title: Harm reduction product distribution in British Columbia.
abstract: OBJECTIVE
  The British Columbia Centre for Disease Control (BCCDC) tracks the distribution of all harm reduction products subsidized by the BC government, including needles and syringes, sterile water vials, alcohol swabs, condoms, and lubricant. This study measures the distribution of harm reduction products in BC, identifies regional variation in distribution, and estimates the supply/demand ratio for needle and syringe units.
  
  
  METHODS
  Using three years of administrative data (2004-2006) from the BCCDC, the quantity of harm reduction products distributed was calculated by Health Service Delivery Area (HSDA). Regional hepatitis C virus (HCV) case report rates were calculated to reflect potential variation in IDU populations at the HSDA-level and the number of needle and syringe units distributed per reported case of HCV was calculated and ranked by HSDA. To compare the demand for sterile injecting equipment to the distribution, the number of illicit drug injections per year was approximated using established estimates of IDU populations in BC and Vancouver.
  
  
  RESULTS
  Marked regional variation exists in the rates of harm reduction product distribution per 100,000 residents aged 15-64. The average number of needle and syringe units distributed annually in BC from 2004-2006 was 5,382,933. The estimated number of injections per year in BC is 24,951,144, suggesting the province distributed 21.5% of the units required to cover all illicit drug injections in the province.
  
  
  CONCLUSIONS
  Harm reduction product distribution is not equitable between BC HSDAs. The current level of distribution of sterile injecting equipment is inadequate to provide a clean needle for every injection.
authors.affiliation: Collaboration for Outcomes Research and Evaluation, Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC.
authors.forename: Stephanie S
authors.initials: SS
authors.lastname: Harvard
authors.forename: Warren D
authors.initials: WD
authors.lastname: Hill
authors.forename: Jane A
authors.initials: JA
authors.lastname: Buxton
mesh_terms: D000293:Adolescent; D000328:Adult; D001955:British Columbia / Q000453:epidemiology; D040261:Harm Reduction; D006526:Hepatitis C / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D013287:Illicit Drugs; D008875:Middle Aged; D018671:Needle-Exchange Programs / Q000592:standards* / Q000706:statistics & numerical data; D009339:Needles / Q000600:supply & distribution*; D020380:Needs Assessment; D015397:Program Evaluation; D011635:Public Health Administration; D012040:Regional Health Planning; D016320:Substance Abuse Treatment Centers / Q000592:standards* / Q000706:statistics & numerical data; D015819:Substance Abuse, Intravenous / Q000150:complications / Q000453:epidemiology* / Q000821:virology; D013594:Syringes / Q000600:supply & distribution*; D014505:Urban Population; D055815:Young Adult
chemical_list: D013287:Illicit Drugs