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
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
& 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