A comparison of syringe prescription and syringe exchange in Rhode Island, USA

Prior to the year 2000, strict laws regulated the purchase and possession of syringes in Rhode Island, USA. More than 50% of the state’s AIDS cases were related to injection drug use, and injecting drug users (IDUs) in Rhode Island reused each syringe, on average, over 20 times. Rhode Island’s syringe exchange programme began in 1995, and has served over 1700 clients. In 2001, the programme exchanged almost 45,000 syringes. Participation in the syringe exchange programme is anonymous, and the programme provides education, outreach, and referral to substance abuse treatment. A syringe prescription programme for IDUs began in Rhode Island in 1999; it has served over 350 patients and prescribed more than 72,000 syringes. In addition to expanding access to sterile syringes, the syringe prescription programme also expanded patients’ access to disease screening and treatment, vaccination, primary medical care, and referral to specialists. Since 1995, there have been three major programmatic and policy approaches adopted in Rhode Island to address the issue of syringe access for injection drug users: syringe exchange, legal reform, and syringe prescription. Each approach offers different ancillary services and appears to appeal to different populations of IDUs. Adopting multiple approaches to syringe access may best serve this high-risk population.