Syringe Service Programs Are Safe, Effective, and Cost-Saving

Content From: Jonathan Mermin, M.D., M.P.H., RADM and Assistant Surgeon General, USPHS, Director, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and PreventionPublished: June 26, 20193 min read


Letters on a rod spelling change or chance
Credit: iStock

The nation is experiencing a crisis at the intersection of opioids and infectious diseases. Large increases in drug use across the country have resulted not only in overdose deaths, but tens of thousands of viral hepatitis infections annually, multiple outbreaks of HIV infections, and increases in bacterial and fungal infections of the heart and other organs.

Hepatitis C virus can be transmitted through unsterile injection equipment and can cause severe illness and death when left untreated. Through this mode of transmission, hepatitis C virus is 10 times more infectious than HIV. Hepatitis C infections have increased more than 250% since 2010. Similarly, after decades of declines in new cases, progress on hepatitis B prevention has stalled in the United States as a whole and, in some states, hepatitis B infections have increased. Together, hepatitis B and C cause more than 22,000 deaths a year in the United States—a number preventable by early screening and treatment, vaccination for hepatitis B, and prevention services. 

Our progress in HIV prevention is also at risk. One of the greatest successes in HIV prevention has been an 80% decrease in incidence of injection drug use-associated HIV infections over the past two decades. But, since 2011, our progress has stalled. Syringe service programs (SSPs) are community-based prevention programs that can provide a range of services, including access to and disposal of sterile syringes and injection equipment; linkage to substance use disorder treatment; distribution of naloxone, a medication that reverses overdoses; and vaccination, testing, and linkage to treatment for infectious diseases. Nearly 30 years of research shows that comprehensive SSPs are safe, effective, and cost-saving; do not increase illegal drug use or crime; reduce transmission of viral hepatitis, HIV, and other infections; and increase the chance that a participant will stop injecting drugs.

The Centers for Disease Control and Prevention has released a suite of materials for use by health departments; national, state, and community partners; and decision-makers that review the safety and effectiveness of SSPs, and highlights their use in combatting the opioid crisis. These materials are available online at and include:

  • A summary outlining the evidence of SSP effectiveness on reducing HIV and viral hepatitis
  • A fact sheet outlining the ways SSPs can prevent transmission of blood-borne infections, help stop substance use, and support public safety
  • A fact sheet for health departments and community partners to share, that describes what SSPs are and what they do
  • Frequently asked questions and answers about SSPs

We hope these materials will help support efforts by national, state and local organizations to reduce the toll of opioids and infectious diseases in our communities. We know how to prevent and treat infections and reduce overdose deaths through SSPs, but it will take all of us working together to combat the nation’s opioid and infectious disease crisis.