Community syringe disposal program keeps residents safe

Increasing Hepatitis C infections, sanitation workers' exposure to contaminated sharps, and time taken unnecessarily from police departments are some of the negative side-effects of the sharing and improper disposal of syringes. These are issues a partnership between Indiana University’s Student Agile Response Team (START), Center for Rural Engagement, and the Prevent Pricks initiative aim to address.

Prevent Pricks is a project that helps communities establish safe and accessible syringe disposal sites, a component of the harm reduction approach to substance use disorder (SUD). Harm reduction is a set of principles that, according to the National Harm Reduction Coalition, incorporates a spectrum of strategies that includes safer use, managed use, abstinence, meeting people who use drugs “where they’re at,” and addressing conditions of use along with the use itself.

Harm reduction principles are the driving force behind syringe service programs (SSPs), which the Centers for Disease Control define as programs that provide a range of services, including linkage to SUD treatment; access to and disposal of sterile syringes and injection equipment; and vaccination, testing, and linkage to care and treatment for infectious diseases. Since the legalization of SSPs in Indiana during an HIV outbreak in Scott County in 2015, only eight of the 92 Indiana counties have opened an SSP—and, Scott County Commissioners recently voted to close the local SSP by the end of the year despite community and statewide protest.

Antonia Sawyer, founder of ShipHappens and the Prevent Pricks campaign, is hoping to expand access to syringe service programs through her work. “Prevent Pricks is truly a building block to services like syringe service programs, through the acknowledgment that there is syringe use in communities, and that everyone needs access to safe and convenient disposal to protect the public health of all residents,” she says. To date, the project has seen two syringe disposal boxes installed in Miami County and a total of 230 pounds of syringes collected between the two.

Sawyer is someone whose loved ones have faced SUD and Hepatitis C (HCV). The sharing of syringes by people who inject drugs has led Indiana to have the nation’s highest rate of HCV infections at 4.8 per 100,000 population according to the CDC. “I always knew my professional career would be dedicated to reducing stigma,” says Sawyer. According to her, a major cause of improper disposal is the stigmatization of syringe use, and Prevent Pricks was created from her belief that providing an accessible, safe place to drop used syringes would help eliminate some of that stigma. “By being inclusive of all residents, stigma around syringes and people who use drugs diminishes and communities can see the success of syringe programming.”

Prevent Pricks is a continuation of Sawyer’s work with her nonprofit, ShipHappens, a zero-barrier point of access to naloxone, an opioid overdose reversal medicine. The Center for Rural Engagement has partnered with ShipHappens previously to deliver over 500 naloxone kits to residents in eight Indiana counties, and now alongside START has helped develop and implement a toolkit for communities wanting to set up a safe syringe disposal site.

Two student START volunteers worked with Sawyer to develop a toolkit for community leaders to arrange for a syringe dropbox in their area. The toolkit takes the form of an 18-page digital document and includes resources and information for every step of the way including assessing community need, picking a location for the box, and forming press releases once a box has been established. “This is a tailorable program, and we encourage all communities to do what is best to meet their needs while maintaining the integrity of the program by keeping it zero-barrier, in an accessible yet semi-private location, and embedding it into the community so it remains sustainable over time,” says Sawyer. Those interested in the toolkit, donating, or volunteering can contact Sawyer through email or the ShipHappens Facebook page.

Paola Gabriela Zaragoza Cardenales is an SJD candidate at the IU Maurer School of Law and one of the students that worked with START and Sawyer to put together the toolkit. “It was a really nice experience because it’s an initiative to address a concern that not many people might understand,” says Zaragoza Cardenales. “It’s one of those things that can pass under the radar if you aren’t used to it.”

Zaragoza Cardenales says the project serves parts of communities that might be stigmatized for syringe use beyond people who inject drugs like diabetics or even herself, someone who self-administers allergy medications by syringe. “Having something like that, that’s accessible to everyone, that’s a big deal for me.”