Help stop HIV/hepatitis transmission in NC. FREE.
Triangle Points provides disease prevention kits free of charge to any individual or organization in central North Carolina. The detailed contents of the kits are described below, and the rationale for their inclusion (the nickel is in the photos to give you a sense of scale). Millions of similar kits have been handed out all over the world. If there are particular items that you do not feel that you or your clients will use, we can make up custom kits for you. The kits help reduce the chance of spreading and/or contracting bloodborne viral infections, including HIV and hepatitis B and C. Each kit is designed to provide sterile materials for 8-10 injections. These kits are 100% legal; everything in them can be purchased without prescriptions. Since syringe exchange remains illegal in North Carolina, the kits do not contain syringes.
Each Item described below includes a per unit cost. Also included is the money that North Carolina citizens spent treating uninsured, Medicaid and Medicare inpatients with each preventable disorder in 2005. One kit costs about $x.xx. The yearly cost of treating the diseases that could be prevented is: $xx,xxx. (Technical details about where the numbers come from are at the bottom of this page.)
Sterile Water & Saline
Why?
Water is used to mix drugs. When water is drawn up into a used syringe, HIV and hepatitis can get left behind; the next person who uses the water can get infected. It is important for each person to have their own water. If your water gets dirty, it can contaminate everything else. Also, tap and bottled water contain bacteria. When you inject bacteria straight into your bloodstream you can get an abscess or a systemwide infection. We provide one or two 5 mL vials; an average shot used about 1.0 mL of water. Without their own source of water, people might share water and be infected with HIV or hepatitis viruses. Without a clean source of water, people may use water from toilets, puddles or streams/ponds. All of these sources of water are filled with bacteria that can kill you. Sterile saline is more like our blood and better for making shots than water. If you don't have access to sterile water or saline, you can boil water for 10-15 minutes (twice as long in the mountains).
Prevention
Cost of one vial of sterile water: $0.16
Treatment
Cost to treat one inpatient with bacteremia: $18,672
Cost to treat one inpatient with abscess: $10,298
Cost to treat one inpatient with infected veins (phlebitis/thrombophlebotis): $25,205
Discounted lifetime cost of treating HIV infection: $385,200
Cost to treat hepatitis C infection: $3,500/month or $40,000/year
Sharps Disposal Containers
Why?
Biohazard containers are used to safely dispose of used syringes. Sharps containers prevent needle-stick injuries from improper disposal. They prevent infected fluids from leaking out. The sharps containers we use come in variety of sizes can can hold between 10 and hundreds of syringes. The containers are spill-proof, break-proof, crush-proof. Our containers are approved by the Food and Drug Administration and the Occupational Health and Safety Agency for the prevention of needlesticks. Breaking off the needle just means there is an used point floating around; it's easy to find a point at the end of a syringe. You can also use a plastic soda bottle, a metal coffee can or a laundry detergent bottle to dispose of your used syringes. However, a biohazard sharps container is the best option if you have one.
Prevention
Cost of one sharps container: $3.00
Treatment
Discounted lifetime cost of treating HIV infection: $385,200
Cost of post-exposure prophylaxis after needlestick injury: $1,092
Cost to treat hepatitis C infection: $3,500/month or $40,000/year
Alcohol Pads and Hand Sanitizer
Why?
There are bacteria naturally growing on your skin. When you put a needle through your skin, you are pushing these bacteria into your blood stream. Once inside your blood stream the bacteria can develop into a bad infection or form an abscess. The bacteria can also live on your heart valves, giving you a heart infection and causing your heart to stop. You can prevent this by washing the skin of the injection site with soap and water before you shoot. If there isn't soap and water available, alcohol pads can be used. Letting the area dry before you shoot will prevent it from stinging. If you don't let the alcohol dry, the shot may sting or it may take longer to stop the blood. That's why we don't use alcohol pads to stop the flow of blood after a shot.
Prevention
Cost of one alcohol pad: $0.02
Treatment
Cost to treat one inpatient with heart valve infection (endocarditis): $51,707
Cost to treat one inpatient with infected veins (phlebitis/thrombophlebotis): $25,205
Cost to treat one inpatient with bacteremia: $18,672
Cost to treat one inpatient with abscess: $10,298
Cottons
Why?
