Syringe Services Programs
Syringe services programs (SSPs), also referred to as syringe exchange programs (SEPs), are programs that allow
people who inject drugs to exchange their used syringes for new, sterile needles, thereby reducing the
transmission of infectious diseases like human immunodeficiency virus (HIV) and
hepatitis C virus that can be transmitted via needle sharing. For example, in 2015 public health officials
reported an outbreak of HIV in rural
Indiana that was ultimately linked to injection use of the prescription opioid oxymorphone. Needle and
syringe programs can be delivered in several different formats. Some of the main sources include fixed sites,
mobile programs, outreach programs, syringe vending machines, and pharmacies.
Syringe services programs have been shown to help prevent
the transmission of HIV and viral hepatitis among individuals who inject drugs. The U.S. Department of Health
and Human Services (HHS) has issued guidance
for use of federal funds in order to implement and expand syringe services programs for individuals who
inject drugs. In 2015, the bipartisan budget agreement revised a longstanding ban on syringe services programs.
In 2015, the Centers for Disease Control and Prevention (CDC) reported increased rates of drug
injection in suburban and rural areas, particularly related to injection of prescribed opioids and
heroin. However, there are substantially fewer harm reduction services available in rural than in urban areas.
Prevention programs like SSPs have shown to be effective in reducing transmission rates of diseases such as HIV
and hepatitis C.
Examples of Syringe Services Programs
- The Indiana
Syringe Exchange Program was signed into law May 5, 2015, permitting SEPs to be created
throughout communities in Indiana. Local health departments, municipalities, or approved nonprofit
organizations are allowed to operate a syringe exchange program through this agreement.
- The Kentucky
Harm Reduction and Syringe Exchange Program (HRSEP) was designed in response to an
amended law allowing individuals to exchange used hypodermic needles and syringes for clean substitutes.
HRSEP provides guidelines to help local health departments initiate HRSEP in their communities.
- The Winnebago County Drug & Alcohol
Coalition, located in Winnebago County, WI, partnered with the AIDS Resource Center of
Wisconsin to bring the LifePoint
Needle Exchange program to the county. The needle exchange service is located in the county health
department. In addition to needle exchange, the program provides information on treatment programs and other
services in the county, as well as referrals to treatment.
Considerations for Implementation
Syringe services programs are a controversial topic in some communities. The services may be misconstrued as
providing injection drug users with easy access to clean needles thereby enabling their drug use. However, the
goal of syringe services programs is to reduce the transmission of blood-borne infections and diseases, such as
HIV and hepatitis B and C virus. Collaborations between public health and public safety/law enforcement
institutions may improve the acceptability of these types of initiatives in rural communities.
Program Clearinghouse Example
Resources to Learn More
Guide to Developing and Managing Syringe
Provides a step-by-step model for designing and managing syringe access programs. Describes planning
and design, operational issues, organization issues, external issues, and population-specific
Author(s): Winkelstein, E.
Organization(s): Harm Reduction Coalition
North American Syringe Exchange Network
A directory that allows viewers to access state syringe exchange networks. Users can search
according to ZIP code or city.
Syringe Services Programs
(SSPs): Developing, Implementing, and Monitoring Programs
Provides a list of multiple tools and resources for health departments and other local agencies in
Organization(s): Centers for Disease Control and Prevention Division of HIV/AIDS Prevention
the Trifecta: State Approaches to Addressing Co-Occurring Substance Use Disorders, HIV, and Hepatitis
Highlights the methods used in Louisiana, New York, and West Virginia to prevent the spread of
co-occurring HIV and HCV infections and SUD through intravenous drug use. Describes their funding
streams, use of data, and community engagement strategies during the development process.
Author(s): Mette, E., Manz, J., & Long, K.
Organization(s): National Academy for State Health Policy