Funding for Needle and Syringe Exchange Programs

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ACT UP march for syringe exchange

It is estimated that the lifetime prevalence of injection drug use is 2.6% in the United States. Persons who inject drugs (PWID) are at higher risk for bloodborn infections such as HIV/AIDS and Hepatitis C due to improperly sanitized needles and syringes as well as the practice of sharing injection equipment with other individuals at high risk for infection. Needle and syringe exchange programs have emerged as a key public health intervention to help reduce the harm of living with a substance use disorder by preventing transmission of infection and reducing harm. Contact with exchange programs also can serve as a reliable point of contact for outreach and treatment recruitment for hard to reach, vulnerable populations such as the homeless.

Despite the public health benefits of needle and syringe exchange programs, opponents such as Drug Free America argue the that funds allocated to these programs from limited federal and state substance use and health budgets could be better allocated to improving the quality of substance use treatment currently available. The limited funding allocated to mental health and substance use issues nationwide is often cited as a barrier to the establishment and maintenance of comprehensive services for PWID. However, for needle and syringe exchange programs, one barrier to funding on the federal level has just come down. After almost a quarter of a century, the majority of the components of federal ban on funding allocation for needle and syringe exchange programs was lifted at the end of the congressional session in 2015.

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With less restrictions on federal funding, states may wish to establish or further expand exchange programs. However, several states still have state-level restrictions on needle exchange programs. New Hampshire is debating the issue in their 2016 session of state legislature and may determine whether evidence-based exchange programs are established for New Hampshire residents who use injection drugs.  With national attention on the importance of such programs and a reduction in funding limitations on the federal level, researchers, advocates, and policy makers are called upon to guide further development and evaluation of local needle and syringe exchange programs in a cost-efficient and measurable way. With such an unparalleled opportunity to program expansion and outreach, it is essential that efforts be coordinated and integrated with other much-needed mental and public health services for this vulnerable population.

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2 Responses to “Funding for Needle and Syringe Exchange Programs”

  1. farhanpervaiz Says:

    Thank you for your post. Personally, I am a proponent of safe injection sites. Vancouver started them a few years ago and has had a lot of success with them. A big benefit of the sites is that people have the opportunity to learn about addiction counselling and mental health resources. In Vancouver universal healthcare allows individuals, who have been identified as needing care for a mental illness, to be referred to the appropriate clinics and receive this care. However, if that same care is not available, such as is the case in many parts of the U.S. then there are many benefits of this program that are lost. If these benefits are not available, then there is a question about how well these sites will work. They still have the opportunity to reduce medical illness related to injection drug sharing, but having opportunity to receive care for infections and mental illness may be much more important.

  2. oyintayo Says:

    Thanks for advocating this topic. Injection drug use is a major public health problem that is contributing to the epidemic of HIV/AIDS in the deep south. I’m happy to hear majority of the components of the federal ban on funding allocation for needle and syringe exchange programs was lifted at the end of the congressional session in 2015. Having well funded syringe exchange programs will reduce the circulation time of contaminated syringes in communities and will link drug users to ancillary services such as drug treatment programs thereby reducing the prevalence of drug addiction and its associated diseases (HIV/AIDS, Hepatitis B and Hepatitis C). Based on my interest in this area and my experience working for needle exchange programs in Baltimore, I have noticed funding as a major set back and removing the ban at the state level will be instrumental to expanding available programs . It is therefore imperative to advocate for the removal of this ban especially as there is no convincing evidence of major negative consequences of these programs instead studies have shown that absence of a needle exchange program is associated with increased crime, increased drug use and permissive attitudes towards drug among youths.

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