Syringe services programs
Local governments can invest in this strategy using State and Local Fiscal Recovery Funds (SLFRF) from the American Rescue Plan Act (ARPA).
- This strategy can help residents access health services. The U.S. Department of Treasury has indicated that strategies that help achieve this outcome are eligible for the use of Fiscal Recovery Funds.
- Investments in this strategy are SLFRF-eligible as long as they are made in qualified census tracts or are designed to assist populations or communities disproportionately impacted by COVID-19.
Program overview
Reducing risks associated with injection drug use: Syringe services programs (SSPs) are community-based harm reduction programs for people who inject drugs. SSPs may reduce risky injection behaviors and the likelihood that people who inject drugs contract HIV.
Providing and disposing of safer drug use supplies: SSPs distribute sterile injection and drug use equipment (e.g., syringes) to enable safer substance use. Other supplies, like fentanyl test strips, may also be provided to reduce the risk of overdoses. In most cases, SSPs also collect used drug use equipment for safe disposal. These supplies and services are offered free of charge and with few administrative barriers.
Connecting individuals to social services and medical care: Typically, SSPs offer additional social and health care services to people who inject drugs. Common services offered by SSPs include overdose recognition and response training, referrals to substance use disorder treatment, and vaccination and testing for infections commonly transmitted through injection drug use.
Varied operators and locations: SSPs may be operated by state and local health departments, health care systems, social service agencies, or other community-based organizations. While most SSPs operate out of a fixed location (e.g., a hospital), mobile programs may operate out of buses or large trailers. While most states allow SSPs to operate, jurisdictions in some states may be preempted from operating a SSP.
- Strategies
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Substance use treatment and prevention
- Cost per Participant
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Not available
Multiple studies with rigorous designs demonstrate that syringe services programs are a well-established strategy for reducing risky injection drug behavior and HIV infection rates.
- This assessment is based on evidence from a 2021 systematic review.
Include those with lived experience: Implementing organizations should engage those with lived experience of substance use in the planning, implementation, and evaluation of a SSP. Meaningful engagement can provide SSPs with insights into community needs and strengthen its ability to conduct outreach to those who use injection drugs. As this approach is encouraged by many federal funding programs, it may also make SSPs more competitive for federal support.
Use a needs-based distribution model: SSPs should use a needs-based syringe distribution model, where supplies are provided as needed to people who inject drugs (as opposed to a 1:1 exchange model for syringes). This approach ensures an adequate supply of sterile injection and drug use equipment, which aids in disease prevention. In addition, by being responsive to the needs of people who inject drugs, the needs-based model may build a greater sense of trust and inclusivity between the SSP and those it serves.
Link to physical and behavioral health care: When feasible, SSPs should provide physical and behavioral health services either directly or through a partnering agency. By doing so, SSPs can increase access and better integrate health care among people who use injection drugs. Key services to provide include substance use disorder treatment; HIV, viral hepatitis, and STD testing and treatment; basic wound care; among others.
Develop relationships with community stakeholders: Although considerable evidence supports the effectiveness and safety of SSPs, many programs face opposition from community members (e.g., false concerns that SSPs lead to greater drug use). Securing buy-in from local law enforcement, elected officials, business leaders, and other key stakeholders may increase public support for the SSP. Outreach efforts, which may involve education campaigns or the establishment of a community advisory board, may also be effective strategies.
Conduct basic data collection and analysis: While it should not distract from a SSP’s main focus, basic data collection and analysis can allow a SSP to better understand the needs of those receiving services and to demonstrate its effectiveness. Key data to collect include the number of people receiving services, the number of syringes and other supplies distributed, and the number of individuals for whom each participant receives syringes (often, participants may provide syringes to others who use injection drugs).