Public-health researchers present local analysis showing decreases in syringe-service participation and naloxone distribution after short ban; data quality andl

Public-health researchers from the University of Colorado and the Colorado School of Public Health presented an interrupted time-series analysis of local data on April 21 examining outcomes before, during and after a temporary ban on syringe distribution by a local syringe-service provider.

Presenters and data Dr. Catherine Lemasters, a public-health researcher and professor at the University of Colorado Anschutz Medical Campus, and Pranav Padmanabhan, a master’s of public health student studying epidemiology, described data drawn from Access Point (one of two local syringe-service programs) and from the city’s parks and recreation department covering January through September 2024. They used May 13, 2024 (vote date) and May 18, 2024 (date the policy went into effect) as interruption points and noted the ban was overturned on June 6, 2024. The presenters described interrupted time-series models that estimate immediate level changes and trend changes at each interruption.

Key findings presented - Program participation: Weekly participant visits rose from about 210 per week in January 2024 to about 248 per week just before the ban. After the ban’s implementation there was a sharp decrease in participants; after the ban was overturned the presenters reported an immediate jump but by September 2024 weekly participation (~264) had not returned to projected pre-ban trend (~290). The presenters reported about 1,150 fewer participant visits in the period from the ban onward than expected under the pre-ban trend. - Naloxone distribution: Weekly naloxone kits distributed moved from about 116 per week in January to roughly 145 in May; the presenters reported a sharp decrease during the ban and an immediate increase after it was overturned but an overall shortfall of approximately 900 naloxone kits compared to projected pre-ban trends. - Syringes distributed: Presenters reported a flat pre-ban trend of about 9,000 syringes per week, a drop to zero during the ban, and a rebound after overturning; by September 2024 the weekly distribution was reported around 15,000 syringes, yielding a net increase of about 3,400 syringes distributed compared with the pre-ban projection when considering the full period. - Discarded syringes collected (syringe litter): The presenters said parks-and-rec data showed a decline in publicly collected discarded syringes from about 200 per week early in the year to about 97 per week later; they cautioned the estimate’s uncertainty and noted that community cleanup efforts continued during the ban, complicating interpretation. Overall they reported about 2,000 fewer discarded syringes collected in the period after the ban than projected by pre-ban trends.

Presenters’ interpretation and caveats The presenters said their findings are consistent with the public-health role of syringe service programs (SSPs): when syringe distribution and SSP participation declined, naloxone distribution and other SSP-linked services likely declined as well. They warned that reduced SSP participation could reduce access to HIV and hepatitis C testing, linkage to substance-use treatment, naloxone and other services, possibly harming population health. They emphasized the study is preliminary, relies on program data not designed originally for research, and that they plan to pursue additional data from the Colorado Department of Public Health and Environment (CDPHE). They also suggested qualitative interviews with SSP clients to understand behavioral changes (for example, hoarding syringes during the ban) and acknowledged the analysis was limited by data availability and timing.

Council questions and concerns Several council members and the mayor pressed presenters on data completeness and collection methods. Speakers noted that syringe-cleanup activities are undertaken by multiple city teams (Parks and Rec, community service crews, other teams), that Access Point’s historical reporting practices had been inconsistent, and that grant-funded programs sometimes report service metrics tied to funding rules. Councilors raised questions about whether the sharp post-overturn increase in syringes distributed reflected a real change in demand, backlog/hoarding, or a previously unreported baseline. Councilors asked for additional data from Parks and Rec and other cleanup teams and said they wanted clearer information about how Access Point records syringe distribution and client visits.

Why this matters: the analysis suggests a temporary policy change affecting an SSP had measurable short-term effects on participation and naloxone distribution in Pueblo; council members flagged data limitations and requested further verification before drawing policy conclusions.

Follow-up and next steps Presenters said they are working to obtain additional state-level data from CDPHE, can request expanded cleanup data from the mayor’s office and Parks and Rec, and are open to doing qualitative interviews with program participants. Councilors requested a more complete accounting of who collects discarded syringes across the city and urged presenters to incorporate that information into any revised analysis. No formal council action was taken at the meeting.