Strategies for addressing needle debris: A scoping review of needle debris and discarded drug paraphernalia associated with substance use.

Abstract

Needle debris and discarded drug paraphernalia can pose risks to people who use drugs (PWUD) and other members of the community. The research question guiding our scoping review was, "What is the scope of literature around discussions of and interventions for needle debris associated with drug use in a community setting"? The review was guided by the Joanna Briggs Institute methodology. Reporting was in accordance with the PRISMA scoping review extension. Searches in August of 2022 on Medline, CINAHL, PsycINFO, EMBASE, and Social Services Abstracts were completed. Quantitative and qualitative study designs were included. Grey literature was excluded. Extracted data included disposal initiatives and factors influencing disposal practices. The databases combined search total was 3074. A total of 1115 duplicates were removed. Inclusion and exclusion criteria resulted in 72 studies full-text studies reviewed. Nineteen articles met all requirements. Studies from multiple continents resulted in similar themes. Two main themes were identified: needle disposal challenges for PWUD and disposal initiatives. Disposal challenges related to legal barriers and law enforcement influence, the varying definitions of 'safe disposal' and perspectives of PWUD. Disposal initiatives stemmed from community-based initiatives, pharmacy contributions and the perceptions and attitudes of community members. Needle debris is a complex phenomenon highly impacted by the threat of persecution from law enforcement. PWUD need various disposal methods in proximity to their injecting location to avoid fear of prosecution from residual substances on the syringes.