By: Marcus J. Hopkins, Policy Consultant
Both the Georgia and Idaho state legislatures have passed laws legalizing Syringe Services Programs (SSPs) in 2019 (Copeland, 2019; Mansoor, 2019; Horn, 2019). These states are just the latest to take measures legalizing SSPs in the wake of the 2015 HIV outbreak amongst People Who Inject Drugs (PWIDs) in Scott County, Indiana. Other state legislatures considering SSP legalization in their 2019 legislative sessions include Florida (Florida Daily, 2019), Iowa (Filter, 2019), and Missouri (Dohrman, 2019).
(You can find out which states have at least one operating SSP in the Community Access National Network’s monthly publication, The HIV/HCV Co-Infection Watch in the Harm Reduction section)
SSP funding on the Federal level was legalized in 2016 in response to the aforementioned 2015 outbreak under The Consolidated Appropriations Act of 2016 which gives states and local communities, under limited circumstances, the opportunity to use Federal funds to support certaincomponents of SSPs (Centers for Disease Control and Prevention, 2018). How Federal funds can be used is laid out in a 2016 Health and Human Services (HHS) guidance (HHS, 2016).
The efficacy of SSPs has long been established – numerous studies conducted since the 1980s, both in the U.S. and internationally, have shown significant decreases in new HIV and Viral Hepatitis infections amongst PWIDs and overall in areas where SSPs are present. Despite their proven efficacy, SSPs remain controversial, particularly in the U.S., where drug addiction is often viewed less as a disease to be treated, and more as a moral failing to be punished. Around the country, SSPs face extreme pressure and protests from local communities who view SSPs as nuisances that subsidize, promote, and validate drug abuse, rather than for the services they provide.
SSPs provide not only clean syringes in exchange for used ones, they often provide clinical healthcare services, access and referrals to substance abuse treatment programs, STD/STI testing, and linkages to other social services programs by helping clients enroll in programs like Medicaid and SNAP if they are eligible. These services, however, are often overlooked by opponents of these programs who argue that SSPs increase biohazardous needle waste, attract “unsavory” elements (by whom they mean “drug addicts”) into presumably otherwise “decent” neighborhoods, and encourage clients to engage in illicit drug use.
In my experience, arguing with or against those who oppose SSPs is often a Sisyphean effort – those who are unwilling to allow that evidence disproves their deeply held beliefs are no more likely to change their opinions than they are to sprout wings and migrate South for the winter. More often than not, programs that are effective – such as those in Charleston, WV and Orange County, CA – are met with staunch resistance with connections to those in power or who are willing to spend unlimited resources to maintain the edifice that “…everything was all right until this needle exchange showed up, and now our community has gone to Hell!” What makes it worse is that those who oppose SSPs frequently have no alternative solutions to the problem of increasing rates of new HIV, Hepatitis B, and Hepatitis C infections related to Injection Drug Use, other than, “Well, they should just stop using.”
This kind of thinking is emblematic of the American Way of Dealing with Social Problems: if we pretend hard enough that the problem doesn’t exist, maybe we can make the problem not exist. We’ve been trying that approach for nearly four decades, now, and the problems haven’t gone away; they only gotten worse. Until such time as those who oppose evidence-based solutions in favor of punitive solutions (for which they are always unwilling to pay additional taxes to fund those efforts) finally remove their heads from the sand, we will continue to fail at stemming the increase in infectious diseases spread via Injection Drug Use.
- Centers for Disease Control and Prevention. (2018, December 18). Syringe Services Programs. Atlanta, GA: United States Department of Health and Human Services: Centers for Disease Control and Prevention: National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention: Division of HIV/AIDS Prevention: HIV Risk and Prevention. Retrieved from: https://www.cdc.gov/hiv/risk/ssps.html
- Copeland, R. (2019, April 01). Governor Little Signs Legislation Allowing Needle Exchanges In Idaho. Boise, ID: National Public Radio: Boise State Public Radio: Idaho Matters. Retrieved from: https://www.boisestatepublicradio.org/post/governor-little-signs-legislation-allowing-needle-exchanges-idaho#stream/0
- Dohrman, D. (2019, April 12). Capitol Report: April 12, 2019. Marshall, MO: The Marshall Democrat-News: Blogs: Reports 51. Retrieved from: https://www.marshallnews.com/blogs/report51/entry/73133
- Filter. (2019, March 27). Legal Syringe Programs Could Finally Be Arriving in Iowa. New York, NY: The Influence Foundation, Inc.: Filter. Retrieved from: https://filtermag.org/2019/03/27/fight-to-bring-syringe-exchanges-to-iowa/
- Florida Daily. (2019, April 11). Legislature Looks Ready to Take Miami Dade’s Needle Exchange Program Across Florida. FL: Florida Daily: Florida Politics: Legislature. Retrieved from: https://www.floridadaily.com/legislature-looks-ready-to-take-miami-dades-needle-exchange-program-across-florida/
- Health and Human Services. (2016, March 29). Department of Health and Human Services Implementation Guidance to Support Certain Components of Syringe Services Programs, 2016. Washington, DC: United States Department of Health and Human Services. Retrieved from: https://www.cdc.gov/hiv/pdf/risk/hhs-ssp-guidance.pdf
- Horn, A. (2019, March 25). ND Legislature votes to create syringe exchange program. Bismarck, ND: KFYR TV: Politics. Retrieved from: https://www.kfyrtv.com/content/news/ND-Legislature-votes-to-create-syringe-exchange-program-507632721.html
- Mansoor, S. (2019, April 04). Georgia latest state to legalize needle exchange to stop HIV. Atlanta, GA: The Associated Press: Idaho Statesman: News: Business. Retrieved from: https://www.idahostatesman.com/news/business/article228833004.html
Disclaimer: HEAL Blogs do not necessarily reflect the views of the Community Access National Network (CANN), but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about Hepatitis-related issues and updates. Please note that the content of some of the HEAL Blogs might be graphic due to the nature of the issues being addressed in it.