Supporting Harm Reduction Programs

COVID-19 Research

Background and Methods

The COVID-19 pandemic has had a substantial impact on harm reduction services, including syringe services programs (SSPs). Our team published the first paper documenting the immediate challenges faced by SSPs early in the pandemic. Over the past three years, we have conducted qualitative interviews with a cohort of SSP staff every 6-12 months to learn about the short- and longer-term impacts of the pandemic on SSP service delivery and the health of people who use drugs. This work has been conducted in collaboration with a multidisciplinary team coordinated by researchers at Weill Cornell using funding from the National Institutes of Health.

Manuscripts and Presentations

2022 National Harm Reduction Conference

Findings were presented at the 2022 National Harm Reduction Conference in San Juan, Puerto Rico put on by the National Harm Reduction Coalition.

Key Findings:

  • Participant and syringe volume continue to increase; SSPs need stable funding to meet growing demand.
  • Adaptive and flexible models for syringe exchange should remain long-term, but this will require adequate staffing and funding.
  • Large disruptions in HIV and HCV testing are likely to have significant impacts on the health of PWID.

 

The Impact of COVID-19 on Syringe Services Programs in the United States

Key Findings

  • Approximately one-quarter of SSPs closed at least one site early in the COVID-19 pandemic
  • Many programs reported prioritizing syringe and naloxone distribution
  • HIV and HCV testing immediately declined or was eliminated
  • Most programs made changes to their service delivery model

Impact of COVID-19 on SSPs Infographic

Program Adaptations to Provide Harm Reduction Services During the COVID-19 Pandemic: A Qualitative Study of Syringe Services Programs in the U.S.

Key Findings

  • The manner in which SSPs were designated essential services impacted closures
  • Community support or lack thereof impacted the ability of some SSPs to adapt
  • Fewer PWUD may be accessing supplies to prevent transmission of drug use-related infections and overdose death
  • COVID-19 has created barriers to linking interested SSP participants to SUD treatment
  • Social distancing guidelines may lead to more use of drugs while alone, increasing overdose risk

Barriers to engaging people who use drugs in harm reduction services during the COVID-19 pandemic: A mixed methods study of syringe services program perspectives

Key Findings

  • One year into the pandemic, SSPs reported continuing to adapt their approaches to syringe distribution
  • Barriers to participant engagement in services included decreased connectivity, resource restrictions, reduced capacity to conduct HIV/HCV testing, and changing modalities for substance use disorder treatment.

Responding to a surge in overdose deaths: perspectives from US syringe services programs

Key Findings

  • Overdose deaths in the US surged during the COVID-19 pandemic, largely attributable to increasing fentanyl use
  • COVID-19 led to more solitary drug use and worsened mental health
  • SSPs increased naloxone distribution and education about risks related to fentanyl
  • Ongoing challenges included the inability to reach some populations at higher risk, an inconsistent naloxone supply, inadequate funding, policy barriers, and community stigma

Syringe Service Program Perspectives on Barriers, Readiness, and Programmatic Needs to Support Rollout of the COVID-19 Vaccine

Key Findings

  • Many SSPs reports that COVID-19 vaccination was not a priority for their participants
  • COVID-19 deepened participant mistrust of health care
  • Most SSPs wanted to provide COVID-19 vaccination but faced barriers including lack of resources, space, personnel, and training