The main point: Syringe services programs (SSPs) are under threat, with states/localities increasingly closing their programs and the federal government targeting harm reduction.

Background:

Underground SSPs emerged in the U.S. during the HIV/AIDS epidemic of the 1980s. Cities and states soon began legalizing programs.
In 2015, injection drug use sparked a historic HIV outbreak in Scott County, Indiana. Then-governor Mike Pence opposed the creation of SSPs in Indiana but eventually established an emergency one in Scott County, and lawmakers later authorized them under certain conditions. By 2018, Scott County saw a 96% reduction in new HIV infections and a 76% drop in new hepatitis C infections.
The Biden administration supported SSPs, though, by law, federal funding could not be used to purchase the needles themselves.

But: Communities across the country and the Trump administration are now pushing back against the programs.

The details:

Federal level: The Trump administration has blasted Biden’s backing of the programs as “dangerous.” In July, SAMHSA prohibited the use of grants to purchase needles, sterile water, saline, vitamin C, or any other supplies “to promote or facilitate drug use” or support such services. HHS recently removed a CDC webpage that touted the benefits of syringe programs.
Indiana: In 2021, Scott County commissioners closed the SSP. Under state law, a county health officer must first declare an HIV or hepatitis C emergency to authorize needle exchanges, and there is not enough testing to quantify the need. In Indiana, possessing a syringe without a prescription constitutes a low-level felony. After the SAMHSA letter this summer, the state health department ordered groups that get state funding to destroy “safer use” supplies (cookers, cottons, tourniquets, sterile water). At least 11 of the state’s 92 counties have operated SSPs, but three have closed in recent years, and the remaining 8 may close next summer if lawmakers do not renew a state law.

Why it’s important: Research shows that SSPs reduce disease transmission rates and do not increase injection frequency or neighborhood crime rates. They help reduce used needles in the community and help connect people to treatment and other services.

It remains unclear whether federal grants can be used to pay staff salaries or other operations for organizations that offer syringes among other services. Organizations or states may shut down their SSPs for fear of losing other funding, given the administration’s stance.