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This Article Full Text Full Text (PDF) All Versions of this Article: AJPH.2005.080770v1 98/2/278    most recent Submit a response Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Bluthenthal, R. N. Articles by Kral, A. H. Search for Related Content PubMed PubMed Citation Articles by Bluthenthal, R. N. Articles by Kral, A. H. Related Collections Health Law Health Policy HIV/AIDS Government Other Statistics/Evaluation/Research Drugs

Ricky N. Bluthenthal, PhD, Keith G. Heinzerling, MD, MPH, Rachel Anderson, BA, Neil M. Flynn, MD, MPH and Alex H. Kral, PhD

Ricky N. Bluthenthal is with the Health Program and Drug Policy Research Center, Rand Corp, Santa Monica, Calif, and the Sociology Department, California State University, Dominguez Hills. Keith G. Heinzerling is with the Department of Medicine and Integrated Substance Abuse Research Programs, University of California, Los Angeles, and the Veterans Affairs Greater Los Angeles Health Care System, Los Angeles. Rachel Anderson and Neil M. Flynn are with the Department of Infectious Diseases, Division of Internal Medicine, School of Medicine, University of California, Davis. Alex H. Kral is with the Urban Health Program, RTI International, San Francisco, Calif, and the Department of Family and Community Medicine, University of California, San Francisco.

Correspondence: Request for reprints should be sent to Ricky N. Bluthenthal, PhD, Rand Corp, 1776 Main S, PO Box 2138, Santa Monica, CA 90407-2138 (e-mail: rickyb{at}rand.org).

Objectives. We studied the effect of local approval of syringe exchange programs in California (through Assembly AB136) on program availability and performance.

Methods. We determined the number of active syringe exchange programs in California by conducting Internet searches and obtaining information from the state and from local programs. To track changes in program availability and performance between 2000 and 2002, we interviewed 24 program directors annually for 3 years about program characteristics, syringe exchange policies, law enforcement contact, and other issues. We conducted multivariate analyses to determine whether AB136 approval status was associated with changes in performance.

Results. Fifteen local governments (13 counties and 2 cities) enacted the new law by 2002, and operating syringe exchange programs increased from 24 to 35. The proportion of these programs that were not locally approved declined from 54% to 40%. No new approved programs were started in high-need counties. Total syringes exchanged increased by more than 1 million per year, average annual budgets increased by more than 50%, and police harassment of the program volunteers, clients, and operators declined. Improvements at approved syringe exchange programs accounted for these changes.

Conclusions. Statewide approval and funding appears necessary to further syringe exchange availability in California.