Syringe Exchange Programs and the Injection Drug User

Today, Syringe Exchange Programs (SEP) are still vital to maintaining the health of the Injection Drug User (IDU) and those who are in intimate contact and communal contact with the user.  The GMC reports 87 cases of HIV were averted in a single year because of a New York State approved SEP.

Since 1988, there has been a federal ban on funding SEPs -- even though SEPs actually help decrease injection drug use -- but in July of this year, the House of Representatives lifted the federal ban -- and added a restriction that basically keeps the ban in place.

No federally funded SEPs are allowed within 1,000 feet of schools, parks, swimming pools, video arcades or day care centers.  For cities with dense urban cores like Los Angeles, Chicago and New York, that 1,000-foot rule essentially maintains the federal ban:


Here's the argument for why we need to make adjustments to the federally funded SEP to help cut down drug use and cross-contamination in the urban core:

SEPs are a needed, cost-effective solution to combating the HIV/AIDS public health crisis. The cost of operating an SEP pales in comparison to the cost of supporting a single HIV infected individual.

SEPs stem the spread of infection by removing millions of used needles each year, and by providing substance abuse services and health resources to IDU communities nationwide.

Public funding is crucial to the success of SEPs, both because it enables an SEP to function better, and also because government support lends a heightened legitimacy to an SEP.

The local, state, and NGO funds currently available to meet the need for safe syringe exchange are grossly inadequate to meet public need. The current ban on federal funding must be lifted, without restrictions, for SEPs to more fully address public need.

The geographically restrictive amendment accepted by the House of Representatives in July 2009 would render the new language unworkable and undercuts the aid House members seek to give communities in need. An IDU community in any area will likely be diverse and multi-factional. SEPs must be able to tailor their services to meet the needs of the particular IDU communities that they serve.

Community outreach is important in establishing, maintaining, and expanding SEP coverage. All interested community members and groups should be allowed to participate in the establishment and running of the SEP, and should be fully informed on: the need for an SEP, the proven success of SEPs, and common misconceptions regarding the effects of SEPs.

Research has shown that a liberal exchange policy is associated with higher levels of syringe coverage. SEPs should employ a liberal syringe distribution policy, including mobile exchange, in order to better meet community need.

IDU communities are very mobile. An important strategy for SEPs is mobile/vehicle distribution, which enables SEPs to 1) better reach IDU communities, 2) provide for more convenient distribution, 3) avoid community opposition to a fixed-location outlet, and 4) rapidly adjust distribution locations or schedules.

The longer an SEP exists, the more likely it is to be successful in addressing community need. Anecdotal evidence indicates that integrating syringe exchange into pre-existing health services that cater to IDU populations (e.g., HIV/AIDS counseling or condom distribution) can be a successful model for establishment of an SEP. An already existing health program that caters to IDUs will likely have the benefits of 1) an established user base, 2) legitimacy in the community, 3) support from public health officials and local community leaders, and 4) established funding resources.

We urge you to get in touch with your representative and make it known that you support SEPs for IDUs in the urban core -- and by supporting that federally funded program -- you realize you are actually protecting your health and the well being of those around you by getting the dirty needles off the street.