Does increased syringe access result in unsafe syringe disposal?

Background: New York's Expanded Syringe Access Demonstration Program (ESAP) permits the sale of non-prescription syringes to individuals >18 years. Policy considerations include the potential for unsafe needle/syringe disposal resulting in needle-stick injuries and subsequent risk of blood-borne disease transmission.

Methods: Law enforcement administrators (n=25), ESAP-registered pharmacists (n=359), and residential sharps collection program administrators (n=566) were surveyed between 2001 and 2006 to obtain attitudes and experiences regarding community syringe disposal issues.

Results: Twenty-five law enforcement agencies in NYS with >10 arrests for hypodermic instrument possession indicated that despite moderate/high levels of illegal drug activity in their jurisdictions, their agencies averaged <1 needle-stick injury during 2004. Less than 5% of pharmacies reported increases in the amount of used needles/syringes found on premises since ESAP implementation. While only 13% provide sharps disposal containers free of charge, 89% sell them and 86% were willing to distribute them if they were provided to pharmacies for free. Only 2% have disposal drop-boxes/kiosks on premises, however, 25% indicated willingness to have them installed. Almost half agreed that ESAP increased opportunities to promote safe syringe disposal.

Residential sharps collection programs (operated by NYS hospitals and nursing homes) reported an increase in hours of operation and community use of programs since ESAP implementation.

Conclusions: We found no evidence of increases in unsafely discarded needles/syringes following ESAP implementation. ESAP provides pharmacists with added opportunities to counsel customers about safe disposal. NYS already funds >80 community disposal sites. Pharmacies can be targeted as willingness to engage in disposal activities is high.