How Can We Reduce Hypodermic Needle Pollution?

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Workshop for the County of Santa Cruz Civil Rights Community

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Hello Everybody,

I attended the forum last night (4/10) on "Drugs, Public Health, and Needle Exchange" and was surprised by the extensive amount of research that has been done on the subject by Alex Kral (http://www.rti.org/newsroom/experts.cfm?obj=18DF4C3E-7160-4B6D-AA9F842CEC5FF5B2) and his colleagues.

There are some acronyms in the link that are not intuitive. SEP = Syringe Exchange Program (AKA Needle Exchange). IDU = Intravenous Drug User.

Here are some conclusions of the studies (and there have been over 20 of such studies):

-Needle Exchanges help remove littered needles from communities. If Santa Cruz were to remove its Needle Exchange, more needles would be littered.

-Needle Exchanges need to be located in places where drug users have access to them. When the Santa Cruz Needle Exchange was moved to Emeline Ave., it was 40% less busy because of the remoteness of that location. The Sentinel article that Brittany Powers linked to (http://www.santacruzsentinel.com/localnews/ci_22503200/santa-cruz-needle-exchange-delivers-twice-that-santa) mentioned how Santa Clara's Needle Exchange was much less busy than the Needle Exchange in Santa Cruz even though Santa Clara had a much higher population. This is not a good thing for Santa Clara. A Needle Exchange does not become more effective when it hands out fewer needles. Drug users won't go to a Needle Exchange if it doesn't give them as many needles as they need, and the benefits of needle exchanges won't be realized if drug users aren't going to the needle exchange.

-Needle Exchanges get people into recovery. When drug users attend Needle Exchanges, they start to use less drugs. This conclusion is totally derived from research. Please view the linked presentation in the "Resource URL" to see the specific statistics. There exists this notion in the community that since Needle Exchanges hand out needles, they must be increasing drug use among the participants. This is the opposite of the truth.

-Furthermore, research shows that the more liberal a Needle Exchange's distribution policy is, the less littered needles there are. This is because drug users don't go to Needle Exchanges that won't give them as many needles as they need. In the debate about our local Needle Exchange program, people often say that the problem is that our Needle Exchange program was not requiring drug users to give in one dirty needles in order to receive one clean needle. It may seem counter-intuitive that the more freely a Needle Exchange distributes needles, the less littered needles there are, but this is derived from research.

This research has never been effectively disputed, as far as I'm aware. The World Health Organization and the American Medical Association have endorsed Needle Exchanges. Giang Nguyen, the Director of the Santa Cruz County Health Services Agency, endorses this research and needle exchanges.

-The panelists noted that this research does not negate that Needle Exchanges can be a nuisance on neighborhoods. It was suggested that the Needle Exchange could rotate its location so as to "spread the burden". I found this to be a sensible suggestion. It was repeatedly reiterated, though, that Needle Exchange should not be pushed out of the urban core of Santa Cruz (like it has been with the move to the Emiline Ave location).

As Craig Reinarman (esteemed researcher of drugs, politics, and society) said at the forum last night, "there is no good drug policy, just a less bad drug policy". Let's support Needle Exchange not because they ARE the solution to drug abuse and littered needles in Santa Cruz, but because they are PART OF the solution. He also said, with a great deal of wit:

"scapegoating of the helpless is like a 60 second crack high- it feels good for a little bit, then it stops working and you've only made the problem worse."

max pleaner from Santa Cruz, California, United States max pleaner
Originally posted 2013-04-11 19:09:37 815 views
Please keep comments civil and on-topic. Submit
Robert Singleton Robert Singleton (facilitator) CMO and Founder, Civinomics from Santa Cruz, California

Thanks for the thorough post Max, unfortunately I am not sure if the link is working.

Added 2013-04-12 08:57:55
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Thank you for letting me know. The link is now fixed. I wanted to mention to you, though, something incorrect that you wrote in the "overview" section for this topic. You wrote that "the exchanges are designed to work on a strict one to one basis". Needle exchanges do not all have the same policies (one for one, one for one plus, etc.). There is no proof that one-for-one is the best policy, nor is one-for-one generally understood as the best practice, to the best of my understanding. In fact, more liberal needle distribution is associated with a better functioning needle exchange, including less littered needles and less disease. There is no significant challenge to research showing that needle exchanges cause a net decrease in littered needles, but this by no means implies that "strict one for one" is the best practice. As of now, your overview section is misleading. I think you should change it to remove the false assertion.

If littered needles in Santa Cruz were to have increased (I am neither challenging or defending this assertion), it would probably be more of a result of external factors that prevent drug users from visiting needle exchanges in the first place. I'll give a couple examples. 1. It's illegal for people to be carrying used needles. If drug users see police, they may litter the needles rather than risk facing arrest. 2. There have been enacted significant legal barriers to homeless people and other nonconformists to simply exist in urban areas of Santa Cruz. They are then driven out of the urban areas and into the woods, where they don't have access to needle exchange and can't safely dispose of their needles. See: https://scruzwiki.org/Sit-Lie_Ordinances https://scruzwiki.org/Sleep_%26_Camping_Ordinances

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Robert Singleton Robert Singleton (facilitator) CMO and Founder, Civinomics from Santa Cruz, California Parent

Max, thank you for the reply. I do need to include more information in my background section about the different practices of needle exchanges and research behind them. It is still a work in progress.

Added 2013-04-14 14:06:02
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Max, Thank you again for your contributions! If possible, we would like to discuss this issue a bit more with you, would you mind sending an email to info@civinomics.com?

Added 2013-04-16 10:56:15
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could you please provide links to the actual references, not just the conclusions? that would be more convincing.

Added 2013-07-11 14:08:33
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if you click the link to the presentation, you can see the names of the studies used. Here's some links to studies, though: https://drive.google.com/folderview?id=0BxB9r3VV-NTUYkJwNmtBRHBOMFE&usp=sharing Note: you might have to make a google account to view them.

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