A local newspaper reports a Muskegon County, Michigan, man found with heroin needle in arm in a parking lot.

That is not uncommon, and is a situation that ambulance crews and other first aider’s will be familiar with. So, what to do?

Firstly will be care of the individual, which in itself can be particularly challenging and often rather unrewarding. The needle must be removed, and disposed safely.

The situation does give a lie to the expectation that placing sharps bins in those areas where IV drug abusers congregate will reduce the incidence of carelessly discarded sharps. If the drugs do their job, either as the user might hope for or less safely due to contaminants and adulterants, then the individual will be in a fit state to consider sharps safety and the welfare of others.

Safety sharps may help, but who will pay for these, and then risk a backlash from the moral majority when teaching addicts and others just how to use them?

Passive, spring loaded safety sharps might work, and have the advantage of preventing reuse thus eliminating needle sharing. But they are expensive and if any safety system is to be used it will most likely be the much cheaper active safety device. These require the user to flip over a sheath, that can be later removed to allow the syringe to be reused. However, if an addict cannot even withdraw a needle from their arm, then the advantaged of any safety engineered needle device is as slight as a sharps bin for field use in local hot spots of drug abuse.

Safety sharps can help reduce the incidence of needle and syringe sharing. Thus, without any additional impact on reducing risks from sharps injury, the public health advantage of reduced needle sharing is reason enough to go ahead. This would be money well spent.

Getting these needles into sharps bins is a key goal and we support it fully. But don’t expect that it will be hugely successful.