Department of Medicine, University of Miami, 1120 NW 14thSt., Miami, FL, 33136, USA.
RTI International, 351 California Street, Suite 500, San Francisco, CA, 94104, USA.
Drug Alcohol Depend. 2019 Sep 1;202:13-17. doi: 10.1016/j.drugalcdep.2019.04.025. Epub 2019 Jun 29.
Due to the increase in people who use opioids in the US, there has been a steady increase in injection drug use. Without access to safe syringe disposal locations, people who inject drugs (PWID) have few options other than improper disposal, including in public places. In 2016, Florida's first legal Syringe Services Program (SSP) was established in Miami. This study aims to compare syringe disposal practices among PWID before and after the implementation of an SSP.
Visual inspection walkthroughs of randomly selected census blocks in the neighborhoods in the top quartile of narcotics-related arrests were conducted to assess improperly discarded syringes. Syringe location was geocoded in ArcGIS. Adult PWID pre-SSP (n = 448) and post-SSP (n = 482) implementation were recruited for a survey using respondent-driven sampling in Miami. A Poisson regression model was used to determine the adjusted relative risk (aRR) of improper syringe disposal pre- and post-SSP.
A total of 191 syringes/1000 blocks were found post-implementation versus 371/1000 blocks pre-implementation, representing a 49% decrease after SSP implementation. In the surveys, 70% reported any improper syringe disposal post-SSP implementation versus 97% pre-SSP implementation. PWID in the post-implementation survey had 39% lower adjusted relative risk (aRR = 0.613; 95% CI = 0.546, 0.689) of improper syringe disposal as compared to pre-implementation.
There was a significant decrease in the number of improperly discarded syringes in public in Miami after the implementation of an SSP. Providing PWID with proper disposal venues such as an SSP could decrease public disposal in other communities.
由于美国使用阿片类药物的人数增加，注射毒品的使用也在稳步增加。由于无法获得安全的注射器处理地点，注射毒品者（PWID）除了不当处理外，几乎别无选择，包括在公共场所。2016 年，佛罗里达州第一个合法的注射器服务项目（SSP）在迈阿密成立。本研究旨在比较 SSP 实施前后 PWID 的注射器处理行为。
对毒品相关逮捕数量最高的街区进行随机人口普查块的目视检查，以评估不当丢弃的注射器。将注射器位置在 ArcGIS 中进行地理编码。在迈阿密使用回应者驱动抽样法招募了 SSP 实施前（n=448）和实施后（n=482）的成年 PWID 进行调查。使用泊松回归模型确定 SSP 实施前后不当注射器处理的调整相对风险（aRR）。
实施后共发现 191 个/1000 个街区的注射器，而实施前为 371 个/1000 个街区，实施 SSP 后下降了 49%。在调查中，70%的人报告说实施 SSP 后有任何不当的注射器处理，而实施 SSP 前为 97%。与实施前相比，实施后调查中的 PWID 不当注射器处理的调整相对风险（aRR=0.613；95%CI=0.546，0.689）降低了 39%。
在迈阿密实施 SSP 后，公共场合不当丢弃的注射器数量显著减少。为 PWID 提供适当的处理场所，如 SSP，可以减少其他社区的公共处理。
