Objective: One hypothesis is that needle exchange programs increase drug use. We performed a study in which injection drug users (IDUs) were randomized to conditions so that the effect of needle exchange could be rigorously assessed. Method: We recruited 652 current IDUs in Anchorage Alaska and randomly assigned 318 to a needle exchange condition (NEP) and 337 to a pharmacy sales condition. The Risk Behavior Assessment (RBA) was obtained at baseline; the Risk Behavior Followup Assessment (RBFA) was obtained on 379 at six-month followup, and 254 at 12-month followup. The number of participants was approximately equal between both assignments at all three times. Initial recruitment has ended, but followup will continue until July 31, 2000. The dependent variable (dv) was the number of injections in the 30 days before interview. Because the dv was skewed to the right and there were several outliers, we transformed the data using the LOG10 function in SAS. Findings: Using 221 complete observations in PROC GLM there was a significant main effect of time on number of injections (F(2, 218)=130.6, p=.0001. The time by assignment interaction was not significant (F(2, 218)=0.61 NS. Using all of the data in PROC MIXED with an unstructured covariance the main effect (F(2, 653)=316.7, p=.0001, and interaction effect (F(2, 653)=0.13 NS) findings were replicated. Conclusions: Our randomized controlled trial failed to find evidence to support the hypothesis of NEP causing an increase in drug use. It is implausible that continued followup will substantially change these results.
Learning Objectives: During this session, faculty will discuss research regarding the relationship between needle exchange and injection drug use
Keywords: Injection Drug Users, Needle Exchange
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: National Institute on Drug Abuse SAS Institute Inc
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Funding for this research was provided in part by grant number R01 DA10181 from the National Institute on Drug Abuse. Funding for the needle exchange was provided by a grant from the Alaska Science and Technology Foundation to the Alaskan AIDS Assist
The 128th Annual Meeting of APHA