Increase Access to Needle Exchanges - Revision history

Mredden at 20:29, 5 February 2021

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Rwashington at 15:59, 2 October 2020

2020-10-02T15:59:02Z

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2020-03-24T21:54:18Z

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2020-03-24T21:51:23Z

← Older revision		Revision as of 20:29, 5 February 2021
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	This finding has been further substantiated by another review which found that supplying IDUs (Injecting Drug Users) with clean or sanitized needles does not lead to more "dirty" needles in a community. <ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC419716/</ref>		This finding has been further substantiated by another review which found that supplying IDUs (Injecting Drug Users) with clean or sanitized needles does not lead to more "dirty" needles in a community. <ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC419716/</ref>
		+
		+	= Impactful Federal, State, and Local Policies =

	= Promising Practices =		= Promising Practices =

@@ Line 29: / Line 29: @@
 This finding has been further substantiated by another review which found that supplying IDUs (Injecting Drug Users) with clean or sanitized needles does not lead to more "dirty" needles in a community.&nbsp;<ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC419716/</ref>
-== Promising Practices ==
+= Promising Practices =
 <span style="line-height:normal"><span style="font-family:"><span style="color:black">There are currently several different models for syringe exchanges that have different advantages and limitations. The models include:</span></span></span>
@@ Line 59: / Line 59: @@
 *<span style="color:black"><span style="line-height:normal"><span style="tab-stops:list .5in"><span style="vertical-align:baseline">This model, in addition to disseminating safer practices and helping make needle exchange programs reach a larger population, may have a psychological impact and help make interventions more effective.&nbsp;<ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5241304/</ref></span></span></span></span>
-<span style="color:black"><span style="line-height:normal"><span style="tab-stops:list .5in"><span style="vertical-align:baseline">'''Prison-Based Facilities''':</span></span></span></span>
+== <span style="color:black"><span style="line-height:normal"><span style="tab-stops:list .5in"><span style="vertical-align:baseline">Prison-Based Facilities</span></span></span></span> ==
 *<span style="color:black"><span style="line-height:normal"><span style="tab-stops:list .5in"><span style="vertical-align:baseline">Still a newly developing practice, only used in 3 of 24 UN countries that have needle exchange programs for the public.<ref>http://blogs.biomedcentral.com/on-health/wp-content/uploads/sites/8/2016/10/Prison-based-needle-and-syringe-programmes-PNSP-final.pdf</ref></span></span></span></span>

@@ Line 7: / Line 7: @@
 Many organizations have endorsed needle exchange including NIH (National Institute of Health), CDC (Center for Disease Control), the American Bar Association, the American Medical Association, the American Psychological Association, the World Health Organization and others.&nbsp;The NIH estimates that in the United States, between fifteen and twenty percent of injection drug users have HIV and at least seventy percent have hepatitis C.<ref>https://aasldpubs.onlinelibrary.wiley.com/doi/abs/10.1002/hep.1840360703 </ref> <span style="line-height:normal"><span style="color:black">As such sharing needles has become the most common mode of HIV transmission among injection drug users (IDUs). In addition, used syringes and needles are a potential biohazard within which users primarily reside, and beyond it as well.&nbsp;</span></span><span style="line-height:normal"><span style="color:black">Harm reduction services such as the provision of sterile needles and syringes can effectively prevent hepatitis C and HIV transmission among people who inject drugs, provided they are accessible and delivered at the required scale.</span></span>
 = Relevant Research =
@@ Line 23: / Line 29: @@
 This finding has been further substantiated by another review which found that supplying IDUs (Injecting Drug Users) with clean or sanitized needles does not lead to more "dirty" needles in a community.&nbsp;<ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC419716/</ref>
-== Importance for Harm Reduction Practice and Education ==
+== Promising Practices ==
 <span style="line-height:normal"><span style="font-family:"><span style="color:black">There are currently several different models for syringe exchanges that have different advantages and limitations. The models include:</span></span></span>

