Large decrease in syringe distribution following the introduction of fentanyl in King County, Washington

Background: Syringe services programs (SSPs) serve as key platforms to deliver harm reduction services to people who use drugs (PWUD). Changes in drug supply and drug consumption behaviors, particularly the increasing use of fentanyl through non-injection methods, may impact SSP utilization. Materia...

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Main Authors: Sara N. Glick, Joe Tinsley, Laura Pritchard Wirkman, Apoorva Mallya, Peter Cleary, Matthew R. Golden, Thomas Fitzpatrick
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:Drug and Alcohol Dependence Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2772724624000854
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author Sara N. Glick
Joe Tinsley
Laura Pritchard Wirkman
Apoorva Mallya
Peter Cleary
Matthew R. Golden
Thomas Fitzpatrick
author_facet Sara N. Glick
Joe Tinsley
Laura Pritchard Wirkman
Apoorva Mallya
Peter Cleary
Matthew R. Golden
Thomas Fitzpatrick
author_sort Sara N. Glick
collection DOAJ
description Background: Syringe services programs (SSPs) serve as key platforms to deliver harm reduction services to people who use drugs (PWUD). Changes in drug supply and drug consumption behaviors, particularly the increasing use of fentanyl through non-injection methods, may impact SSP utilization. Material and Methods: We collected routine program data from three SSPs in King County, Washington. Trends in the annual number of syringes distributed and client encounters were assessed using joinpoint regression analysis to determine when statistically significant changes in trends in annual totals occurred and annual percent change (APC) during each period. Results: The number of syringes distributed per year through King County SSPs reached a maximum of 8,733,413 in 2020 and then decreased sharply to 2,482,056 by 2023. Annual syringe distribution totals were stable or increasing during all periods from 1989 to 2020 (APC range: 2.0–35.3 %), and only developed a decreasing trend between 2020 and 2023 (APC=-32.8 %). Total number of SSP client encounters per year was stable between 2010 and 2023 (APC=0.7 %), but an increasing trend in encounters was identified starting in 2008 (APC=4.4 %) at a community-based SSP that distributed safer smoking supplies (pipes). Discussion: A precipitous decline in syringe distribution through King County SSPs began in 2020 and continued through 2023, which coincided with increasing availability of fentanyl in the local drug market. Nevertheless, the trends in client encounters highlight that PWUD continued to seek harm reduction services, with preliminary evidence that distribution of safer smoking supplies may increase the number of client visits.
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spelling doaj-art-a3cf0c20dc5645149e2b887f99b61bca2025-08-20T02:34:20ZengElsevierDrug and Alcohol Dependence Reports2772-72462024-12-011310030110.1016/j.dadr.2024.100301Large decrease in syringe distribution following the introduction of fentanyl in King County, WashingtonSara N. Glick0Joe Tinsley1Laura Pritchard Wirkman2Apoorva Mallya3Peter Cleary4Matthew R. Golden5Thomas Fitzpatrick6University of Washington, School of Medicine, Division of Allergy and Infectious Diseases, Seattle, WA, United States; Public Health – Seattle & King County, HIV/STI/HCV Program, Seattle, WA, United States; Correspondence to: Harborview Medical Center, Box 359777, 325 9th Ave, Seattle, WA 98104, United StatesPublic Health – Seattle & King County, HIV/STI/HCV Program, Seattle, WA, United StatesPeople’s Harm Reduction Alliance, Seattle, WA, United StatesHepatitis Education Project, Seattle, WA, United StatesSeattle’s LGBTQ+ Center, NEON, Seattle, WA, United StatesUniversity of Washington, School of Medicine, Division of Allergy and Infectious Diseases, Seattle, WA, United States; Public Health – Seattle & King County, HIV/STI/HCV Program, Seattle, WA, United StatesUniversity of Washington, School of Medicine, Division of Allergy and Infectious Diseases, Seattle, WA, United States; People’s Harm Reduction Alliance, Seattle, WA, United StatesBackground: Syringe services programs (SSPs) serve as key platforms to deliver harm reduction services to people who use drugs (PWUD). Changes in drug supply and drug consumption behaviors, particularly the increasing use of fentanyl through non-injection methods, may impact SSP utilization. Material and Methods: We collected routine program data from three SSPs in King County, Washington. Trends in the annual number of syringes distributed and client encounters were assessed using joinpoint regression analysis to determine when statistically significant changes in trends in annual totals occurred and annual percent change (APC) during each period. Results: The number of syringes distributed per year through King County SSPs reached a maximum of 8,733,413 in 2020 and then decreased sharply to 2,482,056 by 2023. Annual syringe distribution totals were stable or increasing during all periods from 1989 to 2020 (APC range: 2.0–35.3 %), and only developed a decreasing trend between 2020 and 2023 (APC=-32.8 %). Total number of SSP client encounters per year was stable between 2010 and 2023 (APC=0.7 %), but an increasing trend in encounters was identified starting in 2008 (APC=4.4 %) at a community-based SSP that distributed safer smoking supplies (pipes). Discussion: A precipitous decline in syringe distribution through King County SSPs began in 2020 and continued through 2023, which coincided with increasing availability of fentanyl in the local drug market. Nevertheless, the trends in client encounters highlight that PWUD continued to seek harm reduction services, with preliminary evidence that distribution of safer smoking supplies may increase the number of client visits.http://www.sciencedirect.com/science/article/pii/S2772724624000854Syringe services programsSyringe accessRoute of drug useFentanylSafer smoking supplies
spellingShingle Sara N. Glick
Joe Tinsley
Laura Pritchard Wirkman
Apoorva Mallya
Peter Cleary
Matthew R. Golden
Thomas Fitzpatrick
Large decrease in syringe distribution following the introduction of fentanyl in King County, Washington
Drug and Alcohol Dependence Reports
Syringe services programs
Syringe access
Route of drug use
Fentanyl
Safer smoking supplies
title Large decrease in syringe distribution following the introduction of fentanyl in King County, Washington
title_full Large decrease in syringe distribution following the introduction of fentanyl in King County, Washington
title_fullStr Large decrease in syringe distribution following the introduction of fentanyl in King County, Washington
title_full_unstemmed Large decrease in syringe distribution following the introduction of fentanyl in King County, Washington
title_short Large decrease in syringe distribution following the introduction of fentanyl in King County, Washington
title_sort large decrease in syringe distribution following the introduction of fentanyl in king county washington
topic Syringe services programs
Syringe access
Route of drug use
Fentanyl
Safer smoking supplies
url http://www.sciencedirect.com/science/article/pii/S2772724624000854
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