Needle News Hits a Nerve

Study finds high rate of used syringes on Miami streets

Medical student Hansel E. Tookes
Informed by a 2008 San Francisco study, second-year medical student Hansel E. Tookes led a comparative study that found Miamians are eight times as likely as San Franciscans to encounter improperly discarded needles in public places. Miami, unlike San Francisco, has no needle and syringe programs—initiatives that allow injection drug users to dispose of contaminated syringes and receive sterile ones.

“It is clear that cities such as Miami may benefit from implementation of needle and syringe programs to provide a venue for safe syringe disposal, and to reduce the transmission of blood-borne diseases to injection drug users and other community members,” says Tookes.

In 2009 Tookes led a visual inspection of the top quartile of Miami neighborhoods with the highest concentration of drug use according to city data. More than 400 dirty syringes were found—over eight times the number his San Francisco team found. Interviewing more than 1,000 injection drug users in both cities, they learned the Miami subjects were more than 34 times as likely to report public disposal of syringes and that 95 percent of syringes used by injection drug users were disposed of improperly in Miami, versus 13 per-cent in San Francisco. In Miami neighborhoods, that translates to nearly 10,000 needles and syringes per month improperly disposed of in trashcans, sewers, parks, and other public places.

The study represented Tookes’s final project for his master’s in public health, also at the Miller School of Medicine. Leading substance use journal Drug and Alcohol Dependence published the study, believed to be the first city-to-city comparison of this kind, online in December. Tookes’s Miller School advisor was Lisa R. Metsch, voluntary professor of epidemiology and public health. His San Francisco team included Alex H. Kral, director of the Urban Health Program in the Behavioral Health and Criminal Justice Research Division of RTI International.