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Journal of Urban Health : Bulletin of the New York Academy of Medicine logoLink to Journal of Urban Health : Bulletin of the New York Academy of Medicine
. 2004 Mar;81(1):122–134. doi: 10.1093/jurban/jth092

A syringe prescription program to prevent infectious disease and improve health of injection drug users

Josiah D Rich 1,2,✉, Michelle McKenzie 3, Grace E Macalino 4, Lynn E Taylor 1,2, Stephanie Sanford-Colby 4, Francis Wolf, Susan McNamara 4, Meenasshi Mehrotra 1, Michael D Stein 1
PMCID: PMC3456147  PMID: 15047791

Abstract

Injection drug users (IDUs) are at increased risk for many health problems, including acquisition of human immunodeficiency virus (HIV) and hepatitis B and C. These risks are compounded by barriers in obtaining legal, sterile syringes and in accessing necessary medical care. In 1999, we established the first-ever syringe prescription program in Providence, Rhode Island, to provide legal access to sterile syringes, reduce HIV risk behaviors, and encourage entry into medical care. Physicians provided free medical care, counseling, disease testing, vaccination, community referrals, and prescriptions for sterile syringes for patients who were not ready to stop injecting. We recruited 327 actively injecting people. Enrolled participants had limited stable contact with the health care system at baseline; 45% were homeless, 59% were uninsured, and 63% did not have a primary care physician. Many reported high-risk injection behaviors such as sharing syringes (43% in the last 30 days), reusing syringes (median of eight times), and obtaining syringes from unreliable sources (80%). This program demonstrates the feasibility, acceptability, and unique features of syringe prescription for IDUs. The fact that drug use is acknowledged allows an open and frank discussion of risk behaviors and other issues often not disclosed to physicians. The syringe prescription program in Providence represents a promising and innovative approach to disease prevention and treatment for IDUs.

Keywords: Injection drug users, HIV, Hepatitis B, Hepatitis C, Syringe prescription program

Full Text

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Footnotes

while the research was being conducted, Mr. Wolf was with the Department of Infectious Disease at The Miriam Hospital; Ms. Mehrotra is with Brown University School of Medicine; and Dr. Stein is with the School of Medicine, Department of Community Health at Brown University and HIV Services at Rhode Island Hospital; all affiliations are in Providence, Rhode Island.

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