@@ Line 46: / Line 46: @@
 *<span style="color:black"><span style="line-height:normal"><span style="tab-stops:list 1.0in"><span style="vertical-align:baseline">Typically, mobile programs are more accessible to injection drug users and face less opposition from a community.</span></span></span></span>&nbsp;<span style="font-size:11.0pt"><span style="line-height:107%"><span style="font-family:"><span style="color:black"><ref>https://www.avert.org/professionals/hiv-programming/prevention/needle-syringe-programmes</ref></span></span></span></span>
-== <font color="#000000" face="calibri, sans-serif"><span style="font-size: 14.6667px">'''Dispensing Machine Distribution''':</span></font> ==
+== <font color="#000000" face="calibri, sans-serif"><span style="font-size: 14.6667px">Dispensing Machine Distribution</span></font> ==
 *<span style="color:black"><span style="line-height:normal"><span style="tab-stops:list .5in"><span style="vertical-align:baseline">A newer strategy, countries in Europe as well as Australia have begun to use syringe vending machines in addition to other forms of NSPs.</span></span></span></span>
@@ Line 53: / Line 53: @@
 *<span style="color:black"><span style="line-height:normal"><span style="tab-stops:list .5in"><span style="vertical-align:baseline">A clinical trial has found that this strategy can be highly effective for reaching populations who are most marginalized or otherwise hard to reach.</span></span></span></span><span style="font-size:11.0pt"><span style="line-height:107%"><span style="font-family:"><span style="color:black"><ref>https://www.avert.org/professionals/hiv-programming/prevention/needle-syringe-programmes</ref></span></span></span></span>
-== <font color="#000000"><font face="calibri, sans-serif"><span style="font-size:14.6667px">'''Peer Service Distribution Networks'''</span></font></font><span style="font-size:11.0pt"><span style="line-height:107%"><span style="font-family:"><span style="color:black">:</span></span></span></span> ==
+== <font color="#000000"><font face="calibri, sans-serif"><span style="font-size:14.6667px">Peer Service Distribution Networks</span></font></font> ==
 *<span style="color:black"><span style="line-height:normal"><span style="tab-stops:list .5in"><span style="vertical-align:baseline">Peer-based strategy, is a&nbsp;process where clients of needle exchanges provide service to their peers, distributing of needles, syringes, and associated injection equipment.</span></span></span></span>

@@ Line 2: / Line 2: @@
 = Overview =
-Needle exchange programs (NEPs) are programs which distribute sanitized needles in exchange for contaminated or used needles. NEPs reduce the spread of blood borne diseases like HIV and Hepatitis C. Many organizations have endorsed needle exchange including NIH (National Institute of Health), CDC (Center for Disease Control), the American Bar Association, the American Medical Association, the American Psychological Association, the World Health Organization and others.&nbsp;The NIH estimates that in the United States, between fifteen and twenty percent of injection drug users have HIV and at least seventy percent have hepatitis C.<ref>https://aasldpubs.onlinelibrary.wiley.com/doi/abs/10.1002/hep.1840360703 </ref> <span style="line-height:normal"><span style="color:black">As such sharing needles has become the most common mode of HIV transmission among injection drug users (IDUs). In addition, used syringes and needles are a potential biohazard within which users primarily reside, and beyond it as well.&nbsp;</span></span><span style="line-height:normal"><span style="color:black">Harm reduction services such as the provision of sterile needles and syringes can effectively prevent hepatitis C and HIV transmission among people who inject drugs, provided they are accessible and delivered at the required scale.</span></span>
+Needle exchange programs (NEPs) are programs which distribute sanitized needles in exchange for contaminated or used needles. NEPs reduce the spread of blood borne diseases like HIV and Hepatitis C.&nbsp;
 = Key Information =
 = Relevant Research =

@@ Line 1: / Line 1: @@
 __NOTOC__ Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map or]] [[ZOOM_MAP_-_Expand_Harm_Reduction_Practices_Associated_with_Opioid_Misuse|Zoom Map (Expand Harm Reduction Practices Associated with Opioid Misuse)]] <div class="wiki" id="content_view" style="display: block">&nbsp; __toc__
-= Background =
+= Overview =
-Needle exchange programs (NEPs) are programs which distribute sanitized needles in exchange for contaminated or used needles. NEPs reduce the spread of blood borne diseases like HIV and Hepatitis C.
+Needle exchange programs (NEPs) are programs which distribute sanitized needles in exchange for contaminated or used needles. NEPs reduce the spread of blood borne diseases like HIV and Hepatitis C. Many organizations have endorsed needle exchange including NIH (National Institute of Health), CDC (Center for Disease Control), the American Bar Association, the American Medical Association, the American Psychological Association, the World Health Organization and others.&nbsp;The NIH estimates that in the United States, between fifteen and twenty percent of injection drug users have HIV and at least seventy percent have hepatitis C.<ref>https://aasldpubs.onlinelibrary.wiley.com/doi/abs/10.1002/hep.1840360703 </ref> <span style="line-height:normal"><span style="color:black">As such sharing needles has become the most common mode of HIV transmission among injection drug users (IDUs). In addition, used syringes and needles are a potential biohazard within which users primarily reside, and beyond it as well.&nbsp;</span></span><span style="line-height:normal"><span style="color:black">Harm reduction services such as the provision of sterile needles and syringes can effectively prevent hepatitis C and HIV transmission among people who inject drugs, provided they are accessible and delivered at the required scale.</span></span>
-Many Organizations have endorsed needle exchange including NIH (National Institute of Health), CDC (Center for Disease Control), the American Bar Association, the American Medical Association, the American Psychological Association, the World Health Organization and others.<ref>https://aasldpubs.onlinelibrary.wiley.com/doi/abs/10.1002/hep.1840360703 </ref>
+= Key Information =
-The NIH estimates that in the United States, between fifteen and twenty percent of injection drug users have HIV and at least seventy percent have hepatitis C.<ref>https://aasldpubs.onlinelibrary.wiley.com/doi/abs/10.1002/hep.1840360703 </ref> <span style="line-height:normal"><span style="color:black">As such sharing needles has become the most common mode of HIV transmission among injection drug users (IDUs). In addition, used syringes and needles are a potential biohazard within which users primarily reside, and beyond it as well.</span></span>
+= Relevant Research =
 <span style="line-height:normal"><span style="color:black">Needle exchanges have been estimated to be a cost effective prevention practice. An analysis of the cost-effectiveness of a New York City needle syringe exchange estimated that the program would result in a baseline one year savings to the government of $1,300 to $3,000 per client. Another analysis by the CDC approximated that increasing access to clean syringes through an additional annual U.S. investment of $10 million would lead to:</span></span>
@@ Line 15: / Line 13: @@
 *<span style="color:black"><span style="line-height:normal"><span style="tab-stops:list .5in"><span style="vertical-align:baseline">And A lifetime treatment cost savings of $75.8 million which would be a return on investment of $7.58 for every $1 spent&nbsp;</span></span></span></span><span style="line-height:normal"><span style="color:black"><ref>https://www.cdc.gov/policy/hst/hi5/cleansyringes/index.html</ref></span></span>
-= Do Needle Exchanges Increase Drug Injection Rates? =
+== Do Needle Exchanges Increase Drug Injection Rates? ==
 <span style="line-height:normal"><span style="font-family:"><span style="color:black">A review of needle exchange done by the office of the Surgeon General and the assistant secretary for health found that needle exchange did not cause an increase in drug injection, but rather typically led to a decrease in injection rates when these programs were used.<ref>http://www.csdp.org/research/surgeongennex.pdf</ref></span></span></span>
@@ Line 23: / Line 21: @@
 This finding has been further substantiated by another review which found that supplying IDUs (Injecting Drug Users) with clean or sanitized needles does not lead to more "dirty" needles in a community.&nbsp;<ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC419716/</ref>
-= Different Models for Syringe Exchanges =
+== Importance for Harm Reduction Practice and Education ==
 <span style="line-height:normal"><span style="font-family:"><span style="color:black">There are currently several different models for syringe exchanges that have different advantages and limitations. The models include:</span></span></span>
@@ Line 40: / Line 44: @@
 *<span style="color:black"><span style="line-height:normal"><span style="tab-stops:list 1.0in"><span style="vertical-align:baseline">Typically, mobile programs are more accessible to injection drug users and face less opposition from a community.</span></span></span></span>&nbsp;<span style="font-size:11.0pt"><span style="line-height:107%"><span style="font-family:"><span style="color:black"><ref>https://www.avert.org/professionals/hiv-programming/prevention/needle-syringe-programmes</ref></span></span></span></span>
-<font face="calibri, sans-serif" color="#000000"><span style="font-size: 14.6667px">'''Dispensing Machine Distribution''':</span></font>
+== <font color="#000000" face="calibri, sans-serif"><span style="font-size: 14.6667px">'''Dispensing Machine Distribution''':</span></font> ==
 *<span style="color:black"><span style="line-height:normal"><span style="tab-stops:list .5in"><span style="vertical-align:baseline">A newer strategy, countries in Europe as well as Australia have begun to use syringe vending machines in addition to other forms of NSPs.</span></span></span></span>
@@ Line 47: / Line 51: @@
 *<span style="color:black"><span style="line-height:normal"><span style="tab-stops:list .5in"><span style="vertical-align:baseline">A clinical trial has found that this strategy can be highly effective for reaching populations who are most marginalized or otherwise hard to reach.</span></span></span></span><span style="font-size:11.0pt"><span style="line-height:107%"><span style="font-family:"><span style="color:black"><ref>https://www.avert.org/professionals/hiv-programming/prevention/needle-syringe-programmes</ref></span></span></span></span>
-<font color="#000000"><font face="calibri, sans-serif"><span style="font-size:14.6667px">'''Peer Service Distribution Networks'''</span></font></font><span style="font-size:11.0pt"><span style="line-height:107%"><span style="font-family:"><span style="color:black">:</span></span></span></span>
+== <font color="#000000"><font face="calibri, sans-serif"><span style="font-size:14.6667px">'''Peer Service Distribution Networks'''</span></font></font><span style="font-size:11.0pt"><span style="line-height:107%"><span style="font-family:"><span style="color:black">:</span></span></span></span> ==
 *<span style="color:black"><span style="line-height:normal"><span style="tab-stops:list .5in"><span style="vertical-align:baseline">Peer-based strategy, is a&nbsp;process where clients of needle exchanges provide service to their peers, distributing of needles, syringes, and associated injection equipment.</span></span></span></span>
@@ Line 58: / Line 62: @@
 *<span style="color:black"><span style="line-height:normal"><span style="tab-stops:list .5in"><span style="vertical-align:baseline">High need because prison populations have higher cases of Hepatitis C and HIV than the average population.&nbsp;<ref>http://blogs.biomedcentral.com/on-health/wp-content/uploads/sites/8/2016/10/Prison-based-needle-and-syringe-programmes-PNSP-final.pdf</ref></span></span></span></span>
-= Importance for Harm Reduction Practice and Education =
+== Success Stories ==
 '''Scott County, Indianna'''
@@ Line 78: / Line 76: @@
 A case study found that Prevention Point, a needle exchange located in Philadelphia helped prevent 10,000 People From Contracting HIV Over 10 Years. The researchers from George Washington University estimate that the total lifetime taxpayer savings from this needle exchange averting 10,000 cases of HIV saved them $1.8 billion.&nbsp;<ref>https://www.phillymag.com/news/2019/10/31/prevention-point-syringe-exchange-study/</ref>
-= Tools & Resources =
+= Available Tools and&nbsp;Resources =
 [[TR_-_Increase_Access_to_Needle_Exchanges|TR - Increase Access to Needle Exchanges]] &nbsp;
 ----
 </div>
 [[Category:SAFE-Full Spectrum Prevention]]

