deaths in the city and increase the well-being of all Chicagoans.
[1] Madah‐Amiri, Desiree, Thomas Clausen, Lars Myrmel, Guttorm Brattebø, and Philipp Lobmaier. “Circumstances surrounding non‐fatal opioid overdoses attended by ambulance services.” Drug and alcohol review 36, no. 3 (2017): 288-294.
[2] Rzasa Lynn, Rachael, and J. L. Galinkin. “Naloxone dosage for opioid reversal: current evidence and clinical implications.” Therapeutic advances in drug safety 9, no. 1 (2018): 63-88.
[3] Ibid.
[4] Ibid.
Disclaimer: Opinions expressed are solely my own and do not express the views or opinions of my employer.
