International Journal of Drug Policy
Volume 21, Issue 3 , Pages 208-214, May 2010

Assessing a drop box programme: A spatial analysis of discarded needles

  • Luc de Montigny

      Affiliations

    • McGill University, The Surveillance Lab, McGill Clinical and Health Informatics, 1140 Pine Avenue West, Montreal, QC, Canada H3A 1A3
    • Corresponding Author InformationCorresponding author. Tel.: +1 514 934 1934; fax: +1 514 843 1551.
    • ,
  • Anne Vernez Moudon

      Affiliations

    • Urban Design & Planning, University of Washington, United States
    • ,
  • Barbara Leigh

      Affiliations

    • Alcohol and Drug Abuse Institute, University of Washington, United States
    • ,
  • Kim Young

      Affiliations

    • Environmental and Occupational Health Sciences, University of Washington, United States

Received 15 May 2009; received in revised form 22 July 2009; accepted 29 July 2009. published online 03 September 2009.

Abstract 

Background

Distributing sterile injection equipment to injection drug users is one of few proven ways of lowering the transmission rate of blood borne viruses. Distribution of equipment has also been linked to increased needle discarding, which is a public health risk for both injectors and their host communities. Drop boxes (anonymous and public-access sharps containers) are a promising and increasingly popular means of reducing unsafe disposal, yet there is little empirical research to support or guide their implementation.

Methods

Using a dataset containing the locations of 7274 discarded needles and syringes collected monthly in the non-park open spaces of a 2.5km2 neighbourhood of Montréal, Canada for a period of five years, we compared levels of discards before and after the installation of 12 drop boxes. We used quasi-Poisson regression to test the effects of drop boxes on monthly counts of collected discards for areas within a walking distance of 25, 50, 100 and 200m of a drop box. We adjusted for known time-dependent covariates linearly and unknown time-dependent covariates using a smoothing function.

Results

We found strong evidence of reduced discarding following the installation of drop boxes; drop boxes were associated with reductions of up to 98% (95% CI: 72–100%) and significant reductions for areas up to 200m from a drop box. Reductions were inversely proportional to walking distance from drop boxes. No measure of weather or use of needle exchange programmes (NEPs) had a consistent relationship with discard counts.

Conclusion

Our research suggests that IDUs changed their needle-disposal behaviour in response to increased safe disposal options. In addition to being relatively low-threshold, economical and rapid, drop boxes appear to be a highly effective intervention to reduce discarded needles.

Keywords: Needle and syringe disposal, Injection drug users, Discarded needles, Spatial analysis, Geographic information system (GIS)

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PII: S0955-3959(09)00110-8

doi:10.1016/j.drugpo.2009.07.003

Refers to erratum:

  • Erratum to “Assessing a drop box program: A spatial analysis of discarded needles” [Int. J. Drug Policy 21(3) (2010) 208–214] , 20 May 2010

    Luc de Montigny, Anne Vernez Moudon, Barbara Leigh, Sun Young Kim
    International Journal of Drug Policy July 2010 (Vol. 21, Issue 4, Page 333)

International Journal of Drug Policy
Volume 21, Issue 3 , Pages 208-214, May 2010

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