Where have all the needles gone?

Data for Western Australia shows that, through needles and syringe programs (NSPs) around 3.5 million needles & syringes are distributed annually. Most of these are distributed to IV drug users (IDUs) as part of an entirely rational public health policy that is intended to reduce the transmission of bloodborne virus infection in this group. There is much evidence that the policy is successful, and Australia is to be applauded for taking the lead.

Nationally, the number increases to around 30,000,000 syringes annually. Australians self-inject at home to treat diabetes, allergies, HIV, rheumatoid arthritis, MS and other medical conditions and this adds to the total though the majority are provided to IDUs.

 But where do all of those syringes and needles go? There is no national policy or guideline for disposal, and each regional or local authority is left to make its own arrangements. This results in substantial variation in approach, and when compared the output and recovery data mismatch suggests that may syringes and needles ‘go missing‘.

The UK has a population around 3x that of Australia, and proportionally as many syringes and needles going out into the community. How many come back safely packaged in a sharps bin?

Unsafe disposal includes dumped syringes (drug litter), further syringe reuse, and syringes & needles finding their way into the domestic waste stream or onto recycling picking lines. The risks are self-evident.

Governments must take the lead to develop and effective strategy for disposal that does not criminalise. For prescribed users, policy must accommodate the necessary practicalities required to support patient care, and the often convoluted funding arrangements involving Local Authorities, PCTs (and their successors) and other healthcare Trusts including Foundation Trusts.

Regulators must be tasked to implement and supervise this policy, without a heavy administrative overhead  or unnecessary bureaucracy, using existing output and recovery data to monitor performance.

It’s a big task, though not difficult. But don’t hold your breath waiting for it to happen!

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