Syringe services programs (SSP), also known as syringe exchange programs (SEP), have existed and been studied extensively in the United States since 1988.Community-based SSPs provide access to sterile needles and syringes free of cost, facilitate safe disposal of used needles and syringes and offer safer injection education. SSPs in Kentucky also provide participants with access to critical services and programs, including substance use disorder treatment programs; overdose prevention education; screening, care and treatment for HIV and viral hepatitis; prevention of mother-to-child transmission; hepatitis A and hepatitis B vaccination; screening for other sexually transmitted diseases and tuberculosis; partner services; and other medical, social and mental health services.
In response to Senate Bill 192 enacted in 2015, the Kentucky Department for Public Health publishes guidelines for local health departments implementing harm reduction and SSPs.
SB 192 impacts KRS 218A.500
KY SEP Guidelines (Long Version)
KY SEP Guidelines (Short Version)
Why Does Kentucky Need SSPs?
SSPs are designed to mitigate a number of public health issues, including emergence of a new HIV epidemic. An Indiana town near Louisville recently had an HIV outbreak among people who inject drugs. Austin, Indiana now has HIV rates comparable to those in sub-Saharan Africa. Undoubtedly, this outbreak will cost Indiana millions of dollars to treat the new HIV infections.
Nearly half of Kentucky’s counties are at risk of an HIV outbreak.
Recently the CDC analyzed every county in the United States to determine how vulnerable others might be to an HIV outbreak like the one in Indiana. Of the 220 counties across the US identified as highly vulnerable, 54 are in Kentucky (see map below). Kentucky also had among the highest rates of hepatitis C in the nation for several years. This is foretelling, because most of these new hepatitis C infections are from people who inject drugs and share needles, cookers and other contaminated equipment. Hepatitis C rates like those in Kentucky are seen as the canary in the coal mine for an HIV outbreak. SSPs have proven capable of reducing the chance of an outbreak.
Printable KY SSP Map formats:
PDF, PNG, and PPTX
*Please contact Krista Mevoli to revise SSP locations and hours.
Facts about SSPs
SSPs do not encourage the initiation of drug use nor do they increase the frequency of drug use among current users. (1
SSPs reduce the spread of infections like HIV and viral hepatitis. (2
SSPs do not increase community crime. Community residents may worry that syringe services locations will increase theft, sex trades, assaults, and an increase of contaminated needles on the street. However, studies have shown that SSPs actually decrease crime in the area they are located. (3
SSPs increase community safety. Research shows that SSPs promote public health and safety by taking syringes off the streets and protecting law enforcement personnel from needle stick injuries, which can result in the transmission of diseases such as HIV/AIDS and hepatitis B and C. (4
SSPs connect people to treatment. One study found that SSP participants are five times more likely to enter a drug treatment program than nonparticipants. (5
Recommended Best Practices for Effective SSPs in the United States
SSPs are central to reducing disease and other health burdens among people who inject illicit drugs. Three decades of research has demonstrated the effectiveness of SSPs in preventing HIV and other blood-borne infections, as well as connecting people who inject drugs with a range of vital medical and social services and supports. The Recommended Best Practices report from the New York City Department of Health and Mental Hygiene with the Drug Policy Alliance summarizes the consensus among United States SSP experts of the underlying principles and programmatic elements that enable or constrain SSP effectiveness. Effective SSPs have the support of local governing bodies and match sound operational characteristics with responsiveness to the unique features of their host communities. New or expanding SSPs may benefit from technical assistance from the considerable expertise of those experienced in operating SSPs around the country. The panel highlighted operational characteristics that are critical for effective SSPs, and measures to be avoided because they undermine the primary goal of SSPs: to make new, sterile syringes available to Persons Who Inject Drugs (PWIDs).
Characteristics of Effective SSPs (6)
Promote secondary syringe distribution
Train and support peer educators
Do not impose limits on number of syringes (doing so promotes sharing of needles)
Maximize responsiveness to characteristics of the local PWID population
Adapt planning activities and service modalities to subgroup needs
Provide or coordinate the provision of other health and social services
Include diverse community stakeholders in creating a social and legal environment supportive of SSPs
SSP Practices to Avoid (6
Supplying single-use syringes
Limiting frequency of visits and number of syringes
Requiring one-for-one exchange (results in sharing of needles)
Imposing geographic limits
Restricting syringe volume with unnecessary maximums
Requiring identifying documents
Requiring unnecessary data collection