Primary Submission Category: Policy
Association between a Citywide Ban on Syringe Distribution and Provision of Other Harm Reduction Services and Syringe Litter in Pueblo, Colorado
Authors: Katherine LeMasters, Pranav Padmanabhan, Paul Christine, Jarratt Pytell,
Presenting Author: Katherine LeMasters*
Background: While syringe service programs (SSPs) provide harm reduction services proven to reduce overdose and infection-related morbidity and mortality among people who use drugs, political backlash towards harm reduction programs has grown. In Summer 2024, Pueblo, Colorado (population 110,000) instituted a three-week ban on syringe distribution, citing syringe litter. In partnership with one of two large SSPs in Pueblo, we sought to evaluate changes in (1) total SSP participation, (2) naloxone distribution, and (3) syringe litter associated with the temporary ban.
Methods: With SSP and Pueblo Department of Parks and Recreation data (January 1, 2024 – September 26, 2024), we conducted Interrupted Time Series analyses using segmented linear regression and two interruption points, the city council vote to ban syringe distribution (May 13, 2024) and resumption of syringe distribution (June 6, 2024).
Results: In January 2024, there were, on average, 229 participants served, 114 naloxone kits distributed, and 160 discarded syringes collected weekly. During the ban, there was an average weekly decrease of 31 participants (95% CI: -48, -15) and 23 naloxone kits (95% CI: -34, -12). After the ban, while there was an immediate (54, 95% CI: -11, 119) and sustained (5, 95% CI: 2, 9), weekly increase in participants and an immediate (48, 95% CI: 5, 91) and sustained (3, 95% CI: 0, 5) increase in naloxone kits, yet, neither returned to pre-ban levels in three months thereafter. There were no changes in syringe litter.
Conclusion: The temporary ban on syringe distribution had no effect on syringe litter – the impetus for the ban – and was associated with decreases in community naloxone distribution and in participants visiting the SSP during and after the ban. Policymakers must consider adverse consequences on community health, including decreased access to evidence-based overdose prevention measures like naloxone, when placing limits on harm reduction organization activities.