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Q&A
Tracking syringe returns and measuring program effectiveness
0:21:28
ยท
5 min
Council Member Linda Lee inquires about methods for tracking syringe returns and measuring the effectiveness of syringe service programs (SSPs). Rebecca Linn-Walton explains the challenges and current practices in measuring syringe returns.
- Exact one-to-one tracking is not implemented due to safety concerns and potential negative impacts on program participation
- Bulk measurement methods are used to estimate the number of syringes returned
- SSPs offer multiple disposal options, including at-home disposal, to promote safety
- Research indicates that syringe litter often comes from individuals not accessing SSPs
- The focus is on engaging more people in services rather than strict syringe counting
Linda Lee
0:21:28
Okay.
0:21:31
And then know in the testimony you mentioned that concerns regarding the requirement to collect syringes distributed by the program, sort of touching upon the point you brought, distributed by the program but not returned by program participants.
0:21:43
So do you know what the current percentages is right now of participants that return their needles?
0:21:50
In other words, what is that correlation between the rationale that you accessible as possible for them to return it?
0:21:58
What's the current percentage of folks that do versus why these needles end up all over the place in you know in the neighborhood?
Rebecca Linn-Walton
0:22:04
Yeah, so there's a couple factors going on here.
0:22:07
So one is that we know from decades and decades of experience that community syringes are not all coming from SSPs.
0:22:13
On top of the 14 providers, there's hundreds of other places to access syringes because we want people with diabetes and other illnesses that require syringes to have both safe syringes and disposal.
0:22:26
On top of that, we also know that the escalated opioid crisis is meaning that many people are getting syringes outside of both of these opportunities.
0:22:34
And that's why the outreach teams being in the streets talking to people that they haven't previously engaged is so vital to the outcome because we know there's a large number of syringes and lots of cities have found this too, that they're not coming.
0:22:47
So we don't unfortunately tell you every for every syringe, this one's coming back because we know that that causes a chilling effect.
0:22:56
And other cities when they've implemented things like this, people don't come in for services, which means that they're immediately going to non safe ways of getting syringes.
Linda Lee
0:23:05
But is there a way to track that internally meaning if because I've been to some of these SSPs and I think they're doing really great work and I know it's very very challenging and it's also interesting because of how the dynamic is in some of the neighborhoods that they are in.
0:23:22
And so I you know this is like my social work hat coming on but you know I think a lot of the services they provide aside from the needle exchange programs incredibly important and it does give them that space to come in.
0:23:36
So but just out of curiosity, is there a way though, going back to my question, to track it internally meaning in a way that is not prohibiting them from feeling comfortable from coming in, but like if if I, Linda Lee, take one, can you track to see if I bring one back?
0:23:53
Like not in terms of the exact, you know, is there a way to track that
Rebecca Linn-Walton
0:23:56
or The one for one causes what we know will be a huge danger to workers because what you're asking them to do is sit there looking through bags.
0:24:05
So what they've done over the decades of these programs is come up with ways to measure bulk.
0:24:10
And so we measure how many syringes are coming back in our receptacles, in the parks receptacles and kiosks.
0:24:17
And we do so by saying what's the weight of the bag and you divide it by the weight of a syringe and that keeps everyone safe and healthy because we don't want needle stick injuries to the community workers who live in these very communities that they're surveying.
0:24:31
So it isn't a one for one, but we are aware that they also get back large numbers of syringes.
0:24:36
All of the providers of syringes across the city also receive back a large number.
Linda Lee
0:24:42
Okay.
0:24:42
Sorry.
0:24:42
So let me rephrase my question a little bit because I definitely don't want to not that I didn't mean literally one for one sort of because obviously we want people to be safe, but is there a way to figure out, and I guess you're kind of alluding to that, is that based on the number of participants that we have in the program versus the weight let's just say of the needles that are brought back, you can sort of guesstimate about how much percentage wise people are actually bringing back to the centers, right?
0:25:08
Is that accurate?
Rebecca Linn-Walton
0:25:08
Don't collect it like that because we offer so many at home options to dispose of.
0:25:14
The same way that when you pick up your syringes with your insulin, we don't want you bringing it back to the You get that freedom to dispose of it in your home.
0:25:23
And also just want to share as well that because we know that seventy percent of overdoses occur in private homes, we know the vast majority of people using substances are doing so in their own homes.
0:25:34
And so providing them receptacles so that when they throw it out in their garbage, it's also not injuring any sanitation workers makes everyone safer.
Linda Lee
0:25:42
Yeah, okay so then let me rephrase my question again because I think the root of my question that I'm trying to get is how are we making sure that this is actually working in the sense, in the broader sense right.
0:25:54
You know obviously taking into factor that we want people to dispose of them safely, definitely 100% whether you're in home or somewhere else like obviously we want safe disposals but is there a way to track if you have all these folks that are coming in for the program that these you know that that I'm just trying to get a broader sense of if this is actually working
Rebecca Linn-Walton
0:26:15
in a I know it seems like it should be that you should give out as many as you give back.
0:26:21
Decades of research does show that you hand out more than you give back because you're offering at home opportunities.
0:26:28
So the syringe litter teams have picked up almost 200,000 syringes, I believe was the number for last year.
0:26:35
And so they pick up many, many, many syringes.
0:26:38
They get many, many syringes.
0:26:40
Or it may have been a combination of the outreach teams actually and the disposal kiosks as well was the almost 200,000.
0:26:46
So they're getting a huge quantity.
0:26:49
But the issue we're trying to solve for is the people who aren't accessing the SSPs, which is what a lot of research in cities are telling that's where the bulk of ground syringe litter comes from.
Linda Lee
0:27:02
Okay.
0:27:03
Sorry.
0:27:03
I'm just thinking in my head right now.
Rebecca Linn-Walton
0:27:05
Okay.
0:27:05
And public health is always very long and complicated, which makes it seem like there should be an easier answer to it, and I apologize that we're all struggling through this.
Linda Lee
0:27:15
No it's I know public health I mean because again through my former you know work in the nonprofit sector we did a lot of public health work which is more looking at you know for example we did a whole you know a lot of Asian Americans for example have very high you know blood pressure hypertension and so it was a lot of long term solutions with working with the grocers, the restaurants, all of those solutions to try and figure out how do we change the behavior of the community from a community perspective.