A response to a recent message from a concerned community member about finding a syringe:

Thank you for writing. The answer to your question “Is there anyway to decrease the likelihood that a person using drugs will improperly dispose of their used needles?” is yes, there are two very simple solutions: Stop arresting them for felonies for possessing syringes and open a Safe Consumption Site.

Syringes being found in public spaces are unfortunately not a new phenomenon. Injection drug use skyrocketed between 2004 to 2014, as younger Americans (ages 18-39) saw an 817 percent increase in admissions for injection of prescription opioids and a 600 percent increase in admissions for heroin injection (CDC, 2017). This has led to more syringes being found in public spaces in Indiana, and finally to the Indiana state legislature increasing the penalty of possession of a syringe from a misdemeanor to a felony in 2014. They did this to deter people from possessing syringes. It has not worked. In fact, it has had the opposite effect, as the number one reported reason for people improperly disposing their syringes is fear of felony arrest.

I want to point at that these increases in injection drug use and improper disposal occurred many years before the first Syringe Service Programs (SSP) were sanctioned by the State of Indiana.

Unfortunately, the State of Indiana did not decriminalize syringes when it sanctioned syringe service programs to distribute them 3 years ago, in large part due to resistance from the Indiana Prosecuting Attorneys Council (IPAC). Also unfortunate is that local police (Indian State Police being the worst offenders) have doubled their arrests for felony possession of a syringe, even as the local prosecutor uses their discretion to drop those charges once the person is identified as an IRA participant. We need our police to use their discretion to stop charging people for possession of syringes, as well as state legislators to stand up to IPAC and decriminalize the possession of syringes. This would result in a decrease in accidental needle sticks to law enforcement (McCampbell 2000), as well as decreasing improper disposal. One of the most effective ways to decrease improper disposal of syringes is to open a Safe Consumption Space (Kinnard, 2014).

We offered to purchase small, tamper proof sharps disposal units for the City of Bloomington Parks Department to install in their parks, they have refused.We offered to purchase small, tamper proof sharps disposal units for the Monroe County Public Library to install in their bathrooms, they have refused. We offered to purchase small, tamper proof sharps disposal units for the City of Bloomington to install downtown, they have refused.

Finally, I want you to know that there is very little risk [“practically negligible” (Riddell, 2015)] of viral disease transmission from a community found syringe. Conditions for viral disease transmission between two people sharing equipment or in an occupational or health care setting is much different than an accidental needle stick from a community found syringe (ANS/CFS). In fact, there has never been a reported case of HIV transmission from a ANS/CFS. (CDC, 2016) Ever. While it is natural to worry about children finding them, it is important to note that there has never been a case of viral Hepatitis or HIV transmission to a child from am ANS/CFS (Papenburg 2008).

Finally, local police continually refuse to respond to calls when community members find improperly disposed syringes, even reportedly threatening to arrest community members who ask them to dispose of syringes they find in the community. Instead, the Monroe County Health Department has been responding. Disposing of community found syringes is easy and safe. Wear gloves (because many times the needles are found in places where people are defecating and urinating, like in the bushes or the corners of abandoned buildings), and pick up the syringe by the barrel. Place it in a plastic container such as a pop bottle, Gatorade bottle or laundry detergent bottle. Tape the lid shut, write “Syringes DO NOT RECYCLE” and either bring it to the Health Department, IRA or Shalom Center, or you can deposit it in the trash yourself. Then wash your hands.

We have hundreds of volunteers on the lookout to pick these up when they see them, not because they’re dangerous, but because they are perceived as dangerous. Our return rates for used syringes are among the best in the country, and we will not further limit access because we know it increases risk fo disease transmission and does not reduce community found syringes (Bluthenthal, 2008). Education is crucial, as well as a change in law and law enforcement. We are working on all of these, and appreciate your help. Thank you, and please let us know if you have any questions. Attached is a brochure with even more information for you.

Best

IRA Crew

Sources:
Kinnard EN1, Howe CJ, Kerr T, Skjødt Hass V, Marshall BD. Harm Reduct J. 2014 Oct 28;11(1):29. doi: 10.1186/1477-7517-11-29.
Riddell A, Kennedy Tong CY British Medical Journal 2015 Sharps injuries in the community – same same but different
CDC 2017 https://www.cdc.gov/…/hepatitis-c-and-opioid-injection-pres…
Centers for Disease Control and Prevention. (2016). Updated Guidelines for Antiretroviral Postexposure Prophylaxis After Sexual, Injection-Drug Use, or Other Nonoccupational Exposure to HIV in the United States: Recommendations from the Centers for Disease Control and Prevention, U.S. Department of Health and Human Services. Retrieved from https://www.cdc.gov/…/programre…/cdc-hiv-npep-guidelines.pdf
Papenburg, J., Blais, D., Moore, D., & Al-Hosni, M., Laferriere, C., Tapiero, B., & Quach C. (2008). Pediatric Injuries from Needles Discarded in the Community: Epidemiology and Risk of Seroconversion. Pediatrics,122:2, e478-e492
Ricky N. Bluthenthal,1,2,* Rachel Anderson,3 Neil M. Flynn,3 and Alex H. Kral Drug Alcohol Depend. 2007 Jul 10; 89(2-3): 214–222. Published online 2007 Feb 5. doi: 10.1016/j.drugalcdep.2006.12.0354,5

Find A Syringe_ 8.10.18

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