Glick Sara N, Tinsley Joe, Wirkman Laura Pritchard, Mallya Apoorva, Cleary Peter, Golden Matthew R, Fitzpatrick Thomas
University of Washington, School of Medicine, Division of Allergy and Infectious Diseases, Seattle, WA, United States.
Public Health - Seattle & King County, HIV/STI/HCV Program, Seattle, WA, United States.
Drug Alcohol Depend Rep. 2024 Nov 19;13:100301. doi: 10.1016/j.dadr.2024.100301. eCollection 2024 Dec.
Syringe services programs (SSPs) serve as key platforms to deliver harm reduction services to people who use drugs (PWUD). Changes in drug supply and drug consumption behaviors, particularly the increasing use of fentanyl through non-injection methods, may impact SSP utilization.
We collected routine program data from three SSPs in King County, Washington. Trends in the annual number of syringes distributed and client encounters were assessed using joinpoint regression analysis to determine when statistically significant changes in trends in annual totals occurred and annual percent change (APC) during each period.
The number of syringes distributed per year through King County SSPs reached a maximum of 8,733,413 in 2020 and then decreased sharply to 2,482,056 by 2023. Annual syringe distribution totals were stable or increasing during all periods from 1989 to 2020 (APC range: 2.0-35.3 %), and only developed a decreasing trend between 2020 and 2023 (APC=-32.8 %). Total number of SSP client encounters per year was stable between 2010 and 2023 (APC=0.7 %), but an increasing trend in encounters was identified starting in 2008 (APC=4.4 %) at a community-based SSP that distributed safer smoking supplies (pipes).
A precipitous decline in syringe distribution through King County SSPs began in 2020 and continued through 2023, which coincided with increasing availability of fentanyl in the local drug market. Nevertheless, the trends in client encounters highlight that PWUD continued to seek harm reduction services, with preliminary evidence that distribution of safer smoking supplies may increase the number of client visits.
注射器服务项目（SSP）是为吸毒者（PWUD）提供减少伤害服务的关键平台。毒品供应和吸毒行为的变化，特别是通过非注射方式越来越多地使用芬太尼，可能会影响注射器服务项目的利用率。
我们收集了华盛顿州金县三个注射器服务项目的常规项目数据。使用连接点回归分析评估每年分发的注射器数量和客户接触次数的趋势，以确定年度总数趋势何时发生统计学上的显著变化以及每个时期的年度百分比变化（APC）。
2020年，金县注射器服务项目每年分发的注射器数量达到最多8733413支，到2023年急剧下降至2482056支。1989年至2020年的所有时期，每年注射器分发总数稳定或增加（APC范围：2.0-35.3%），仅在2020年至2023年期间呈下降趋势（APC=-32.8%）。2010年至2023年期间，注射器服务项目的客户接触总数稳定（APC=0.7%），但从2008年开始，在一个分发更安全吸烟用品（烟斗）的社区注射器服务项目中发现客户接触次数呈增加趋势（APC=4.4%）。
2020年开始并持续到2023年，金县注射器服务项目的注射器分发量急剧下降，这与当地毒品市场芬太尼供应增加相吻合。尽管如此，客户接触次数的趋势表明吸毒者继续寻求减少伤害服务，初步证据表明分发更安全的吸烟用品可能会增加客户就诊次数。
