University of Washington School of Public Health

UW SPH News: Most syringe exchange clients in Washington state say they want help

Most syringe exchange clients in Washington state say they want help

12/12/2018
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More than two million people in the United States in 2016 were addicted to opioids, according to the Center for Behavioral Health Statistics and Quality. Despite the existence of effective medication and services, nearly 80 percent of them did not receive treatment.

Researchers from the University of Washington School of Public Health peeked inside syringe exchange sites in Washington state in 2015 – via surveys – to understand people’s interest in stopping or reducing their opioid use. They found that most people wanted help, but weren’t getting it, according to the study, published this month in the Journal of Addiction Medicine.

Data for the study was collected from 436 people from 17 syringe exchange programs across the state. Eligible participants reported opioid use and injecting any drug, both within the past three months, and were not currently in treatment. More than 77 percent of participants reported wanting to stop or reduce their use, according to the study.

“This research shows that people do want to stop using opioids,” said senior author Caleb Banta-Green, interim director of the UW’s Alcohol and Drug Abuse Institute (ADAI) and affiliate associate professor of health services at the School of Public Health. “We just need to get people the care they need on their terms. We’ve started to deliver that care and now we’re evaluating the services.”

According to the study, women were more likely to express interest in reducing use, as were people who recently had an abscess. (Intravenous drug users are at increased risk for developing abscesses and other types of skin infections and inflammation.) People who had already been through treatment for opioid use disorder were still interested in getting help to reduce their use.

Data was gathered using the Washington State Drug Injector Health Survey, developed by ADAI in collaboration with syringe exchange programs. The study was led by Madeline Frost, a graduate of the Department of Health Services at the School of Public Health, who did the research for her master’s thesis.

"Syringe exchange programs are a crucial part of the public health response to the opioid crisis,” Frost said. “They not only help prevent the spread of infectious diseases, but are also a setting in which we can connect people who may not have other contact with the health care system to evidence-based treatment for opioid use disorder."

Historically, none of the syringe exchange programs in Washington state offered treatment on site. Only a few provided referrals to specialized care. Last year, before study publication, data from this research directly influenced state policy crafted by Governor Jay Inslee to fight the opioid crisis, Banta-Green said. Medication for opioid use disorder is now offered at three syringe exchange programs in the state and many more provide referrals to treatment. In Washington state, several programs now offer buprenorphine on site, which Banta-Green says is a “new public health model” that both supports recovery and reduces mortality.

“This type of public health research can drive changes that reduce addiction and mortality,” he added.

Co-authors of the study are Emily Williams, associate professor of health services at the School and core investigator at Veterans Affairs Puget Sound Health Services Research & Development, and Susan Kingston, a program operations specialist at ADAI.