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The Washington Needle Depot: fitting healthcare to injection drug users rather than injection drug users to healthcare: moving from a syringe exchange to syringe distribution model.

Small D, Glickman A, Rigter G, Walter T - Harm Reduct J (2010)

Bottom Line: Distribution and retrieval are co-existent in the exchange model.Likewise, limitations on how many needles can be received at a time compel addicts to have multiple points of contact with professionals where the virtues of treatment and detox are impressed upon them.Further, the experience of IDUs is utilized, through paid employment, to provide a vulnerable population of people with clean syringes to prevent HIV and HCV.

View Article: PubMed Central - HTML - PubMed

Affiliation: PHS Community Services Society, 20 West Hastings Street, Vancouver, BC, V6B 1G6, Canada.

ABSTRACT
Needle exchange programs chase political as well as epidemiological dragons, carrying within them both implicit moral and political goals. In the exchange model of syringe distribution, injection drug users (IDUs) must provide used needles in order to receive new needles. Distribution and retrieval are co-existent in the exchange model. Likewise, limitations on how many needles can be received at a time compel addicts to have multiple points of contact with professionals where the virtues of treatment and detox are impressed upon them. The centre of gravity for syringe distribution programs needs to shift from needle exchange to needle distribution, which provides unlimited access to syringes. This paper provides a case study of the Washington Needle Depot, a program operating under the syringe distribution model, showing that the distribution and retrieval of syringes can be separated with effective results. Further, the experience of IDUs is utilized, through paid employment, to provide a vulnerable population of people with clean syringes to prevent HIV and HCV.

No MeSH data available.


Related in: MedlinePlus

Daisy receptacle. A repository for used syringes installed in a Vancouver park.
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Figure 4: Daisy receptacle. A repository for used syringes installed in a Vancouver park.

Mentions: In fact, a culture change in terms of our understanding about the process of retrieving syringes has occurred in the past ten years in Vancouver. Rather than linking the retrieval process to the point of distribution, the addict, we were separating the process of recovering used syringes from distributing new ones. It has become clear that retrieval of used needles is a practical matter of sanitation and public safety rather than something that has to be tied to needle exchange. This process was taking place at many levels. The City of Vancouver, for example, installed a needle receptacle, in the artful shape of a daisy, in a park adjacent to the Downtown Eastside during this period (see Figure 4). In analogy, if there is a problem with too much garbage in public parks, then it is a suitable public response to install more garbage cans. Similarly, with a goal to recover as many used syringes from the public spaces as possible, there can be increasing resources dedicated to this issue with a practical response: more receptacles for dirty needles and more people paid to pick them up with gloves and tongs. Needle receptacles were placed throughout the public spaces wherever addicts might require them and roving teams called "needle sweeps" were created. The VCH began to keep track of each area of the City of Vancouver as a separate zone to determine "hot spots" where more attention to needle pick-up might be required. Today it is also the standard of practice to install and maintain receptacles to retrieve used syringes within social (government funded) housing in Vancouver.


The Washington Needle Depot: fitting healthcare to injection drug users rather than injection drug users to healthcare: moving from a syringe exchange to syringe distribution model.

Small D, Glickman A, Rigter G, Walter T - Harm Reduct J (2010)

Daisy receptacle. A repository for used syringes installed in a Vancouver park.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2806876&req=5

Figure 4: Daisy receptacle. A repository for used syringes installed in a Vancouver park.
Mentions: In fact, a culture change in terms of our understanding about the process of retrieving syringes has occurred in the past ten years in Vancouver. Rather than linking the retrieval process to the point of distribution, the addict, we were separating the process of recovering used syringes from distributing new ones. It has become clear that retrieval of used needles is a practical matter of sanitation and public safety rather than something that has to be tied to needle exchange. This process was taking place at many levels. The City of Vancouver, for example, installed a needle receptacle, in the artful shape of a daisy, in a park adjacent to the Downtown Eastside during this period (see Figure 4). In analogy, if there is a problem with too much garbage in public parks, then it is a suitable public response to install more garbage cans. Similarly, with a goal to recover as many used syringes from the public spaces as possible, there can be increasing resources dedicated to this issue with a practical response: more receptacles for dirty needles and more people paid to pick them up with gloves and tongs. Needle receptacles were placed throughout the public spaces wherever addicts might require them and roving teams called "needle sweeps" were created. The VCH began to keep track of each area of the City of Vancouver as a separate zone to determine "hot spots" where more attention to needle pick-up might be required. Today it is also the standard of practice to install and maintain receptacles to retrieve used syringes within social (government funded) housing in Vancouver.

Bottom Line: Distribution and retrieval are co-existent in the exchange model.Likewise, limitations on how many needles can be received at a time compel addicts to have multiple points of contact with professionals where the virtues of treatment and detox are impressed upon them.Further, the experience of IDUs is utilized, through paid employment, to provide a vulnerable population of people with clean syringes to prevent HIV and HCV.

View Article: PubMed Central - HTML - PubMed

Affiliation: PHS Community Services Society, 20 West Hastings Street, Vancouver, BC, V6B 1G6, Canada.

ABSTRACT
Needle exchange programs chase political as well as epidemiological dragons, carrying within them both implicit moral and political goals. In the exchange model of syringe distribution, injection drug users (IDUs) must provide used needles in order to receive new needles. Distribution and retrieval are co-existent in the exchange model. Likewise, limitations on how many needles can be received at a time compel addicts to have multiple points of contact with professionals where the virtues of treatment and detox are impressed upon them. The centre of gravity for syringe distribution programs needs to shift from needle exchange to needle distribution, which provides unlimited access to syringes. This paper provides a case study of the Washington Needle Depot, a program operating under the syringe distribution model, showing that the distribution and retrieval of syringes can be separated with effective results. Further, the experience of IDUs is utilized, through paid employment, to provide a vulnerable population of people with clean syringes to prevent HIV and HCV.

No MeSH data available.


Related in: MedlinePlus