The opioid crisis is fueling a 

dramatic increase in infectious 

diseases associated with 

injection drug use.

Reports of acute hepatitis C 

virus (HCV) cases rose 3.5-fold 

from 2010 to 2016.1

The majority of new HCV 

infections are due to injection 

drug use. 

Over 2,500 new HIV infections 

occur each year among people 

who inject drugs (PWID).2

Syringe Services Programs 

(SSPs) reduce HIV and HCV 

infections and are an effective 

component of comprehensive 

community-based prevention 

and intervention programs that 

provide additional services. 

These include vaccination, 

testing, linkage to infectious 

disease care and substance 

use treatment, and access to 

and disposal of syringes and 

injection equipment.

CS 300156-G July 19, 2019

Syringe Services Programs 

(SSPs) Fact Sheet

Helps prevent transmission of blood-borne infections

For people who inject drugs, the best way to reduce the risk of acquiring and 

transmitting disease through injection drug use is to stop injecting drugs. For 

people who do not stop injecting drugs, using sterile injection equipment for 

each injection can reduce the risk of acquiring and transmitting infections and 

prevent outbreaks.

SSPs are associated with an estimated 50% reduction in HIV and HCV 

incidence.3 When combined with medications that treat opioid dependence 

(also known as medication-assisted treatment), HCV and HIV transmission is 

reduced by over two-thirds.3,4

SSPs serve as a bridge to other health services, including HCV and HIV testing 

and treatment and medication-assisted treatment for opioid use disorder.5

Helps stop substance use

The majority of SSPs offer referrals to medication-assisted treatment,6 and new 

users of SSPs are five times more likely to enter drug treatment and three times 

more likely to stop using drugs than those who don’t use the programs. 

SSPs prevent overdose deaths by teaching people who inject drugs how 

to prevent overdose and how to recognize, respond to, and reverse a drug 

overdose by providing training on how to use naloxone, a medication used to 

reverse overdose. Many SSPs provide “overdose prevention kits” containing 

naloxone to people who inject drugs.7-12

Helps support public safety

SSPs have partnered with law enforcement, providing naloxone to local police 

departments to help them respond and prevent death when someone has 

overdosed.13 

SSPs also protect first responders and the public by providing safe 

needle disposal and reducing the presence of discarded needles in the 

community.14-19

In 2015, CDC’s National HIV Behavioral Surveillance System found that the 

more syringes SSPs distributed per the number of people who inject drugs in 

a geographic region, the more likely the people who inject drugs in that region 

were to dispose of used syringes safely.20

Studies in Baltimore21 and New York City22 have also found no difference in 

crime rates between areas with and areas without SSPs.
1. Centers for Disease Control and Prevention. Surveillance for Viral

Hepatitis — United States, 2016. https://www.cdc.gov/hepatitis/

statistics/2016surveillance/pdfs/2016HepSurveillanceRpt.pdf.

2. Centers for Disease Control and Prevention. Estimated HIV

incidence and prevalence in the United States, 2010–2015. HIV

Surveillance Supplemental Report. 2018;23(No. 1). https://www.

cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillancesupplemental-report-vol-23-1.pdf. Published March 2018. 

3. Platt L, Minozzi S, Reed J, et al. Needle syringe programmes and

opioid substitution therapy for preventing hepatitis C transmission

in people who inject drugs. Cochrane Database Syst Rev.

2017;9:CD012021. doi:10.1002/14651858.CD012021.pub2.

4. Fernandes RM, Cary M, Duarte G, et al. Effectiveness of needle and

syringe programmes in people who inject drugs - An overview of

systematic reviews. BMC Public Health. 2017;17(1):309.

doi:10.1186/s12889-017-4210-2.

5. HIV and Injection Drug Use – Vital Signs – CDC. Centers for Disease

Control and Prevention. https://www.cdc.gov/vitalsigns/hiv-druguse/index.html. Published December 2016.

6. Des Jarlais DC, Nugent A, Solberg A, Feelemyer J, Mermin J,

Holtzman D. Syringe service programs for persons who inject drugs

in urban, suburban, and rural areas — United States, 2013. MMWR

Morb Mortal Wkly Rep. 2015;64(48):1337-1341. doi:10.15585/

mmwr.mm6448a3.

