Getting rid of dirty needles may soon be as easy as mailing a letter.
Under an experimental program that begins in two weeks, Baltimore health officials will transform rusted, old mailboxes from the U.S. Postal Service into burgundy drop boxes for drug addicts' syringes. Six boxes will be bolted down to corners in neighborhoods troubled by heavy drug use, where trashmen, children and others risk getting pricked -- and contracting a fatal disease.
About a million dirty needles are discarded in Baltimore streets, parks and alleys every year, local health officials estimate. If enough needles are deposited in the boxes over the next several months, the project might be expanded.
The concept, started in Florida six years ago, is turning up in places as diverse as Australia and Texas. It is being considered as a solution in cities grappling with drug users' litter and in other areas trying to cope with proliferating syringes.
As more patients are treated on an outpatient basis, they are sent home with self-injection kits, said Dr. Steve Jones of the U.S. Centers for Disease Control in Atlanta. Studies have shown as many as one in 10 trash collectors suffer needle injuries every year.
"There's clearly a problem of inappropriate syringe disposal," said Jones. "I was riding on an airplane and tried to take out a magazine, and there was a syringe in the pocket."
Yet there are few approaches to safe disposal. In a few weeks, a national meeting will be convened in Baltimore to discuss methods tried around the world, including the mailbox concept.
L In local neighborhoods, residents have given their approval.
"It [drug use] is illegal, but it's happening, so what do we do about it?" asked Sylvia Fulwood, executive director of the East Baltimore Midway Community Development Corporation. "What do we do to save the nonusers? We don't want other people to get infected by the AIDS virus or other diseases."
Although the risk is small, people who accidentally get stuck with a used needle could contract several diseases, from AIDS to syphilis. About 25 percent of Baltimore area drug users carry the human immunodeficiency virus, about 90 percent have evidence hepatitis C infection, and about 70 percent of them are probably still infectious, said Dr. David Vlahov, professor of epidemiology at the Johns Hopkins School of Public Health.
Dr. Vlahov will monitor the mailbox experiment, much as his team of Hopkins researchers evaluates the needle exchange program run by Baltimore's health department. That program, which issues coded, clean needles to drug users in exchange for dirty needles, is intended to help combat drug addiction and the spread of HIV, which causes AIDS.
With the drop boxes, people can drop needles inside without being able to get anything out. The boxes are visible, accessible, and don't require staffing. Workers will empty them as needed.
"It's kind of a win-win," said Dr. Peter Beilenson, city health commissioner. The mailboxes were donated, and the city is spending no additional money on the project. "The worst that happens is no one uses them."
In the rural Florida county where the idea originated, the mailboxes have been popular.
Donald Toews, health officer for DeSoto County, came up with the idea after a 10-year-old girl got stuck by a syringe in a brown bag left on the road after she tried to put it into the trash. From 1990 to 1995, DeSoto collected 3,706 pounds of needles and plastic containers.
"It's been fabulous," said Toews. "Before, diabetics were putting them in garbage. They were dumping them everywhere."
In Baltimore, a city with roughly 48,000 drug addicts, the emphasis will be on illicit drug users, Beilenson said. Groups of drug users gathered for interviews by Hopkins researchers were asked about their practices. About 75 percent of them said they would use the boxes. Many apparently accumulate their needles, put them in bags or bottles and then in a Dumpster. They said they would welcome a safer way.
In West Baltimore, a box will be placed in the Rosemont area, at the corner of Rosedale Street and North Avenue.
Fulwood's group has identified four corners for the boxes: 25th Street and Brentwood Avenue, 20th and Barclay streets, 22nd and Calvert Streets, and 20th and Boone streets. A fifth spot in vTC East Baltimore is yet to be selected.
The group asked that boxes not be put near playgrounds, in fears that children trying to be helpful might pick up needles and stick themselves.
Anthony J. Ambridge, a Baltimore councilman, said he likes the idea. "I can't tell you how many hundreds of time I've been in alleys and have seen discarded syringes. It's very dangerous and very disgusting," said Ambridge, who checks for syringes every time he takes his children to a playground. "Even in your better neighborhoods you'll find syringes."
At Hopkins, Vlahov has received a $35,000 grant from the CDC. Researchers will interview drug users and community residents before, during and after the boxes are put into use. They will count needles discarded before and after the program begins, near the boxes and away from them. They will test random samples of the needles for HIV.
According to Beilenson, people who use the mailboxes to drop off empty syringes will be immune from prosecution under the exemption given the city's needle exchange program. But anyone carrying syringes containing illegal drugs can be arrested.
Pub Date: 6/08/96