There are a variety of ways that SSPs do inventory control, from informal to more structured.
Most accurate methods require carefully counting all of the supplies provided to participants for:
- a set period of time (say a week or two), at
- a variety of points in time during the year (because drug use, and therefore supply needs, often change throughout the year), and
- in all locations where the organization provides services (because drug use and supply needs also vary by geographic location).
Many SSPs attempt to always keep a careful count, however the reality is that data occasionally gets lost or forgotten in the rush to provide services so picking periods to pay special attention to inventory ensures the most accurate results.
Dedicated counting can give an organization a sense of the average number of supplies necessary for each location for a specific period. This allows organizations to calculate overall inventory needs by multiplying average demand for a set period (for example 1 week) by the total for the year (52 weeks a year). For example, let’s say an SSP did inventory one week a month for 6 months and found that, on average, they needed 1000 27g 5/8s and 2000 30g 1/2 syringes per week at site A and 1000 27g 5/8s and 3000 30g 1/2 syringes per week at site B. This means they would need:
5000 30g 1/2 X 52= 260,000 @ 1000 per case/$150 per case = $39,000
If their budget was too small to support the full community need with proper inventory management, they could place modest caps on how many supplies were provided so that their participants would not be left without supplies at the end of the funding period. This also gives programs the ability to clearly explain those caps to participants, transparency which helps to empower participants and alleviate potential community tensions.
Another method is the comparison method, where programs identify what they have ordered versus what they have on hand after a set period of time (say a week or month). One way to do this is to wait for an order to come in for something you are completely out of and then see how many of those supplies are left after a set period of time.
Week-to-week or Month-to-Month Stock on Hand
Another method is to do inventory counts of stock on hand once every set period (say each month) and use an average of those counts to calculate how much is needed for a year and, again, use a comparison to the supply budget to calculate how much to order each month.
Line on the Wall
The final method is the “line on the wall” method developed by Shiloh Jama when he was at the People’s Harm Reduction Alliance (PHRA) in Seattle, WA. This method is very simple but only available to programs with a fixed storage location. It evolved by initially using more traditional counting methods to determine how many syringes of each size they needed for an average week.
Shiloh was armed with the knowledge that his suppliers normally take two weeks to a month to ship supplies, so he made two marks on the wall of his storage space for each supply type. One mark was at the height and width the stacked boxes occupied when he had a month’s worth of supplies, and one at the height and width when he had two weeks’ worth of supplies. When the lines appear, PHRA knows it is time to reorder.
The limitations of this method are that it doesn’t help programs who may have a variable or limited supply budget and it does not lend itself to fluid recalibration in the face of a changing drug scene. It does have the very real benefit of being a passive method that allows overworked harm reductionists a “no-brain” method of ensuring they always have supplies on hand. Its inventor encourages programs to adopt and adjust this method to their needs.
Used Sharps Accounting
Despite the move away from one-for-one exchange in favor of evidence-based syringe distribution, most SSPs must still account for the used syringes that are surrendered to them. Though there are several ways to do this, here are some of the most common:
- Literal Count – this is the most exhaustive and time-consuming method. It requires participants to literally count each syringe in front of staff. Some programs allow participants to bundle syringes in groups of 10 or 20 to speed up dropping them off.
- The Container Method – a method perfected by the Humboldt Area Center for Harm Reduction (HACHR) in Humboldt, CA. Volunteers stuffed a variety of containers with syringes to see how many would fit – both official sharps containers they distribute to participants and other containers participants frequently brought sharps back in (like soda and bleach bottles). They then record that number each time they receive a container of that style.
- Self-Report – perhaps the easiest method is to simply rely on participant self-report to determine how many used syringes they are turning in to the SSP. This has the added benefit of helping to build trust with participants by giving trust to them first.
In addition to these methods, many leaders gave the advice that one of the best tools for getting used syringes turned in was to simply turn your participants into empowered allies by telling them about demands or push-back their program is receiving from communities because of concerns about improper sharps disposal and requesting their help in reducing it by turning in used supplies.