Substance Misuse, Infectious Disease, and the Powerful Potential of Syringe Service Programs

Content From: Brett P. Giroir, M.D., ADM, U.S. Public Health Service, Assistant Secretary for Health, Senior Adviser, Immediate Office of the Secretary, U.S. Department of Health & Human ServicesPublished: November 08, 20193 min read


Cross-posted from U.S. Department of Health & Human Services

Office of the Assistant Secretary for Health hosts: Syringe Service Programs. The Essential Roles of Non-Governmental and Community-Based Organizations. Thursday, November 21, 2019, 2:00-3:15 PM ET
Credit: Office of Infectious Disease and HIV/AIDS Policy, HHS

Summary: Opioid and drug misuse has profound economic and health consequences on Americans, including a rise in certain infectious diseases throughout our nation.

Opioid and drug misuse has profound economic and health consequences on Americans, including a rise in certain infectious diseases throughout our nation. Drug misuse is linked to marked increases in acute hepatitis C infections, increases in acute hepatitis B infections in some states, and hepatitis A outbreaks in 30 states since 2016. Injection drug use has also been associated with local HIV outbreaks in multiple areas of the country. In 2017, approximately 9% of new HIV cases in the United States were linked to injection drug use, threatening prior progress made in reducing HIV.

The data show that we cannot look at the substance use crisis and infectious disease epidemics separately; but instead we must see them as intersecting, and mutually reinforcing. Comprehensive syringe services programs (SSPs) have the proven ability to help combat the opioid crisis and prevent the spread of infectious disease linked to injection drug use. These community-based prevention programs help prevent overdoses, reduce the transmission of infectious diseases, and promote long-term recovery by offering access to sterile syringes and injection equipment as well as other health care services, such as:

  • Vaccinations for hepatitis A, hepatitis B, and influenza;
  • Testing and linkage to care for infectious diseases, such as HIV, viral hepatitis, and other sexually transmitted infections;
  • Naloxone and training to prevent overdoses; and
  • Linkage to medication-assisted treatment for substance use disorder and other needed services such as primary care.

Nearly 30 years of research indicates that comprehensive SSPs are safe, effective, and cost-saving; do not increase illegal drug use or crime; and serve an important role in reducing transmission of viral hepatitis, HIV, and other infectious diseases. SSPs can serve as an entry point to recovery support services and overdose prevention and HHS is dedicated to informing communities about this critical public health intervention.

State and local health officials can take action by joining us for the Syringe Services Programs – A Critical Public Health Intervention webinar series. This three-part series will conclude with a final webinar on Thursday, Nov. 21Exit Disclaimer to highlight successful SSPs from non-governmental and community-based organizations. In addition to the webinar series, HHS offers a number of resources to support SSP implementation including fact sheets and support through the Ryan White HIV/AIDS Program and the Substance Abuse Prevention and Treatment Block Grant.

The impact of the substance use crisis on our nation’s public health is far-reaching. SSPs are a powerful convergence point for tackling both substance misuse and infectious diseases, and part of our comprehensive 5-Point Strategy (PDF, 76 KB) to combat opioid misuse. As the Assistant Secretary for Health, I am committed to making meaningful progress in tackling the substance use crisis and the associated infectious disease outbreaks that prevent us from achieving health in all, by all, and for all. There are a number of ways my office is doing this, including developing the first-ever Sexually Transmitted Infection Federal Action Plan, due out next year, increasing immunization coverage across the lifespan, and spearheading the Ending the HIV Epidemic initiative.