Syringe swap program to expand in Michigan: How it works

File photo.

LANSING, Mich. – Michigan is expanding a program that has been shown to help reduce overdose deaths and the spread of disease through a needle swap.

The Syringe Service Program (SSP) is expanding in the state, as a part of a larger effort to combat the opioid crisis.

During the last decade, the United States has seen an increase in injection drug use — primarily the injection of opioids. Outbreaks of hepatitis C, hepatitis B and HIV infections have been correlated with these injection patterns and trends. The majority of new hepatitis C virus (HCV) infections are due to injection drug use, and the nation has seen a 3.5-fold increase in reported cases of HCV from 2010 to 2016, reaching a 15- year high, according to the CDC.

MDHHS has expanded support for SSP, which are now being offered by 25 agencies, up from 13 the previous year. This includes organizations in Detroit and Macomb, St. Clair, Genesee, Washtenaw, Ingham, Jackson, Calhoun, Kalamazoo, Ionia, Kent, Muskegon, Grand Traverse, Chippewa and Marquette counties, and several other counties. A full list is available here.

How it works

SSPs are programs that provide syringe access, disposal and/or exchange to injecting drug users (IDUs), while also referring and linking IDUs to HIV and viral hepatitis prevention services, substance abuse treatment, and medical and mental health care.

Various types of SSPs provide syringe services to IDUs, including syringe exchange programs (SEPs), pharmacies, physician prescription and health care services.

Services can include:

  • HIV and Hepatitis C testing and linkage to care 
  • Training in overdose prevention and response with access to Narcan/naloxone 
  • Hepatitis A and B vaccines 
  • Recovery coaching and linkage to substance use disorder treatment
  • Assistance in accessing medical care.
  • Basic wound care that reduces emergency room visits and hospitalizations from untreated minor injuries
  • Access to safer sex education and supplies

What are the benefits of an SSP?

  • Reduce HIV prevalence by as much as 50%
  • Reduce hepatitis C prevalence by as much as 50%
  • Reduce drug poisoning (overdose) death by providing naloxone/Narcan to people at high risk of witnessing and opiate overdose.
  • Reduce accidental needle sticks by 66% in law enforcement professionals
  • Increase the proper disposal of syringes and other hazardous materials
  • Increase access to substance use disorder treatment and recovery services – SSP participants have been shown to be up to 5 times more likely to access substance use disorder and recovery services, and stay enrolled in those services, than people injecting drugs and not utilizing an SSP

Syringe services programs can benefit communities and public safety by reducing needle-stick injuries and overdose deaths, without increasing illegal injection of drugs or criminal activity. Studies show that SSPs protect first responders and the public by providing safe needle disposal and reducing community presence of needles, according to the CDC.

As many as one in every three officers may be stuck by a used needle during his or her career. Needle stick injuries are among the most concerning and stressful events experienced by law officers.

SSP providers also work with local law enforcement to ensure that SSP staff and participants are not mistakenly treated as lawbreakers.

The first implementation of such a program can be traced back to Amsterdam in the 1980s, which was targeted at preventing the spread of HIV and Hepatitis.

The first SSP started in North America started in Tacoma, Washington in 1988. SSPs in Michigan began in the mid-1990’s. Prior to 2017, 5 “Legacy” SSPs existed in the state of Michigan. These programs are identified as “Legacy” programs because they operated prior to federal or state support. The rising hepatitis C and drug poisoning (overdose) death rates indicated a strong need for expansion of SSPs throughout the state.

MDHHS data highlights the impact the opioid epidemic has had on infectious disease transmission and demonstrates the need for SSP expansion. New diagnoses of hepatitis C (HCV) among adults less than 40 years old increased from 292 in 2000 to 3,774 in 2018, following similar patterns in accidental drug overdoses in the state. Where data was collected on HCV diagnoses among adults less than 40 years old in 2018, more than 80 percent self-reported a history of injecting drugs.

Find our more about the SSP program here.

The state announced new actions in all three areas; the beginning of a multi-year blitz to cut opioid-related overdose deaths by half in five years. In 2017, Michigan recorded more than 2,000 opioid-related overdose deaths and more than 7,000 Michiganders have lost their lives to this epidemic in the last five years.

“We are losing more than five people every single day to opioid overdoses,” said Gov. Gretchen Whitmer. “This epidemic touches all areas of our state and is one of the greatest health crises of our lifetimes. My number one priority is protecting our families and our overall public health, and these efforts will help bring us closer to ending this epidemic.”

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