In comparing the two cities, Hansel E. Tookes, a second-year medical student, replicated the methods of a previous study done in San Francisco in 2008. For the 2009 Miami study, Tookes and fellow students and staff members conducted visual inspections in the top quartile of Miami neighborhoods with the highest concentration of drug use, as designated by city data.
The researchers walked the streets of each city looking for syringes and found that there were close to 400 dirty syringes in Miami, more than eight times as many as on the streets of San Francisco, the city with needle and syringe programs.
The researchers also interviewed more than 1,000 injection drug users in these cities, and found that in Miami they were more than 34 times as likely to report public disposal of syringes as their counterparts in the city with needle and syringe programs (NSPs). The study—which is believed to be the first NSP versus non-NSP city-to-city comparison— revealed that 95 percent of syringes used by injection drug users in Miami were disposed of improperly, versus only 13 percent in San Francisco. Improper disposal in Miami neighborhoods translated to nearly 10,000 needles and syringes per month cast aside in trash cans, sewers, parks and other public places.
“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,” said Tookes, who conducted the study with his colleagues as his final project for his master’s in public health, also at the Miller School.
The study, “A comparison of syringe disposal practices among injection drug users in a city with versus a city without needle and syringe programs,” was published online on December 28 in a leading substance use journal, Drug and Alcohol Dependence.
For the study, Tookes worked with a team from the Miller School, which included his advisor Lisa R. Metsch, Ph.D., professor of epidemiology and public health, and a San Francisco-based team, which included Alex H. Kral, Ph.D., an infectious disease epidemiologist who is director of the Urban Health Program in the Behavioral Health and Criminal Justice Research Division of RTI International.