@@ Line 1: / Line 1: @@
-<div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output">__NOTOC__ <div class="mw-parser-output"><div class="mw-parser-output">Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map or]] [[ZOOM_MAP_-_Expand_Harm_Reduction_Practices_Associated_with_Opioid_Misuse|Zoom Map (Expand Harm Reduction Practices Associated with Opioid Misuse)]] <div class="mw-parser-output"><div class="mw-parser-output"><div class="wiki" id="content_view" style="display: block">&nbsp; __toc__
+__NOTOC__ Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map or]] [[ZOOM_MAP_-_Expand_Harm_Reduction_Practices_Associated_with_Opioid_Misuse|Zoom Map (Expand Harm Reduction Practices Associated with Opioid Misuse)]] <div class="wiki" id="content_view" style="display: block">&nbsp; __toc__
 = Background =
@@ Line 40: / Line 40: @@
 *<span style="color:black"><span style="line-height:normal"><span style="tab-stops:list 1.0in"><span style="vertical-align:baseline">Typically, mobile programs are more accessible to injection drug users and face less opposition from a community.</span></span></span></span>&nbsp;<span style="font-size:11.0pt"><span style="line-height:107%"><span style="font-family:"><span style="color:black"><ref>https://www.avert.org/professionals/hiv-programming/prevention/needle-syringe-programmes</ref></span></span></span></span>
-<font color="#000000" face="calibri, sans-serif"><span style="font-size: 14.6667px;">'''Dispensing Machine Distribution''':</span></font>
+<font face="calibri, sans-serif" color="#000000"><span style="font-size: 14.6667px">'''Dispensing Machine Distribution''':</span></font>
 *<span style="color:black"><span style="line-height:normal"><span style="tab-stops:list .5in"><span style="vertical-align:baseline">A newer strategy, countries in Europe as well as Australia have begun to use syringe vending machines in addition to other forms of NSPs.</span></span></span></span>
@@ Line 61: / Line 61: @@
 Needle exchange programs help educate and inform injection drug users regarding injection practices, safety steps, non-sharing behavior, and other risk reduction methods. “The need for and value of targeted education and behavior modification efforts directed at injection drug users at risk of HIV transmission have been clearly demonstrated in programs that do not include needle exchange (Wiebel et al., 1993).”<font color="#000000">&nbsp;<ref>https://www.ncbi.nlm.nih.gov/books/NBK232350/</ref></font>
 = Success Stories =
@@ Line 92: / Line 94: @@
 #[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC419716/ [10]]
 #[http://sideeffectspublicmedia.org/post/indiana-law-makes-harm-reduction-opioid-addiction-yearly-battle [11]]
-</div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div>
+</div>
 [[Category:SAFE-Full Spectrum Prevention]]

