Rural users of syringe exchanges who say they can quit or cut use (and don't use meth) are more likely to get treatment

One of the first studies to explore syringe-service programs in rural counties found that the participants who consistently used a syringe exchange and voiced high confidence in their ability to decrease substance use -- and did not first inject methamphetamine -- had significantly higher odds of participating in treatment, according to a new study.

"These findings support the notion that providing brief motivational and targeted, goal-setting interventions may improve treatment seeking and enrollment," says the study.

The study, published in The Journal of Rural Health, looked at 186 people who injected drugs (PWIDs) and used syringe-service programs, (SSPs) in two rural southeastern Kentucky counties, Knox and Owsley, and Clark, a rural-suburban county near Lexington. The study involved voluntary, on-site, face-to-face interviews about behaviors, injecting practices, syringe service program utilization and treatment services.

Data were collected through an ongoing National Institute on Drug Abuse-funded study designed to examine uptake of SSPs among PWIDs in Appalachian Kentucky.

Partly because it has so many small counties, Kentucky leads the nation in the number of syringe-exchange programs, which allow drug users to swap dirty needles for clean ones to thwart the spread of HIV and hepatitis C, as well as offering other "harm reduction" services.

Among the 186 study participants, 83, or 44.6 percent, reported using a SSP more than six times over six months, which was considered "consistent use" for the purposes of the study. Asked about the importance of quitting or reducing their substance use, 69.9% of the participants said that was highly important; 17.7% said it was of medium importance and 12.4% said it was of low importance.

However, their confidence in their ability to quit or reduce their substance use was much lower, with 48.4%, (90) of them reporting high confidence; 28.5% (53) voicing medium confidence and 22.6% (42) expressing low confidence.

The researchers found that 21% (39) of the study participants had participated in treatment in the month before they were surveyed. They also found that participants in rural exchanges had a higher proportion of newer clients and a higher proportion of repeat users, compared to some urban studies.

The researchers said they couldn't pinpoint the reason why high confidence to change made consistent injectors of drugs more likely to get treatment. They writes, "It is plausible that the association is a result of active, intentional treatment referrals from the SSP, an indirect effect of general social and recovery support available at the SSPs, or increased agency for behavior change that accrues from ongoing successful participation in the SSP. These findings are nevertheless promising and warrant additional investigation."

They also noted that because Kentucky has such high rates of methamphetamine use, it is of particular concern that the study found that people who inject meth were less likely to be treated.