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Orange County Health Department I Safe Syringe Initiative Proposed January 2016 Background The individual and community health benefits of reducing syringe re -use and removing potentially infectious syringes from the community are clear. • A significant risk for the transmission of HCV is the sharing of syringes', with over 50% of new infections attributable to the practice (Wasley, Miller, & Finelli, 2007). • Between 2007 and 2011 in North Carolina, reported rates of acute hepatitis C (HCV) increased by 200 %. Reported rates of hepatitis A and B both decreased during the same time period, by 57% and 21% respectively. (CDC, 2013 State Health Profile) • No high - quality studies exist, however anecdotal evidence shows that many diabetic patients reuse syringes due to the cost and availability of syringes. Some research concludes that reuse of syringes leads to tissue micro trauma, increased incidence of needle breakage, and increased incidence of lipodystrophy (Look, Strauss, 1998). • A study of 851 injection drug users (IDU) in the Triangle showed that African - American IDUs were one -fifth as likely as white IDUs to report pharmacies as their primary source of syringes (Costenbader, Zule, & Coomes, 2010). • A literature review of 47 studies found that legal or health concerns are not the primary reason for pharmacists' decisions not to sell syringes to customers. The primary concern is safety, such as staff safety, theft, and improper syringe disposal. (Janulis, 2003) • OCHD has built strong relationships with a number of important community stakeholders during our county's work to increase naloxone availability. Cost Considerations The initial set -up and maintenance costs of the SSI at OCHD are expected to be minimal. The majority of the cost will be through personnel time, mainly of the Board of Health Strategic Planning Manager, clinic leadership, and select clinic personnel. Set -Up Costs • $50 — Syringes • $1,000 — Disposal materials (drop box, Fitpacks, etc.) • $250 — Printing costs of educational materials • 40 -50 hours - Staff time to design program (meetings w/ stakeholders, program design, staff training, work with media) • Board of Health member time to attend select meetings with key stakeholders Maintenance Costs per Year • $TBD — Medical waste disposal • $300 — Syringes ($0.05 /syringe, 10 syringes /person, 50 people per month, 12 months) • $250 — Printing costs of educational materials • 36 hours — Clinic staff time to educate clients and dispense syringes (4 hrs /month) • 15 hours — Staff time to monitor program and complete process /output evaluation 1 For the purposes of this summary, the term syringe includes both the syringe and needle components