Syringe Access and Disposal Programs

 

Overview

The San Francisco Syringe Access and Disposal Program (referred to as Syringe Program or “SP”), is an evidence-based public health program that aims to protect injection drug using communities from the spread of infections, such as HIV and hepatitis C. Both evaluation research and experience in the field have demonstrated that adequate syringe access produces positive health effects without creating negative societal ones.

Syringe programs have existed in San Francisco since the beginning of the HIV epidemic. Services began as a grassroots movement to respond to various community needs for sterile syringes. The City and County of San Francisco formally sanctioned syringe access in 1993, when Mayor Frank Jordan declared a public health state of emergency, a move that gave him the power to legalize SPs, and began funding programs as an essential structural component of HIV prevention services. Compared to cities that were not early adopters of syringe access, San Francisco has significantly lower rates of HIV infection among injection drug users (IDUs) and has been able to greatly minimize the bridging of HIV infection to the heterosexual community. Drug users often want to know how to pass drug screenings – especially mouth swab drug test and hair follicle test. We give them this information.

 

Syringe Access and Disposal Locations

Syringe access and disposal locations (search by SF neighborhood, hours of operation, or other criteria)

Opportunities for collection and disposal of used syringes and injection supplies

 

Types of Providers

Syringe programs consist of pharmacy providers and community providers offering comprehensive access to sterile syringes and safe disposal of syringes and injection supplies, including collection and disposal of used syringes.

Community Providers

Community providers offer syringes to help prevent bloodborne viral infections. Community organizations provide a wide range of supplies and services, such as:

  • A range of needle gauges, syringes, and injection supplies
  • Condoms, lubricant, and other safer sex supplies
  • Sharps containers and disposal services
  • Education, health promotion and brief interventions
  • Referrals to a wide range of health and community services
  • Culturally appropriate services that are relevant to the communities with which and neighborhoods in which the SP works

Community providers also collect data on services in accordance with the requirements established by the San Franricso Department of Public Health (SFDPH). Click here to find a community provider near you.

Pharmacy Providers

In order to prevent the spread of bloodborne infections such as HIV and hepatitis C, California Senate Bill (SB) 1159 “Pharmacy Access to Syringes” was enacted in January 2005. Under this legislation, any city or county in California may authorize pharmacies within its jurisdiction to sell or provide up to 10 syringes to an individual over 18 years of age without a prescription.

Pharmacies wishing to enroll should email Alla Rivas or contact her by phone at 415-554-8450.

The SFDPH has three statutory duties:

  1. To register pharmacies that agree to certain conditions (listed below).
  2. To maintain a list of participating pharmacies.
  3. To provide participating pharmacies information on how to access HIV and hepatitis screening, and how to safely dispose of used syringes, so that pharmacies can pass this information on to their customers either orally or in writing.

Any pharmacy in SF may register through HPS to sell up to 10 syringes to an adult without a prescription. Pharmacy chains are allowed to register en masse.

Participating pharmacies must observe the following minimal guidelines

  • Syringes will be stored behind the pharmacy counter.
  • Each purchaser of nonprescription syringes will be counseled verbally or provided written information about: 1) how to access drug treatment; 2) how to access HIV and hepatitis screening and treatment; and 3) how to safely dispose of used syringes.

Registered pharmacies will support safe disposal of used syringes by doing at least one of the following:

  • Selling or furnishing sharps containers (puncture-proof biohazard containers).
  • Selling or furnishing mail-back sharps containers.
  • Participating in syringe take-back programs.

Opportunities for Collection and Disposal of Used Syringes and Injection Supplies

A partnership approach is essential for sharps disposal in SF. This responsibility is shared between a numbers of stakeholders including community clinics, community-based organizations, local government, injection equipment users, and local businesses.

SF residents have one of the best programs in the nation to safely dispose of their used syringes and lancets: the Safe Needle Disposal Program administered by SF Recycling & Disposal. Information on this program can be found at http://www.sfrecycling.com/hazardousWasteNeedles.htm.

The Safe Needle Disposal Program, started in 1990, was the first of its kind in the nation and has been replicated in many other cities. It was designed by a coalition composed of Sunset Scavenger Company, Golden Gate Disposal & Recycling, SF Recycling & Disposal, the SFDPH, the American Diabetes Association, and Walgreens in order to protect garbage company workers and the public’s health by providing residents with a safe and convenient disposal option for sharps used in non-clinical settings. SF Recycling & Disposal administers the program. The company buys the sharps containers, delivers them to participating Walgreens, and arranges for a medical waste company to pick up full containers.

Promoting safe disposal of used needles and syringes is a key component of syringe programs. All public hospitals and community clinics are required to accept used sharps from members of the community. At a syringe program, used syringes and other medical sharps waste must be accepted at no charge, regardless of whether the person accessing the disposal service is a participant of the syringe program.

Click here to find a disposal location near you.

If San Francisco residents find sharps on the street or in other public spaces, they may call the San Francisco Department of Public Works or 311. The Department of Public Works will deploy someone to retrieve the sharps and dispose of them properly.

San Francisco Syringe Access and Disposal Program Policy and Guidelines

The SFDPH has developed the Syringe Access and Disposal Program Policy and Guidelines. This document outlines broad operational guidelines for SPs. The document is intended as a framework within which organizations funded by the SFDPH must develop detailed operational guidelines appropriate to their own organization and setting. These guidelines summarize best practices based on public health strategies and we strongly recommend that organizations not funded by SFDPH adhere to the principles and protocols provided in this document.

Below is a link to a copy of the guidelines and links to resources listed in the document:

Guidelines: