Don’t they promote drug use?
There is no evidence that providing people with clean syringes and resources such as treatment referrals and other health care for the consequences of injection drug use, encourages drug use. In fact, syringe services programs can help facilitate entry into treatment.
Why are they necessary?
Individuals who inject drugs are at heightened risk of contracting HIV and HCV because of risky practices such as sharing used syringes. This can occur due to lack of access to sterile supplies and the stigma attached to accessing these supplies. According to the CDC, 1 in 10 HIV diagnoses are among people who inject drugs (PWID). In addition, if current rates continue, the CDC believes that 1 in 23 women who inject drugs and 1 in 36 men who inject drugs will be diagnosed with HIV in their lifetime. More than half of people who inject drugs used a syringe services program in 2015. In addition, the CDC also reports that new injection drug users tend to be younger and white, cohorts that are more likely to share needles.
How do they work?
Syringe services programs vary by the types of services they provide. But the basic premise of all syringe services programs is that they provide new, sterile syringes in exchange for used ones. They also provide other services such as treatment for infectious diseases, referral to treatment for substance use disorders, naloxone distribution, enrollment in health care, and other health related services such as wound care or contraceptives.
Why does my community need it?
Increased rates of injection drug use has led to increased risk for bloodborne diseases such as HIV and HCV. While overall, the rates of HIV have decreased nationally, we are seeing increases in areas that previously had low rates of both HIV and HCV. The chance of an HIV negative individual contracting HIV by sharing a used needle is 1 in 160 per the CDC. Implementing a syringe services program in your community can save money, save lives, and help people with chronic substance use disorders get into treatment. One 2014 study found that a $10 to $50 million in funding for syringe services programs throughout the United States would avert 194-816 HIV infections and generate a net savings of $65.8 to $269.1 million dollars in averted HIV treatment costs.
Won’t they promote more needles on the street?
At least one study has shown that there was less visible evidence of needles on a street with an operational exchange than in a city without an exchange. In addition, many syringe services programs track the number of needles returned and in many cases, they come close to or exceed the number that are distributed, implying that it is unlikely used needles would litter public streets. In a one for one exchange, where you must provide one syringe for every new, sterile syringe needed, there is an incentive to find discarded needles on the street. However, a needs based exchanges is still the optimal type of exchange to decrease infections due to sharing needles.
Do they help get people into treatment?
A survey of syringe services programs in 2013 found that the vast majority (82%) of syringe services programs provided referrals to treatment for people with substance use disorders. And some syringe services programs, such as in West Virginia, partner with local recovery programs to provide clients with referrals to treatment.
Do they decrease HIV rates?
The short answer is yes, according to several research studies.i One such study in Washington, DC found that once a ban on DC funding for syringe services programs was lifted, 120 injection drug use related HIV cases were averted over a 24 month period, resulting in $45.6 million in cost savings.
How can we pay for a syringe services program?
Syringe services programs are paid for in a variety of ways and depend upon state and federal laws. Usually, funding comes from a variety of grant, state, local and federal funds. Information on applying for federal funds can be found here.
How much do they cost?
Costs for syringe services programs vary by location and by services are provided. If they are implemented in areas before injection drug use and bloodborne diseases begin to increase, they can save state and local governments considerable healthcare costs. The Scott County, Indiana outbreak is estimated to cost $48 million in lifetime treatment based on 135 cases in that area. The median income in Scott County, Indiana, according to the US Census Bureau is just $44,442.
Don’t syringe services programs increase crime?
No, research has shown that syringe services programs do not increase crime. A research study on crime in Baltimore MD showed that there was no significant increase in crimes near the area of the syringe services program than in the non-syringe services program.
Do they prevent needle stick injuries?
Discarded needles can create a risk for injury for members of a community, including law enforcement and fire fighters who may encounter them. Law enforcement report concern about needle stick injuries, and because they may encounter people who inject drugs, they are among the most at risk members of a community for needle stick injuries. A study in Connecticut found significant decreases in self-reported needle stick injuries among law enforcement personnel after passage of laws increasing access to clean needles.
i Wodak A, Cooney A. Do needle syringe programs reduce HIV infection among injecting drug users: a comprehensive review of the international evidence. Subst Use Misuse. 2006;41:777–816.