Fear of arrest increases needle sharing

The laws making possession of sterile needles illegal increases needle sharing.  This has been well documented in a number of research studies. 

1.  Fear of arrest causes users not to carry needles    
2.  Positive impact of laws that permit needle access     
3.  Negative impact of a needle exchange’s closure  

1. Fear of arrest causes users not to carry needles

A multivariate study, done in Oakland, California, found that injecting drug users concerned with being arrested while carrying drug paraphernalia were over one-and-a-half times more likely to share syringes.  In this study, 32 percent of the 1,257 injecting drug users in the study reported fearing arrest.(1) 

A Connecticut study found that 23 percent of 159 injecting drug users interviewed had syringes in their possession and only 30 percent reported normally carrying syringes.  Some 64 percent reported that their primary reason given for not carrying syringes was fear of arrest.(2) 

A study in Ohio found that 73 percent of the 276 active drug injectors interviewed feared carrying needles because of drug paraphernalia laws.(3)

A Denver study revealed that street-based injectors rarely carried needles, even when engaged in buying drugs for their own consumption.  Injectors explained this was because of the needle possession laws and their penalties.(4)

 2. Positive impact of laws that permit needle access

After partial repeal of the needle prescription and drug paraphernalia laws in Connecticut, interviews with134 active injecting drug users revealed that:

  • Over two-thirds were aware of the change in the law; more IDUs reported purchasing syringes on the street before the law change than after (74 percent before vs 28 percent after). 

  • Among IDUs who reported ever sharing a syringe, syringe-sharing decreased after the new laws (52 percent before vs. 31 percent after). 

  • More IDUs reported purchasing syringes from a pharmacy after the new laws were enacted (19 percent before vs. 78 percent after).(5)

In Baltimore, a study of 221 injecting drug users, found significant reductions in both borrowing someone else’s syringe (22 percent down to 8 percent) and loaning one’s used syringe to a friend (27 percent down to 12 percent) after the drug users began attending the syringe exchange program.(6)

A New York City study found that attendance at a syringe exchange was associated with a continued downward trend in sharing syringes.(7)

An analysis in Baltimore found that diabetic injecting drug users, because of their legal access to syringes, had a lower HIV infection rate than nondiabetic injecting drug users.(8)

3. Negative impact of a needle exchange’s closure

A Wyndham, Connecticut, study found that after the city’s needle exchange program was closed, pharmacies also cut back on their sale of syringes.  The result was that there were almost no sources of safe syringes in the community.  Interviews with people who injected drugs showed that there was increasing use of unreliable sources of syringes.(9) 

Footnotes

(1) Ricky N. Bluthenthal, Jennifer Lorvick, Alex H. Kral, Elizabeth A. Erringer, and James G. Kral, “Collateral damage in the war on drugs: HIV risk behaviors among injection drug users,” International Journal of Drug Policy, vol. 10, 1999, pages 25-38.  For an article reporting early results from this same study see "Drug paraphernalia laws and injection-related infectious disease risk among drug injectors." 
(2) Jean-Paul C. Grund, Douglas D. Heckathorn, Robert S. Broadhead, and Denise L. Anthony, 1995.  “In eastern Connecticut, IDUs purchase syringes from pharmacies but don’t carry syringes,” Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, vol. 10, 1999, pp. 104-5.
(3)

R. G. Carlson, H. A. Siegal, J. Wang, and R. S. Flack, “Attitudes Toward Needle ‘Sharing’ Among Injection Drug Users: Combining Qualitative and Quantitative Research Methods,” Human Organization, 1996, vol. 55, pp. 361-69.
(4) Robert E. Booth, Stephen K. Koester, Charles S. Reichardt and Thomas Brewster, “Quantitative and qualitative methods to assess behavioral change among injection drug users,” in Dennis G. Fisher and Richard Needle, eds. AIDS and Community-Based Drug Intervention Programs: Evaluation and Outreach, New York: Harington Park Press, 1993, pages 161-183.
(5) Samuel L. Groseclose, Beth Weinstein, T. Stephen Jones, Linda A. Valleroy, Laura J. Fehrs, and William J. Kassler, “Impact of Increased Legal Access to Needles and Syringes on Practices of Injection-Drug Users and Police Officers – Connecticut, 1992-1993,” Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, vol. 10, 1999, pp. 82-29. 
(6) D. Vlahov, B. Jung, R. Brookmeyer, S. Cohn, E. Riley, H. Armenian, and P. Beilenson, 1997, “Reductions in high risk drug use behaviors among participants in the Baltimore needle exchange program,” Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, vol. 16, 1999, pages 400-406.
(7) Denise Paone, D.C. Des Jarlais and Q. Shi,  “Syringe exchange use and HIV risk reduction over time,” AIDS, 1998, vol. 12, no. 1, pages 121-123
(8) The HIV rate was 10 percent among diabetic and 24 percent among nondiabetic injecting drug users. K. E. Nelson, D. Vlahov, S. Cohn, A. Lindsay, L. Solomon and J.C. Anthony, “Human immunodeficiency virus infection in diabetic intravenous drug users. Journal of the American Medical Association, 1991, vol. 266, pages 2259-2261.
(9) Robert S. Broadhead, Yael van Hulst, and Douglas D. Heckathorn, “The impact of a needle exchange’s closure,” Public Health Reports, September/ October 1999, vol. 114, pages 439-447. Abstract. See also Robert S. Broadhead, Yael van Hulst, and Douglas D. Heckathorn, “Termination of an established needle-exchange: a study of claims and their impact,” Social Problems, 1999, vol. 46, no.1, pages 48-66. Abstract.
For a list of other materials used on this website, see References.