dates on supplies. Keeping the SAP stocked is vital to maintaining trust among participants, as well as encouraging positive behavior change. When supplies at the exchange run out while participants are working on modifying injection behaviors, it makes it easier to fall back to old habits. Along these lines, it is also important for more than one staff person to be involved in, and aware of supply purchasing procedures. While it may be useful to assign a point-person or people to be primarily responsible for managing stock and or placing orders (in order to avoid duplicate orders and/or work), it is essential that this knowledge be shared and that others can respond in the absence of the point-person. The danger is that if only one person knows when and how to order supplies, the SAP could suffer shortages in the event that the staff person leaves, is on vacation or has an emergency. Where to get supplies The following is a list of not-for-profit venues for obtaining syringes and other injection supplies: • The NASEN (North American Syringe Exchange Network) Buyers Club offers a way for SAPs to acquire lowcost syringes and supplies. • When working in collaboration, Health Departments will often manage syringe supply. • Other exchange programs can be a resource for new or smaller programs to obtain syringes and other supplies and/or in cases where thereis a short-term/emergency need; other programs may also be able to share vendor information for supply purchase. In addition, there are also several for-profit entities that sell safer injection supplies and equipment. Many of these companies can be found online, or feel free to contact HRC for more information.
DI SPO S A L Assisting participants with the proper disposal of used syringes and injecting equipment is an important role for the SAP. In turn, the SAP must comply with regulations for subsequently disposing of used syringes, which qualify as Regulated Medical Waste (RMW). Proper disposal is first and foremost about individual and public safety; improperly discarded waste poses a risk for the continued spread of infectious disease and can result in accidental needlestick injuries. In addition, improperly discarded injection equipment can draw unnecessary attention and negative criticism to the SAP despite program efforts to improve disposal practices. Unfortunately, although improper syringe disposal does tend to decrease when an SAP is present, the reality is that drug users may still be afraid to carry used injection equipment for fear of interactions with law enforcement, and stigma around drug use makes disposal options scarce and difficult to access. SAP Disposal of Returned Injection Equipment The SAP will be held to standards for the proper disposal of used injection equipment, which is qualified as Regulated Medical Waste (RMW). It is important for the SAP to carefully document all procedures for handling and disposing of medical waste. Also, when RMW is disposed of, keep clear and verifiable records. It is also a good idea to become familiar with state disposal laws for your area. Safe disposal procedures are necessary to avoid accidental needlestick injuries among staff, volunteers and participants, but also to avoid any potential backlash, should an accident occur. Although the likelihood of infectious disease transmission is low in cases of accidental needlestick, it can be a very stressful and anxiety-producing experience for anyone involved. For more information on needlestick injury prevention and response, please see Module 3. The following are tips for the proper handling and disposal of syringes at the SAP level: • Research statewide regulations for the proper handling and disposal of RMW. • Consider reserving funds in the budget to hire a private waste management service that will pick up and -42-