Cottons are used to filter impurities before injection. Common types of filters are Q-tips, cigarette filters, cotton balls and tampons. However, each of these filters require you to use your hands to ball them up and the fibers can break into small pieces. If you don't wash your hands before you ball or roll up your filter, you can get bacteria all over them. Cotton plants also have bacteria growing on them, some of which may still be alive in your filter. These bacteria can be sucked up into the syringe and end up in your blood stream causing a nasty infection. The small pieces of fiberglass in a cigarette filter can get sucked into the syringe and end up in your lungs, where they cause infections (cotton fever) and blockages. While cotton fever usually runs its course, but in extreme cases you can wind up with pneumonia. If cottons are stored in warm and humid places, bacteria and fungus will grow on them. So, use a new cotton each time you shoot. Sharing cottons that have been touched with contaminated drugs or water or cookers can lead to HIV or hepatitis transmition. The cottons in our kits are tightly spun cotton pellets used in dental procedures. Ideally they would be sterilized. They are the right size for using as a filter and the fibers are less likely to break off.
Prevention
Cost of 10 cotton pellets: $0.03
Treatment
Cost to treat one inpatient with bacteremia: $18,672
Cost to treat one inpatient with pneumonia: $26,520
Discounted lifetime cost of treating HIV infection: $385,200
Cost to treat hepatitis C infection: $3,500/month or $40,000/year
Gauze Pads
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Antibiotic Ointment
Why?
It is important to take care of our bodies. Creams and ointments for the skin can be part of that. Antibiotic ointment can reduce the chance of getting and abscess by killing any bacteria that are living around the injection site. Antibiotic ointment can also help reduce scarring. You should wait for the blood to stop before putting any on.
Prevention
Cost of one 1/32 oz. packet of triple antibiotic ointment: $0.19
Treatment
Cost to treat one inpatient with bacteremia: $18,672
Cost to treat one inpatient with abscess: $10,298
Adhesive Bandages (aka Band-Aids)
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Cirtic and Ascorbic Acid (Vit C) Packets
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Cookers
Why?
Cookers are used to mix or heat drugs to disolve them with water. Cookers are also used to divide drug solution. Cookers can become contaminated with blood if they are used more than once. Different people prepare their drugs differently. For example, you may know someone who adds a drop of blood to their drugs. Having your own cooker gives you control over how the solution is prepared and who touches it.
Prevention
Cost of one cooker: $0.10
Treatment
Discounted lifetime cost of treating HIV infection: $385,200
Cost to treat hepatitis C infection: $3,500/month or $40,000/year
Tourniquets/Ties
Why?
Tourniquets reduce damage to veins from injecting, just like in the hospital. Using a tourniquet makes your vein bigger so you can hit it quicker. You do less damage to the vein and tissue around it since you aren't digging around for a vein. If you can hit a vein under pressure, there will be less leakage of blood and drug. A tourniquet also makes it easier to taste your shot as you are injecting it, allowing you to know whether to stop or proceed depending on how it tastes. You can reduce your risk for overdose by tasting your shot first.
Prevention
Cost of one tourniquet: $0.16
Treatment
Discounted lifetime cost of treating HIV infection: $385,200
Cost to treat hepatitis C infection: $3,500/month or $40,000/year
Cost to treat one inpatient with heroin overdose: $12,075
Where do these financial numbers come from?
The average cost per inpatient discharge is present. Data are from the Agency for Healthcare Research Quality (AHRQ), a US government agency that keeps track of hospital cost and care. The data are from the Healthcare Cost and Utilization Project (HCUP), in which North Carolina participates.
The HCUP database only contains patients who were admitted to the hospital for an overnight stay ("inpatients"). So these numbers do not include those who were went to their doctor's office, or were treated and released from emergency departments or by EMS. We conservatively used the primary diagnosis code so that we would understate the cost; patients with more than one complaint are more expensive to treat. It is certain that some of these diseases were not the result of injection drug use. However, these are specific medical problems that IDUs have.
The ICD-9 codes used in the analysis are as follows.
682.3 Cellulitis/abscess, upper arm
790.7 Bacteremia
459.2 Compression Of Vein - $27,586
422.0 Acute myocarditis - $35,590
451.11 Femoral Vein Phlebitis - $10,440
The prices of each kit component is taken from the North American Syringe Network's 2005 Buyers Guide. In instances where NASEN was not able to provide the item, we list the wholesale cost that Triangle Points paid.
Want to recreate this analysis?
We have nothing to hide and believe in scientific openess. Do these numbers seem odd to you? Don't believe us and want to run the numbers for youself? Please do, and please let us know if your findings are different from ours.
If you want to recreate this analysis, you should start here.
Click on "State Statistics from the SID" and identify yourself as a researcher or medical professional.
Chose "Statistics on specific diagnoses or procedures."
Pick a state and year.
Choose "Specific diagnoses by ICD-9-CM?"
Click on "Principal Diagnosis"
Enter the ICD-9-CM code from above, click next.
Check boxes: number of discharges, hospital charges mean, hospital charges median. Click next.
Check boxes: All patients and payer. Click next.
In the next screen you will get a table with the information that you can download to Excel.