EVALUATING NEEDLE EXCHANGE - ARE THERE NEGATIVE EFFECTS

Objective: We analyzed data on all drug-treatment admissions in San Fr ancisco County over a 4-year period (n = 35 460) to evaluate the poten tial negative effects of the San Francisco needle-exchange program. Me thods: Admissions in the 2 years preceding implementation of the excha nge program (1987-1988) were compared with admissions in the 2 years f ollowing implementation (1989-1990). Results: No negative consequences of needle exchange were detected. Specifically, the presence of the e xchange program was not associated with (1) increases in injection dru g use, (2) increases in needle-sharing behavior, or (3) changing drug- use behavior from non-injection to injection. We also compared high-dr ug-use neighborhoods with and without local needle-exchange sites. Nei ghborhoods without needle-exchange sites showed a greater increase in proportion of admissions for injection drug use, and in frequency of i njection, over time. Conclusions: Because of methodological limitation s, our findings are preliminary. Longitudinal studies comparing needle -exchange and non-exchange cohorts are needed to further evaluate effe cts of this intervention.