Media Guide

SSPs do not enable drug use, but rather provide case management and patient navigation services that link people into drug treatment. Participants in syringe exchange programs are five times more likely to enter drug treatment programs than those who have never participated in a syringe exchange program.¹ In fact, in New Jersey, 22% of the state’s SSP clients have entered drug treatment.² SSPs offer a point of connection – and by extension, intervention – to people who use and inject drugs. SSPs are the only health or social service accessed by 80% of program participants.

As declared by the CDC in November 2017, Iowa is at risk of an HIV outbreak, primarily due to injection drug use.(SOURCE) HIV, hepatitis C (HCV), and endocarditis related to IV drug use are currently costing IA Medicaid millions of dollars, annually. These costs are preventable. SSPs can reduce both short and long-term costs to the state budget. SSPs across the US have been shown to decrease the number of new HCV and HIV cases by up to 80%.(SOURCE) Iowa Department of Public Health data has credited IHRC and similar organizations which provide SSP services with a 27% decrease in new cases of HCV in Iowans under 40 since 2016.³

There is no evidence base for this. The U.S. Surgeon General has determined that SSPs, when part of a comprehensive disease prevention strategy, do not increase the illegal use of drugs by injection. Syringe services programs are an effective public health intervention that can reduce the transmission of HIV and facilitate entry into drug treatment and medical services, without increasing illegal injection of drugs.⁴ One study showed that SSP participants were up to 75% more likely to report a decrease in injection drug use, to stop using injection drugs, and to remain in treatment than those who had never participated in an SSP.⁵

The American College of Medical Toxicology and the American Academy of Clinical Toxicology, the two largest toxicology bodies in the United States, directly quoted, state that:

• The risk of clinically significant exposure to emergency responders is extremely low.⁶
• We have not seen reports of emergency responders developing signs or symptoms consistent with opioid toxicity from incidental contact with opioids.⁷
• Incidental dermal absorption is unlikely to cause opioid toxicity.⁸

Stories of secondhand overdoses, often occurring to law enforcement officers, have become high-profile, which could have significant and dangerous implications. Symptoms associated with these cases often more closely align with symptoms of panic. The widespread attention these stories receive could have the ability to further perpetuate unnecessary fear for our law enforcement officers, and even more frightening, could cause first responders to an overdose incident to delay intervention, such as administering Naloxone. Such a delay could lead to brain damage, or even death for a person experiencing an overdose.

Needles and syringes cost less than 50 cents each, while the lifetime cost of treating an HIV-positive person is upwards of $600,000.⁹ $1 invested in an SSP results in $3-7 in savings through diverted HIV infections.¹⁰ In Massachusetts, there was a 54% decrease in new HIV diagnosis between 1999 and 2012, preventing 5,699 infections and saving more than $2 billion in health care costs.¹¹

Public drug use is more often due to a lack of access to private spaces, fear of arrest, or a desire to inject in a safer or more sterile environment. The majority of people who report injecting drugs in public spaces, are those who are unhoused, and do not have an alternative, often due to discriminatory housing policies which limit opportunity to access stable housing.

Additionally, fear of arrest often leads to increased likelihood of hasty, unsafe practices, such as quickly using in a public space. Public drug use is also indicative of the desire to stay alive. With the increased presence of highly potent synthetic opioids, often present in a drug supply without the buyer’s knowledge, people may use in a public space hoping that if they experience an overdose, a bystander will be able to intervene.¹²

No cases of HIV or viral hepatitis from syringe litter have ever occurred in the US, according to the Department of Health and Human Services.¹³ The Society for Hospital Epidemiology of America has stated, “There is no evidence that a member of the public or waste industry worker has ever acquired infection from medical waste.”¹⁴ Alternatively, law enforcement officers do experience a high risk for needlestick injuries. One out of every three law enforcement officers will be stuck by a needle in their career.¹⁵ Fortunately, the implementation of syringe services programs have been shown to reduce needlestick injuries to law enforcement officers by 66%.¹⁶

The World Health Organization, Harm Reduction Coalition, NASTAD, and many other leading public health organizations conclude that need-based distribution programs provide the most effective intervention. Though some may feel that a one-for-one exchange is a necessary model to prevent syringe litter, there is no evidence to demonstrate this. There is evidence to suggest though, that some distribution models, particularly one-for-one programs, are dramatically less effective at preventing infectious disease.¹⁷ One-for-one exchanges needlessly penalize participants, especially those who do not have stable housing, for losing, breaking, having confiscated or stolen syringes., or disposing of syringes in a different location from where they obtain new syringes.

A root cause leading to syringe litter by people who inject drugs is drug paraphernalia charges. People who inject drugs are fearful of arrest if they attempt to bring used syringes to a safe disposal location, and are often limited in safe disposal sites, most often offered by harm reduction programs. Even if syringe possession is legal in a state, a person might still be searched, arrested, or detained for other reasons, with the initial reason for contact being the used syringes. Additionally, syringes are often not intended for drug use. Diabetes is a much more common generator of syringes and many people experiencing homelessness and people who use drugs use syringes primarily for insulin.¹⁸ Even in settings where safe disposal is lacking, people who inject drugs attempt to discard syringes in minimally harmful ways, such as breaking off the needle, capping it before discarding it, removing the contents, or attempting to destroy it.

Fortunately, SSPs are one of the most effective interventions in reducing syringe litter, as SSPs provide safe disposal of used syringes, a service not typically offered by other major distributors of syringes, such as pharmacies, clinics, online ordering services, home healthcare services, etc). In Portland, Oregon, the implementation of SSPs reduced the number of improperly discarded syringes by two-thirds.¹⁹ In Baltimore, SSPs helped to reduce the number of improperly discarded syringes by almost 50%.²⁰

Safe consumption spaces, also known as safe injection facilities, have not been shown to encourage drug use, but in fact been associated with an increase in detoxification service use, and long-term addiction treatment initiation.²¹