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<br />I. Community Benefit of Syringe Exchange Programs
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<br />The evidence for harm reduction and syringe exchange programs is overwhelming.
<br />SEPs increase substance use treatment engagement for those with SUDs, which leads to
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<br />decreases in injection drug use as well as fatal and non-fatal drug overdoses. A study in
<br />Seattle found that individuals who used SEPs were 5 times as likely to initiate substance use
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<br />treatment than those who did not use SEPs. Those who utilized SEPs often were also three
<br />times as likely to report reductions or stopping of illicit drug use compared to those who had
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<br />never used SEPs.
<br />SEPs greatly reduce the spread of communicable diseases including HIV, hepatitis and
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<br />other fungal and bacterial infections by limiting use of non-sterile needles and needle sharing.
<br />SEPs therefore have positive health benefits to not just those who inject drugs, but also first
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<br />responders, family members of people who use drugs, and the rest of the community.
<br />Additionally, SEPs do not lead to more crime or drug use, and in fact have the opposite effect,
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<br />by addressing the underlying needs of those with SUDs.
<br />The proposed ordinance purports to be concerned with community safety, specifically
<br />with regards to syringe litter. However, a ban on SEP operations within the city is likely to
<br />substantially increase syringe litter in Santa Ana. A study comparing a city without an SEP
<br />program to a city with SEP programs found eight times as many improperly disposed syringes in
<br />the city without SEP programs, suggesting that SEPs are a “significant means of collecting used
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<br />syringes and do not increase the amount of publicly discarded used syringes.”
<br />The proposed ordinance also claims that “residents who require syringe exchange
<br />services for medical purposes are currently able to acquire these services at pharmacies and
<br />hospitals,” making the assumption that this results in less syringe litter. However, a study in Los
<br />Angeles found that "Sourcing syringes from SEPs decreased the odds of improper disposal”
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<br />and “sourcing syringes from pharmacies increased the odds of improper disposal." Yet another
<br />study found that pharmacy obtained syringes are associated with unsafe syringe disposal vs.
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<br /> Davis, S. M., Daily, S., Kristjansson, A. L., Kelley, G. A., Zullig, K., Baus, A., Davidov, D., & Fisher, M. (2017). Needle exchange
<br />programs for the prevention of hepatitis C virus infection in people who inject drugs: A systematic review with meta-analysis. Harm
<br />Reduction Journal, 14(1), 25. https://doi.org/10.1186/s12954-017-0156-z
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<br /> Abdul-Quader, A. S., Feelemyer, J., Modi, S., Stein, E. S., Briceno, A., Semaan, S., Horvath, T., Kennedy, G. E., & Des Jarlais, D.
<br />C. (2013). Effectiveness of structural-level needle/syringe programs to reduce HCV and HIV infection among people who inject
<br />drugs: A systematic review. In AIDS and Behavior (Vol. 17, Issue 9, pp. 2878–2892). Springer. https://doi.org/10.1007/s10461-013-
<br />0593-y
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<br /> Des Jarlais, D. C., Feelemyer, J. P., Modi, S. N., Abdul-Quader, A., & Hagan, H. (2013). High coverage needle/syringe programs
<br />for people who inject drugs in low and middle income countries: a systematic review. In BMC public health (Vol. 13, Issue 1, p. 53).
<br />BioMed Central. https://doi.org/10.1186/1471-2458-13-53
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<br /> CDC. (2019). Syringe Services Programs FAQs. https://doi.org/10.2105/AJPH.2014.302111
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<br /> Tookes, H. E., Kral, A. H., Wenger, L. D., Cardenas, G. A., Martinez, A. N., Sherman, R. L., Pereyra, M., Forrest, D. W., LaLota,
<br />M., & Metsch, L. R. (2012). A comparison of syringe disposal practices among injection drug users in a city with versus a city without
<br />needle and syringe programs. Drug and Alcohol Dependence, 123(1–3), 255–259. https://doi.org/10.1016/j.drugalcdep.2011.12.001
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<br /> Quinn, B., Chu, D., Wenger, L., Bluthenthal, R. N., & Kral, A. H. (2014). Syringe disposal among people who inject drugs in Los
<br />Angeles: The role of sterile syringe source. International Journal of Drug Policy, 25(5), 905–910.
<br />https://doi.org/10.1016/j.drugpo.2014.05.008
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