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SANE's Involvment in Research

SANE is committed to the tenet of evidence-based work.  Thus, research will always be a part of our activities.


 In the early 1990s, Jim Britton worked at the Sacramento AIDS Foundation, creating programs for people who inject drugs (PWID) at risk for HIV (human immunodeficiency virus, the virus that causes AIDS).  SANE’s Director, Rachel Anderson, worked as a Research Associate at the University of California, Davis with Dr. Neil Flynn.  Some of the studies they did in Sacramento County showed 11% of PWID who injected methamphetamines and 4% of PWID who injected heroin were infected with HIV1-3.  This alarming finding spurred Jim & Rachel, with support from many others, to start SANE (at the time known as Sacramento Area Needle Exchange).  Jim, Rachel, and many Sacramento PWID started the syringe exchange program  with the aim of slowing the spread of HIV among PWID in the region.  The current rate of HIV among PWID in Sacramento County is about 3%.  A 2007 article in a local medical journal credited SANE as a significant part of the efforts to lower the rate of HIV among PWID in Sacramento 4.


The results of many of the studies conducted by Dr. Flynn (SANE’s medical advisor 1993-2015) and his team in the 1990’s are presented in a 1997 international textbook on the use of methamphetamines in different parts of the world 5.  In 2003, an article about SANE’s operations and our reliance on Satellite Syringe Exchangers (SSE) was published in the International Journal of Drug Policy 6.  The SSE in SANE’s SAP are responsible for the success of SANE’s work against the spread of HIV and other harm reduction efforts in our region, such as reducing the number deaths related to overdose and abscesses among local PWID.


In the early years of the new century, SANE was co-investigator (designed and conducted the research) with San Francisco Needle Exchange, on overdoses among Sacramento and San Francisco PWID.  We gathered information from PWID who had OD’d or seen someone OD and the circumstances around those events.  The results were presented at the 2003 conference of the American Public Health Association 7 and showed 38% of PWID interviewed in Sacramento had OD’d and 83% had witnessed an OD; 69% had OD’d and 69% had witnessed an OD in San Francisco.  This study and other anecdotal evidence were some of the reasons SANE created its Overdose Prevention, Recognition, and Response Program (see Overdose page for more information).


In 2001, SANE and Dr. Flynn joined two other California researchers (Dr. Ricky Bluthenthal from the Rand Corp. and Dr. Alex Kral from the University of California, San Francisco) as co-investigators on a study of how California SAP were run and assessed which methods were most effective.  The study lasted for three years and is known as the CalSEP study.  The CalSEP study was one of the first to look at SAP operations and found some important results that SAP can use to improve services for PWID and support advocacy efforts for SAP.  Also, 17 (check #) published papers (in peer-reviewed journals) resulted from the Cal-SEP study, adding to the ever-growing body of evidence on the effectiveness of SAP as a public health strategy.  

Another way SANE participates in research studies is as a respondent or participant.  This means SANE is one of the subjects of the research rather than one of the investigators.  One such study was conducted by Dr. Sam Friedman of New York and looked at the numbers of PWID in many communities in the US, the risk of harm for PWID, and the levels of service provided to PWID8, 9.


Also, SANE participates as a respondent each year in the national syringe exchange study.  The study is conducted by Dr. Des Jarlais of New York and the results are published in the Centers for Disease Control & Prevention’s MMWR (Morbidity and Mortality Weekly Report).  The results of the 2005 survey are on page 1164 {here}B. 

In 2009 and 2011, SANE participated in studies to test the effectiveness of a more humane and dignified way to conduct drug testing than collecting blood or urine samples, using saliva instead. 


Updates coming soon


SANE will continue to post research both from studies SANE is a part of as well as results from other studies that may be of interest to you.  We are looking at putting together some studies on women who inject drugs, OD and/or abscesses, & conducting SAP in other agencies (not SAP agencies), but these are in the beginning stages of the planning.  If you have any ideas about future research projects SANE may be interested in and can learn from, please let us know.  In the same way, we will continue to put information on this site about research studies in our area that you may want to be a part of.  We will tell you who are conducting the studies, what they are looking at, what the rules for participating are, possible benefits and/or costs, and who to contact if you’re interested.   


1 Zeldis JB, Jain S, Kuramoto K, Richards C, Sazama K, Samuels S, Holland P, Flynn NM.  Seroepidemiology of Viral Infections Among Intravenous Drug Users in Northern California.  Western Journal of Medicine.  1992;156:30-35.


2 Flynn NM, Anderson R, Britton J, Ascher M, Tabnak F, Nassar N.  Major Differences in HIV Seroprevalence Between In-Treatment (IT) and Out-of-

Treatment (OT) Injection Drug Users (IDU).  Paper presentation.  IXth International Conference on AIDS.  June 1993.  Berlin, Germany.


3 Anderson R, Flynn NM, Britton J, Ascher M, Tabnak F, Nassar N.  On-the-Street HIV Testing & Interviews of Injection Drug Users (IDU) Using Finger-Stick Antibody Tests.  Paper Presentation.  IXth International Conference on AIDS.  June 1993.  Berlin, Germany.


4 McCarthy J.  Legal Syringe Exchange in Sacramento - at Last!  SSVMS: Sierra Sacramento Valley Medicine.  2007;58(6):1-3.  Click {here}C to read the article.


5 Anderson R, Flynn NM.  The Methamphetamine-HIV Connection in Northern California.  1997.  In Amphetamine Misuse: International Perspectives on Current Trends.  Klee, H ed.  Harding Press, Reading, England


6 Anderson RL, Clancy L, Flynn NM, Kral A, Bluthenthal RN.  Delivering syringe exchange services through “satellite exchangers”: the Sacramento Area Needle Exchange, USA.  International Journal of Drug Policy.  2003;14(5/6):461-463.


7 Anderson RL, Clancy L, Howe M, Flynn NM, Goffman I.  Drug Related Overdose: Sacramento and San Francisco IDU Experiences.  Invited paper. One Hundred Thirtieth American Public Health Association Meeting.  Philadelphia, PA.  November 9-13, 2003.  Click {here}D to see the presentation overheads.


8 Friedman SR, Templaski B, Cooper H, Perlis T, Keem M, Freidman R, Flom PL.  Estimating numbers of injecting drug users in metropolitan areas for structural analyses of community vulnerability and for assessing relative degrees of service provision for injecting drug users.  Journal of Urban Health.  2004 Sep;81(3):377-400.


9 Friedman SR, Cooper HLF, Templaski B, Keem M, Freidman R, Flom PL, DesJarlais DC.  Relationships of deterrence and law enforcement to drug-related harms among drug injectors in US metropolitan areas.  AIDS.  2006;20:93-99.

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