Prevalence and Correlates of Syringe Disposal Box Use in a Philadelphia Neighborhood with High Levels of Public Drug Injection

Abstract

Background: Philadelphia (Pennsylvania, USA) is facing an unprecedented public health crisis due to fentanyl use. To combat drug-related litter, the Philadelphia Department of Public Health installed 7 public syringe disposal boxes (SDB) in Kensington, the neighborhood most impacted by the opioid crisis and home to a syringe exchange. Methods: We used street- and business-intercepts to recruit residents (N=358) and business owners/staff (N=78) who completed a brief survey with two binary items measuring observing and using SDB. Multivariable logistic regression was used to assess factors independently associated with SDB observance and use. Results: 78% (340/436) observed SDB and 34.1% (116/340) had ever used SDB among those who had seen them. Unstably housed persons had 4.3 times greater odds of observing SDB (Adjusted odds ratio [aOR= 4.29; 95% confidence interval [CI]: 1.56, 11.82) and had 2.5 times greater odds of using SDB (aOR = 2.51; 95% CI: 1.33, 4.74) as did people who use opioids (aOR = 2.61; 95% CI: 1.45, 4.72). Among individuals reporting opioid use who also saw SDB (n=123), those who were unstably housed were more likely to use SDB than those with stable housing (67.8% vs 45.3%, p=.012). Conclusion: These results suggest Kensington residents, especially those who are unstably housed, use SDB once they see them in the neighborhood.

Keywords:

• Syringe disposal boxes
• syringes
• drug litter

Acknowledgment

The authors thank the participants and dedicated Research Assistants: Brogan Piecara, Asuseyi Daniyan, Bolutife Odeniyi, Eliza Ziegler, and Carolann Torres. In addition, we’d like to thank Brogan Piecara and Matthew Lipow for assisting with the review of the literature. We also thank Andres Freire and Silvana Mazzella for providing us information about the Prevention Point Philadelphia syringe exchange program and Allison Herens from the Philadelphia Department of Public Health for information about the installation of the syringe disposal boxes, and the Drexel Urban Health Collaborative for data and technical support.

Disclosure statement

No potential conflict of interests was reported by the author(s).

Additional information

Funding

This work was supported by Arnold Ventures and the Drexel University Dornsife School of Public Health.