7. Seal KH, Thawley R, Gee L. Naloxone distribution and

cardiopulmonary resuscitation training for injection drug users to

prevent heroin overdose death: A pilot intervention study. J Urban

Health. 2005;82(2):303–311. doi:10.1093/jurban/jti053.

8. Galea S, Worthington N, Piper TM, Nandi VV, Curtis M, Rosenthal

DM. Provision of naloxone to injection drug users as an overdose

prevention strategy: Early evidence from a pilot study in New York

City. Addict Behav. 2006;31(5):907-912. doi:10.1016/j.

addbeh.2005.07.020.

9. Tobin KE, Sherman SG, Beilenson P, Welsh C, Latkin CA. Evaluation

of the Staying Alive programme: Training injection drug users to

properly administer naloxone and save lives. Int J Drug Policy.

2009;20(2):131-136. doi:10.1016/j.drugpo.2008.03.002.

10. Doe-Simkins M, Walley AY, Epstein A, Moyer P. Saved by the nose:

Bystander-administered intranasal naloxone hydrochloride for

opioid overdose. Am J Public Health. 2009;99(5):788-791.

doi:10.2105/ajph.2008.146647.

11. Bennett AS, Bell A, Tomedi L, Hulsey EG, Kral AH. Characteristics of

an overdose prevention, response, and naloxone distribution

program in Pittsburgh and Allegheny County, Pennsylvania. J Urban

Health. 2011;88(6):1020-1030. doi:10.1007/s11524-011-9600-7.

12. Leece PN, Hopkins S, Marshall C, Orkin A, Gassanov MA, Shahin RM. 

Development and implementation of an opioid overdose 

prevention and response program in Toronto, Ontario. Can

J Public Health. 2013;104(3):e200-204. 

13. Childs R. Law enforcement and naloxone utilization in the United

States. FDA website. https://www.fda.gov/downloads/Drugs/

NewsEvents/UCM454810.pdf.

14. Tookes HE, Kral AH, Wenger LD, et al. A comparison of syringe

disposal practices among injection drug users in a city with versus a

city without needle and syringe programs. Drug Alcohol Depend.

2012;123(1-3):255-259. doi:10.1016/j.drugalcdep.2011.12.001.

15. Riley ED, Kral AH, Stopka TJ, Garfein RS, Reuckhaus P, Bluthenthal

RN. Access to sterile syringes through San Francisco pharmacies

and the association with HIV risk behavior among injection drug

users. J Urban Health. 2010;87(4):534-542. doi:10.1007/s11524-

10-9468-y.

16. Klein SJ, Candelas AR, Cooper JG, et al. Increasing safe

syringe collection sites in New York State. Public Health Rep.

2008;123(4):433-440. doi:10.1177/003335490812300404.

17. de Montigny L, Vernez Moudon A, Leigh B, Kim SY. Assessing a drop

box programme: a spatial analysis of discarded needles. Int J Drug

Policy. 2010; 21(3):208-214. doi:10.1016/j.drugpo.2009.07.003.

18. Doherty MC, Junge B, Rathouz P, Garfein RS, Riley E, Vlahov D. The

effect of a needle exchange program on numbers of discarded

needles: a 2-year follow-up. Am J Public Health.

2000;90(6):936-939.

19. Bluthenthal RN, Anderson R, Flynn NM, Kral AH. Higher syringe

coverage is associated with lower odds of HIV risk and does not

increase unsafe syringe disposal among syringe exchange program

clients. Drug Alcohol Depend. 2007;89(2-3):214-222.

20. Centers for Disease Control and Prevention. HIV Infection, Risk,

Prevention, and Testing Behaviors among Persons Who Inject Drugs

—National HIV Behavioral Surveillance: Injection Drug Use, 20 U.S. 

Cities, 2015. HIV Surveillance Special Report 18. Revised edi ion.

https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hivhssr-nhbs-pwid-2015.pdf. Published May 2018. Accessed July 30, 

2018.

21. Marx MA, Crape B, Brookmeyer RS, et al. Trends in crime and the

introduction of a needle exchange program. Am J Public Health.

2000;90(12),1933-1936.

22. Galea S, Ahern J, Fuller C, Freudenberg N, Vlahov D. Needle

exchange programs and experience of violence in an inner city

neighborhood. J Acquir Immune Defic Syndr. 2001;28(3),282-288. 

Endnotes