Dr. Sean Rourke shows staff and volunteers at Dixon Hall's affordable housing shelter in Toronto the services and features of the vending machine.Cole Burston/The Globe and Mail
In the former Bond Place Hotel in downtown Toronto, which is now a supportive housing building, a brightly decorated six-foot-tall vending machine is placed in the facility’s newly renovated lobby, ready to dispense items.
Instead of confectionery or other snacks, it distributes life-saving supplies – naloxone, clean syringes, HIV testing kits, personal hygiene products – for free.
Called Our Healthbox, and built by SMRT1 Health, an electronics company based in Nelson, B.C., the vending machine was launched at 65 Dundas Street East earlier this month. It is one of 14 such units installed across Canada since 2023. While a similar machine is stationed at Toronto’s specialty HIV hospital, Casey House, it is the city’s first Our Healthbox unit – and its first such machine to be located in a supportive housing building.
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Jolanta Radziszewska, a harm reduction and health supports supervisor for Dixon Hall, a multi-service agency that serves 10,000 of the city’s most vulnerable residents and operates the supportive housing building, said the machine breaks down barriers, allowing those in need to access these critical supplies “based on their own choices and at their own pace.”
Dixon Hall CEO Mina Mawani is hopeful the machines will make essential health supplies easily accessible.Cole Burston/The Globe and Mail
The machine at the Dixon Hall building is aiming to fill a gap as the Ontario government closes five supervised drug-use sites in Toronto and multiple across the province, which provided access to these supplies.
Mina Mawani, CEO of Dixon Hall, said she is hopeful the machine will “put essential health and wellness supplies directly into the hands of our residents,” with the larger goal of “providing support to the people society ignores.”
Sean Rourke, a clinical neuropsychologist at St. Michael’s Hospital in Toronto and developer of Our Healthbox, said the machines are effective because they provide 24/7 access to supplies, and provide care without prejudice.
“This is about more than just providing supplies – it’s about restoring dignity and trust in health care,” said Dr. Rourke.
The vending machines have been visited over 122,000 times since 2023, distributing more than 52,900 health and harm reduction supplies, according to Our Healthbox.Cole Burston/The Globe and Mail
Without these machines, users would have to consult a clinic for medical supplies, said Ms. Radziszewska, a process that can be alienating. “People feel uncomfortable, especially at clinics. Every time you get a new doctor, it’s a new person that you have to tell your story to, and this way you just press a couple of buttons, and the item comes out.”
Similar machines have been shown to save lives in other jurisdictions. Researchers in the U.S., who measured the impact of the implementation of vending machines that dispense naloxone in Las Vegas, found that expected overdose fatalities dropped by 15 per cent in the first year after the units were installed, according to a study published in 2022 in the peer-reviewed journal, Annals of Medicine.
Another study, published in the International Journal of Drug Policy, observed that syringe machines in Australasia and Europe had been shown to “enhance the availability of sterile injecting equipment.”
Since January, 2023, Our Healthbox vending machines have been visited over 122,000 times, distributing more than 52,900 health and harm reduction supplies, according to data provided by Our Healthbox.
But the vending machines have been met with some opposition.
Last summer, three hospitals on Vancouver Island suspended similar vending machines following scrutiny from a BC Conservative Party candidate, who argued that the machines would trap people in the addiction cycle.
Dr. Rourke was among several doctors who successfully fought back against opposition to the initiative in Hamilton, where city councillors voted last fall to allow a hospital to continue to supply syringes and pipes through a vending machine.
Doug Ford’s Progressive Conservative government says it is replacing the sites with Homeless and Addiction Recovery Treatment (HART) Hubs. The $378-million initiative will fund 19 HART hubs to provide “a safe and welcoming space for the client to identify their needs and access immediate support,” according to the province.
While supervised drug-use sites provided access to safer supplies such as clean pipes and syringes, the province said these HART hubs “will not offer so-called safer supply, supervised drug consumption, or needle exchange programs.”
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Experts warn that by not providing safer drug use supplies, individuals are at greater risk of preventable diseases. For instance, Hannah Stahl, a registered nurse with the Street Nurses Network who works in supervised drug-use sites, said individuals sometimes resort to smoking out of broken light bulbs, which are toxic, or reusing syringes for months at a time, which can spread diseases such as HIV.
The Ontario government’s direction has come under fire. Dr. Na-Koshie Lamptey, Acting Medical Officer of Health at Toronto Public Health, said in a report in January that the decision “will reduce access to an evidence-based clinical health care service, leading to an anticipated increase in preventable overdoses.”
Editor’s note: This article has been updated to clarify that the vending machine was built by SMRT1 Health, a wing of SMRT1 Technologies.