Archival Content: 1999-2005

Safe Community Needle Disposal

What Can States and Communities Do To Achieve Safe Community Needle Disposal?

Public health, environmental, and occupational health laws have traditionally focused on safe collection and disposal of syringes and needles that have been used in health care settings, such as hospitals and nursing homes. Less attention has been paid to safe disposal of syringes that are used by individuals living in the community.

However, these “community syringes” add up to billions: It is estimated that between 0.9 and 1.68 billion insulin injections and up to 1 billion illegal drug injections occur each year in the United States. After being used and discarded, most of these syringes end up in the public solid waste system. This presents a risk of needlestick injury and infection with bloodborne pathogens, such as HIV and viral hepatitis. This risk is highest for solid waste workers.

Many state and local public health agencies, waste management companies, and other organizations have begun to promote safe disposal options and build awareness among the public about the risks of disposing of used syringes in the trash. Public health agencies and groups that work with injection drug users (IDUs) are raising awareness about the legal barriers faced by IDUs in safely disposing of syringes and are working to encourage IDUs to participate in community syringe disposal programs and syringe exchange programs.

This goal has not yet been achieved, but states and local communities have many options for helping make it a reality. The options include:

• Develop partnerships with interested local groups to encourage and facilitate safe disposal of used syringes. Partnerships should include pharmacists, HIV/AIDS prevention programs, diabetes educators, solid and infectious waste companies, local health departments, government solid waste agencies, solid waste workers, and physicians.
• Develop low-cost, user-friendly programs that encourage individuals to place used syringes in containers that are collected for treatment as medical waste. These programs include:
  • community syringe container collection programs at sites such as pharmacies, medical facilities, and fire stations;
  • syringe mailback programs; and
  • syringe exchange programs.
• If community collection programs are infeasible or too costly, communities may allow residents to put their syringes in puncture-resistant containers before disposal in the trash, provided the practice is not prohibited by law or regulation.
• Create public education and information programs to explain the importance of safe disposal and describe methods that individuals can use to safely dispose of used syringes.
• Gather data on the extent of the problem of improperly disposed syringes and on needlestick injuries, particularly injuries among solid waste workers. This information can be used to support efforts to develop safe disposal initiatives.
• Review drug paraphernalia and drug possession laws and regulations to see how they affect syringe disposal attitudes and behaviors of IDUs.
• Consider amending laws, regulations, and policies to promote effective community syringe disposal. These efforts should increase options and provide incentives for IDUs as well as for individuals who use syringes for medical indications.
• Work with neighboring states to develop consistent laws and programs that promote safe community syringe disposal.

Pharmacists, physicians, and other health care providers can play a crucial role by:

• Participating in safe disposal partnerships.
• Promoting awareness of safe syringe disposal methods.
• Encouraging changes in laws and policies to increase access to safe disposal options.
• Participating in safe disposal programs by becoming a syringe container collection site.

For more information:

See the November/December 2002 issue of the Journal of the American Pharmaceutical Association, “Preventing Blood-borne Infections Through Pharmacy Syringe Sales and Safe Community Syringe Disposal.” This Supplement contains 33 papers on a range of issues related to syringe law and deregulation, pharmacy syringe sales and regulation, pharmacist attitudes, and safe community syringe disposal. Two papers of particular relevance are:

• Burris S, Welsh J, Ng M, Li M, Ditzler A. State syringe and drug possession laws potentially influencing safe syringe disposal by injection drug users. Journal of the American Pharmaceutical Association 2002;42(6 Suppl 2):S94-S99.
• Turnberg W, Jones TS. Community syringe collection and disposal policies in 16 states. Journal of the American Pharmaceutical Association 2002;42(6 Suppl 2):S99-S104.

Read the August 5, 2002 “Dear Colleague” letter, “Safe Community Disposal of Needles and Other Sharps,” from the American Association of Diabetes Educators (AADE), American Diabetes Association (ADA), American Medical Association (AMA), American Pharmaceutical Association (APhA), Association of State and Territorial Health Officials (ASTHO), and National Alliance of State and Territorial AIDS Directors (NASTAD).

Visit the website of the Coalition for Safe Community Needle Disposal. The Coalition is a collaboration of businesses, community groups, non-profit organizations, and government agencies that promotes public awareness and solutions for safe disposal of needles, syringes, and other sharps in the community. The Coalition’s Advisory Council includes the American Association of Diabetes Educators, American Diabetes Association, American Medical Association, American Pharmaceutical Association, and National Alliance of State and Territorial AIDS Directors.

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