番茄社区

SAN DIEGO -- Tracking publicly discarded needles in Boston using "311" reports showed that this crowd-sourced data could, in a timely way, pinpoint areas with potential need for harm-reduction services, according to researchers here.

The highest concentrations of discarded needles were seen near homeless shelters, followed by needle disposal sites and hospitals, reported Benjamin Bearnot, MD, of Massachusetts General Hospital and Harvard Medical School in Boston, and colleagues.

"Information that we're using is out of date," explained Bearnot, at the American Society of Addiction Medicine annual meeting. "EMS [emergency medical services] information about where overdoses are happening come out on a yearly basis and are not publicly available, so really a lagging indicator."

In 2015, Boston added the option to report discarded needles to its municipal request service, Boston 311. The researchers looked at this data from May 2015 to August 2017. During this stretch of time, 4,747 discarded needles were reported -- mostly via a smartphone app (66%) -- prompting needle pick-up at the reported locations.

On average, 170 needle pick-up requests were made each month (interquartile range 110.5-217.8), and increased each year:

• 623 in 2015 from May to December
• 1,993 for all of 2016
• 2,131 in 2017 from January to August

"This is a publicly available crowdsourcing dataset that hasn't really been used to look at drug paraphernalia or discarded needles in the past," said Bearnot, who said that this type of data could be used to better target and deliver harm-reduction and opioid addiction treatment services.

The researchers then conducted a geospatial analysis of the data (time, address, neighborhood) to map out hot spots, cold spots, and outliers. Based on census block groups from the ArcGIS mapping and analytics platform, the highest discarded needle concentration were found in two neighborhoods -- and .

"There's not a lot of on-the-ground information about where people are using publicly," said Bearnot. "People that use drugs publicly aren't able to use test doses or use fentanyl test strips, which are some of the best practices."

Cumulatively, 76.5% of needles were reported within 1 km of homeless shelters, safe needle exchanges, hospitals or methadone clinics. Needles were consistently concentrated near the 23 homeless shelters in Boston, representing areas of high substance use:

• <250 m: 26.1%
• <500 m: 51.2%
• <1 km: 71.4%

"There are so many 311 services around the country," said Bearnot, "it would be relatively easy for them to layer on a service that would enable them for needle pick-up, with the added benefit of being able to target these addiction and harm-reduction services."

Future directions of research include linking this data to overdose/census data and comparisons with other municipalities, though right now Seattle (a pilot program) is the only other city that offers discarded needle pick-up through 311 services.