Syringe Exchange Programs and the Opioid Epidemic

Joaquin Jay Gonzalez III, Ph.D., is vice provost for global affairs as well as chair and Mayor George Christopher Professor of Public Administration at Golden Gate University. He founded GGU’s law enforcement and security program and is a San Francisco advocate for the safety and security of Filipino American kids and their families. Mickey P. McGee, DPA, is professor of public administration and director of the Doctor of Business Administration Program at Golden Gate University. He co-developed GGU’s Urban Innovations Program including the course, Inclusion, Diversion, Equity, and Accessibility. He has consulted for the U.S. Agency for International Development and the International City/County Management Association.

Table of Contents


Acknowledgments

Preface

Part I. The Opioid Epidemic

 1. Opioid Epidemic Causing Rise in Hepatitis C Infections and Other Serious Illnesses

Thomas J. Stopka

 2. Syringe Services Programs (SSPs) Fact Sheet

Centers for Disease Control and Prevention

 3. An Ethical Dilemma for Doctors: When Is It OK to Prescribe Opioids?

Travis N. Rieder

 4. The Opioid Epidemic Is Finally a National Emergency—Eight Years Too Late

Erin Winstanley

 5. As the Opioid Epidemic Continues, the Holidays Bring Need to Support Those in Grief

Emily B. Campbell

 6. Keeping Away from Criminalization

Sarah Sweeney

 7. Stepping Up, Then Stepping Back

Brenda Bond-Fortier

 8. Needle Exchanges Find New Champions Among Republicans

Victoria Knight

Part II. Syringe Use and Infection Risks

• A. HIV •

­ 9. Syringe-Exchange Programs Are Part of Effective HIV Prevention

National Institute on Drug Abuse

10. Needle Exchanges Can Now Get Federal Funding

Anna Gorman

11. Trump Pledges to End HIV Transmission by 2030. Doable, But Daunting

Carmen Heredia Rodriguez

12. The Unexpected Public Health Emergency

Jenna Tyler

13. An Addiction Researcher Shares 6 Strategies to Address the Opioid Epidemic

Nabila El-Bassel

14. Why Are HIV Survival Rates Lower in the Deep South Than the Rest of the U.S.?

Susan Reif and Carolyn McAllaster

15. Should You Be Tested for HIV? Why June 27 Is a Good Day to Do

Jodi Sutherland

16. Violence Against Women Is Overlooked in Its Role in Opioid Epidemic

Nabila El-Bassel

17. Fighting HIV in Miami, One Dirty Needle at a Time

Amy Driscoll

• B. Hepatitis C •

18. Addressing Increases in Hepatitis C Infections Linked to the Opioid Epidemic

Don C. Des Jarlais

19. Hepatitis C and Injection Drug Use

U.S. Department of Health and Human Services

20. A “Safe” Space to Shoot Up: Worth a Try?

Stephanie O’Neill

21. Treating the New Hep C Generation on Their Turf

Pauline Bartolone

Part III. Practices, Programs, and Policies

of Governments and Nonprofits

• A. Federal •

22. New Rules for Safe and Secure Prescription Drug Disposal Options

U.S. Drug Enforcement Administration

23. Safely Using Sharps (Needles and Syringes) at Home, at Work and on Travel

U.S. Food and Drug Administration

24. HRSA Implementation Guidance of Syringe Services Programs

U.S. Department of Health and Human Services

25. Implementation Guidance for Syringe Services Programs

U.S. Department of Health and Human Services

26. Injection Drug Use

Centers for Disease Control and Prevention

27. Syringe Services Programs (SSPs) FAQs

Centers for Disease Control and Prevention

28. The Safety and Effectiveness of Syringe Services Programs

Centers for Disease Control and Prevention

29. CDC’s Role in Safe Injection Practices

Centers for Disease Control and Prevention

30. CDC Program Guidance for Syringe Services Programs

Centers for Disease Control and Prevention

31. Medical Waste

U.S. Environmental Protection Agency

32. Opioid Overdose Reversal with Naloxone

National Institute on Drug Abuse

• B. State •

33. Syringe Exchange Programs in California: An Overview

California Department of Public Health

34. California Legal Code Related to Access to Sterile Needles and Syringes

California Department of Public Health

35. Florida Is the Latest ­Republican-Led State to Adopt Clean Needle Exchanges

Sammy Mack

36. Syringe Exchange in Southern Indiana to Respond to an Increase in HIV Cases

Jeannie D. DiClementi

37. HIV, STDs, and Hepatitis

New York State Department of Health

38. Utah Syringe Exchange Program

Utah Department of Health

39. Arizona Declares Opioid Emergency, but Signals Are Mixed Over Best Response

Will Stone

40. Unable to Arrest Opioid Epidemic, Red States Warm to Needle Exchanges

Shefali Luthra

• C. County and City •

41. The Competing Views and a Way Forward

Elissa Velez and Mickey P. McGee

42. Harm Reduction Services in San Francisco: Executive Summary

San Francisco Department of Public Health

43. Syringe Access and Disposal Programs in San Francisco

San Francisco Department of Public Health

44. Syringe Disposal Practices of Intravenous Drug Users in Monterey County

Jaime Teeter Householder and Mickey P. McGee

45. How Did Ohio Local Government Leaders Dramatically Reduce Opioid Deaths?

Gerald Young

46. How Lowell Is Fighting the Opioid Crisis

Audrey Fraizer

47. How One City Went “All In” to Fight the Opioid Epidemic

International City/County Management Association

48. The High Cost of Opioid Abuse in Your Community

Marty Harding

49. Boston’s Heroin Users Will Soon Get a Safer Place to Be High

Martha Bebinger

50. In Boston’s “Safe Space,” Surprising Insights into Drug Highs

Martha Bebinger

51. What’s Next for “Safe Injection” Sites in Philadelphia?

Elana Gordon

52. “Crackhouse” or “Safehouse”?

Nina Feldman

• D. Nonprofits and Associations •

53. Offering Syringes Along with Prayers, Churches Help IV Drug Users

Taylor Sisk

54. San Francisco AIDS Foundation’s Syringe Access Services Evaluation Results

Elissa Velez and Mickey P. McGee

55. Leading the Fight Against the Opioid Crisis

Geoff Beckwith

56. Statement of Policy: Opioid Epidemic

National Association of County and City Health Officials

57. Statement of Policy: Syringe Services Programs

National Association of County and City Health Officials

Part IV. The Future

58. Some Good News on Opioid Epidemic: Treatment Options Are Expanding

William Greene and Lisa J. Merlo

59. Sterile Needles Can Stop the Spread of Disease in Prisons—Here’s How

Jack Wallace

60. Meth vs. Opioids: America Has Two Drug Epidemics, but Focuses on One

April Dembosky

61. Big Data for Big Disease

H. Daniel Xu

62. Chittenden County’s Hub and Spoke Model for Combatting Opioid Deaths

Paul C. Prevey

Appendices

Appendix A. Glossary of Syringe Exchange and Opioid Terms, Abbreviations and Acronyms

Joaquin Jay Gonzalez III

Appendix B: Syringe Exchange Programs (2019): North American Syringe Exchange Network

Centers for Disease Control and Prevention

Appendix C. Adopting a Harm Reduction Policy for Substance Abuse, STD and HIV

San Francisco Health Commission Resolution No. 10–​00

Appendix D. Press Release: Mayor Mark Farrell Announces Innovative Program to Fight Opioid Crisis on San Francisco Streets

City and County of San Francisco, Office of the Mayor

Appendix E. Executive Summary: Secure and Responsible Drug Disposal Act of 2010

Federal Register

About the Contributors

Index