Drug-Users' Needles Endanger Public, Study Shows

A new study comparing needle disposal practices in Miami and San Francisco illustrates how legislative support for harm-reduction strategies like needle exchange can impact transmission rates of diseases like HIV and hepatitis.

Hansel Tookes and colleagues at the University of Miami interviewed 448 injection drug users in the city's downtown area who admitted throwing away a total of 9,845 syringes during a one-month period. The IDUs either shared or sold some 700 needles. In all, 95 percent of the used needles were disposed of improperly -- in public trash cans, on sidewalks, in parks, into sewers and down toilets. By contrast, just 13 percent of used needles in San Francisco were improperly disposed of.

In 2009, IDUs accounted for 9 percent of new HIV infections in the United States, 15 percent of new hepatitis B cases and 44 percent of new hepatitis C infections. "Many [IDUs] contract these viral infections through the sharing of contaminated syringes," Tookes wrote. Non-IDUs are at risk of infection "through accidental needle-sticks from unsafely disposed contaminated syringes," though such transmissions are rare.

San Francisco has had needle-exchange programs since 1988. Florida law bans NEPs, so it is not among the 32 states in which 220 such programs are distributing 30 million clean needles, according to the North American Syringe Exchange Network.

A 2009 study in the Journal of Urban Health reported that 12 percent of San Francisco IDUs were HIV-positive, compared to 23 percent of IDUs in Miami-Dade.

Tom Liberti, chief of the Florida Department of Health HIV/AIDS Bureau, said he would support NEPs on the grounds they reduce disease; however, no legislation is in process to repeal the ban, which has been on the books for more than a decade.

The study, "A Comparison of Syringe Disposal Practices Among Injection Drug Users in a City With Versus a City Without Needle and Syringe Programs," was published in Drug and Alcohol Dependence (2011; http://dx.doi.org/10.1016/j.drugalcdep.2011.12.001).

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