title: Syringe exchange, injecting and intranasal drug use.
abstract: OBJECTIVE
  To assess trends in injecting and non-injecting drug use after implementation of large-scale syringe exchange in New York City. The belief that implementation of syringe exchange will lead to increased drug injecting has been a persistent argument against syringe exchange.
  
  
  METHODS
  Administrative data on route of administration for primary drug of abuse among patients entering the Beth Israel methadone maintenance program from 1995 to 2007. Approximately 2000 patients enter the program each year.
  
  
  RESULTS
  During and after the period of large-scale implementation of syringe exchange, the numbers of methadone program entrants reporting injecting drug use decreased while the numbers of entrants reporting intranasal drug use increased (P < 0.001).
  
  
  CONCLUSIONS
  While assessing the possible effects of syringe exchange on trends in injecting drug use is inherently difficult, these may be the strongest data collected to date showing a lack of increase in drug injecting following implementation of syringe exchange.
authors.affiliation: Beth Israel Medical Center, New York, New York 10038, USA. dcdesjarlai@aol.com
authors.forename: Don C
authors.initials: DC
authors.lastname: Des Jarlais
authors.forename: Kamyar
authors.initials: K
authors.lastname: Arasteh
authors.forename: Courtney
authors.initials: C
authors.lastname: McKnight
authors.forename: Martin
authors.initials: M
authors.lastname: Ringer
authors.forename: Samuel R
authors.initials: SR
authors.lastname: Friedman
mesh_terms: D000281:Administration, Intranasal; D001294:Attitude to Health; D015658:HIV Infections / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D008691:Methadone / Q000627:therapeutic use; D009294:Narcotics / Q000627:therapeutic use; D018671:Needle-Exchange Programs; D009519:New York City / Q000453:epidemiology; D015397:Program Evaluation; D016320:Substance Abuse Treatment Centers / Q000706:statistics & numerical data; D015819:Substance Abuse, Intravenous / Q000453:epidemiology*; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000534:rehabilitation*; D013997:Time Factors
chemical_list: D009294:Narcotics; D008691:Methadone