Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #117446

Josiah D. Rich, MD, MPH¹, AK DeLong, PhD², Joseph Hogan, PhD³, Meena Mehrotra, MD⁴, SE Reinert, PhD⁴, and Francis A. Wolf, BA⁵. (1) Department of Medicine, The Miriam Hospital /Brown University, 164 Summit Avenue, Providence, RI 02906, (401) 793-4770, Josiah_Rich@brown.edu, (2) Center for Statistical Studies, Brown University, Box G-A, Providence, RI 02912, (3) Center for Statistical Sciences, Brown University, 167 Angell Street, 2nd Floor, Providence, RI 02906, (4) Department of Immunology, The Miriam Hospital /Brown University, 164 Summit Avenue, Providence, RI 02906, (5) Department of Immunology, The Miriam Hospital, 164 Summit Avenue - CFAR Bldg., Providence, RI 02906

BACKGROUND About one-third of U.S. AIDS is attributed to syringe sharing, mostly as a direct result of laws restricting syringe access. In 2000, Rhode Island (RI) legalized syringes, whereas in Massachusetts (MA), syringes remain illegal. We surveyed drug users in MA and RI to determine effects of the law change. METHODS Drug detoxification inpatients in RI (247) and MA (226) were surveyed October, 2001-August, 2003. RESULTS The populations had similar age, gender, race and drug of choice (heroin). Access to safe syringes was reported in 85% in RI and 42% in MA (p<0.001). Participants from MA were >10X as likely to always use a contaminated syringe (p=0.002), and reused syringes more (11.2 vs. 8.5) (p=0.004). Since the location of detoxification facility is not a direct measure of an individual's access to safe needles, the method of instrumental variables, with state used as the instrument, was used to quantify the direct effect of safe access on risky needle use behaviors. Access to safe needles leads to a 55% reduction in short-term (30 day) sharing rates (95% CI 18%-92%), 30% more individuals able to obtain all syringes as needed (95% CI 6%-54%), and an 82% reduction in the number of times syringes are reused (95% CI 56%-93%). CONCLUSIONS We found a dramatic reduction in syringe sharing and reuse after the law was changed in RI, which did not occur in neighboring MA. Legalizing syringe purchase and possession reduces risky injection practices.

Learning Objectives: At the end of the session participants will be able to

• identify the differences in syringe availability in RI and MA
• discuss the impact that these differences have on safer injection practices in the two states
• identify various strategies for increasing sterile syringe access for injection drug users

Keywords: Injecting Drug Use, Syringe Sources

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.