@@ Line 1: / Line 1: @@
-<div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output">__NOTOC__ <div class="mw-parser-output"><div class="mw-parser-output">Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map or]] [[ZOOM_MAP_-_Expand_Harm_Reduction_Practices_Associated_with_Opioid_Misuse|Zoom Map (Expand Harm Reduction Practices Associated with Opioid Misuse)]] <div class="mw-parser-output"><div class="mw-parser-output"><div class="wiki" id="content_view" style="display: block">&nbsp; __toc__
+<div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output">__NOTOC__ <div class="mw-parser-output"><div class="mw-parser-output">Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map or]] [[ZOOM_MAP_-_Expand_Harm_Reduction_Practices_Associated_with_Opioid_Misuse|Zoom Map (Expand Harm Reduction Practices Associated with Opioid Misuse)]] <div class="mw-parser-output"><div class="mw-parser-output"><div class="wiki" id="content_view" style="display: block">&nbsp; __toc__
 = Background =
@@ Line 35: / Line 35: @@
 '''Mobile or On-Call Service''':
-*<span style="color:black"><span style="line-height:normal"><span style="tab-stops:list .5in"><span style="vertical-align:baseline">Mobile programs operate from a van or bus with clean needles that are distributed.</span></span></span></span> <ul style="list-style-type:circle">
+*<span style="color:black"><span style="line-height:normal"><span style="tab-stops:list .5in"><span style="vertical-align:baseline">Mobile programs operate from a van or bus with clean needles that are distributed.</span></span></span></span>
-</ul>  </ul>
+**Larger mobile programs typically provide testing and other healthcare services and operate along regular reoutes at fixed times, often at night at times when increased use occurs.
-</ul>
+**Mobile services can also be smaller and choose to target specific populations.
-*<span style="color:black"><span style="line-height:normal"><span style="tab-stops:list 1.0in"><span style="vertical-align:baseline">Larger mobile programs typically proved testing and other healthcare services.</span></span></span></span> <ul style="list-style-type:square">
+*<span style="color:black"><span style="line-height:normal"><span style="tab-stops:list 1.0in"><span style="vertical-align:baseline">Typically, mobile programs are more accessible to injection drug users and face less opposition from a community.</span></span></span></span>&nbsp;<span style="font-size:11.0pt"><span style="line-height:107%"><span style="font-family:"><span style="color:black"><ref name="https://www.avert.org/professionals/hiv-programming/prevention/needle-syringe-programmes" /></span></span></span></span>
 <font color="#000000" face="Calibri, sans-serif"><span style="font-size: 14.6667px;">'''Dispensing Machine Distribution''':</span></font>
@@ Line 85: / Line 78: @@
 = Tools & Resources =
-[[TR_-_Increase_Access_to_Needle_Exchanges|TR - Increase Access to Needle Exchanges]]
+[[TR_-_Increase_Access_to_Needle_Exchanges|TR - Increase Access to Needle Exchanges]] &nbsp;
 &nbsp;
 ----
 Sources
 #[http://www.alaskapublic.org/2017/06/28/wave-of-addiction-costs-is-hitting-alaskas-healthcare-system/ [4]]
 #[http://www.alaskapublic.org/2017/06/28/wave-of-addiction-costs-is-hitting-alaskas-healthcare-system/ [5]]
@@ Line 97: / Line 92: @@
 #[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC419716/ [10]]
 #[http://sideeffectspublicmedia.org/post/indiana-law-makes-harm-reduction-opioid-addiction-yearly-battle [11]]
-</div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div>
+</div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div>
 [[Category:SAFE-Full Spectrum Prevention]]