San Francisco hands out more free syringes to drug addicts — 400,000 a month and growing — than New York City, which has 10 times the population.

The San Francisco Department of Public Health oversaw the distribution of an estimated 4.5 million syringes last year, through various programs aimed at reducing HIV transmission and other health risks for injection drug users. Many of the needles wind up discarded on city streets, in parks and at homeless encampments. And they cost hundreds of thousands of dollars to retrieve.

This year, the city is on track to hand out upward of 6 million syringes — which, with a city population of 884,363, works out to nearly seven syringes for every man, woman and child living here.

New York, by comparison, distributed 3.48 million syringes in 2016, according to the New York City Department of Public Health. In the first nine months of 2017, the latest data available, New York gave out 2.98 million, putting the city in line to hand out 3.7 million for the full year — one needle for every two residents.

“It may be that we are doing a better job of providing clean needles for our drug users,” San Francisco health department spokeswoman Rachael Kagan said when informed of the numbers.

Or at least making them easier to get.

Unlike San Francisco, which has no limits or requirement that users return used needles, New York has controls on their handouts. Under New York state law, most drug users are limited to 10 needles per visit to a dispensary. If they want more, they have to do a one-to-one exchange.

Homeless people and others who might have difficulty getting to a distribution center are eligible for up to 30 needles a visit.

Even with the controls, New York has reported a 33 percent cut in the spread of HIV infections among its program participants since 1993.

“In New York City, we do not have an issue with publicly discarded syringes” near exchange sites, said Stephanie Buhle, a spokeswoman for the city’s health department. Needles have begun showing up at parks in the Bronx, though.

Closer to home, Seattle and surrounding King County hands out more than 7 million needles annually, according to the county’s public health department. But it has more than double San Francisco’s population, so the handout rate per resident is lower than here.

San Francisco city officials say they have no intention of limiting access to free needles, arguing that clean syringes are the best way to eliminate the spread of blood-borne pathogens among drug users and their sexual partners.

“I will not roll back our health policy ... to the stone ages,” Mayor Mark Farrell said Tuesday when asked about the city’s liberal needle distributions.

Farrell, however, pointed to his attempts to address the “the unintended consequences” of the city’s policy — including proposing to spend $750,000 a year so the San Francisco AIDS Foundation can hire workers just to collect used syringes.

He also wants to spend $6 million to fund a special first-of-its-kind medical team to treat addicts on the street with the medication buprenorphine, which curbs the appetite to shoot up in the first place.

“There is a problem on our streets with syringes, and that is exactly why I chose to create a dedicated team of 10 people to pick them up,” Farrell said.

Meanwhile, city officials cite other measures they’re taking to try to get the dirty needles off the streets — everything from setting up disposal kiosks to offering volunteers working in the AIDS Foundation clean-up program $20 gift cards.

On Tuesday morning, the mayor donned a yellow vest and joined a San Francisco Public Works team cleaning out a homeless encampment in a South of Market alleyway.

Public Works estimated they removed upward of 2 tons of debris — everything from furniture to about 100 syringes and crack pipes.

Earlier this month, Public Works crews cleaning a camp on Quint Street, near the Caltrain tracks, came across a tent with what appeared to be a makeshift meth lab, complete with portable Bunsen burners.

For some residents, the problem is popping up much closer to home. Visitacion Valley resident Toni Zernik tells us her school-age son nearly stepped on a needle recently while walking near Kearny and Jackson streets.

“I am sick of this,” she said. “Do we need to issue steel-sole boots?”

San Francisco Chronicle columnists Phillip Matier and Andrew Ross appear Sundays, Mondays and Wednesdays. Matier can be seen on the KPIX TV morning and evening news. He can also be heard on KCBS radio Monday through Friday at 7:50 a.m. and 5:50 p.m. Got a tip? Call 415-777-8815, or email matierandross@ sfchronicle.com. Twitter: @matierandross