Syringe exchange programs are a public health strategy designed to prevent the spread of blood borne pathogens such as HIV and hepatitis amongst people who inject drugs (PWID). The programs also connect clients to other services, including substance abuse treatment, HIV testing, and, in some cases, physical and mental health treatment. In March of 2016, The Center for Community Solutions released a report containing information on every syringe exchange program in the state of Ohio. At that time, there were six. The first was established in Cleveland in 1995 and the most recent was established in Columbus earlier in 2016. There are now 16 syringe exchange programs in the state of Ohio, representing a 167% increase over the last two and a half years. Several other areas in the state are also considering developing exchange programs of their own. The rise in programs is due, at least partially, to a change in Ohio law that was included in the 2016-17 state budget. This change allowed local boards of health to develop syringe exchange programs without declaring a state of emergency, a step that had been necessary up to that point.
Syringe exchange programs also connect clients to other services, including substance abuse treatment, HIV testing, and, in some cases, physical and mental health treatment.
I have been tasked with updating our original report. I am a Graduate Assistant at Community Solutions, meaning I work here part time while also taking classes towards my Masters in Public Administration at the John Glenn College of Public Affairs at the Ohio State University. I am in the second (and last) year of my program, but have been at Community Solutions for just over two months. When I was initially given this assignment, I had been here for about a week, making this not just my first project for Community Solutions but my first project in the field of public administration outside of a classroom setting. While the paper itself won’t be out for another couple of months, I’d like to give you some sense of what I have been up to, and what I have learned, thus far.
When I was initially given this assignment, I had been here for about a week, making this not just my first project for Community Solutions but my first project in the field of public administration outside of a classroom setting.
The first step was to find contact information for the people running the programs. In some cases, this was relatively easy, with the first result of a google search for “[City Name] needle exchange” being a document laying out what the city or county’s syringe exchange program is, when it happens, and who to contact for more information.
Other times, it was more difficult. Despite evidence from news reports and Harm Reduction Ohio that the new syringe exchanges exist, not all health departments have information about the needle exchanges on their websites. For these programs, I ended up sifting through news articles, seeing if the local paper ever mentioned a contact person for the program in their area. Sometimes they did. Other times, all the information I could find was a general phone number from the “Contact Us” portion of the Health Department website.
Despite evidence from news reports and Harm Reduction Ohio that the new syringe exchanges exist, not all health departments have information about the needle exchanges on their websites.
The final step before updating the paper, and the one that is ongoing, is reaching out to those in charge of each syringe exchange for more in-depth information. After several games of phone tag, I have successfully contacted somebody involved in almost all of the new exchanges and I have interviewed leaders of five of the exchanges. In some other cases, I am still involved in games of phone tag trying to get an interview scheduled. Additionally, a couple of the newer exchanges have expressed some trepidation about participating in an interview at this time, as they are not well established enough to be able to provide much information.
After several games of phone tag, I have successfully contacted somebody involved in almost all of the new exchanges and I have interviewed leaders of five of the exchanges.
The conversations I did have had are with leaders of the exchanges in Athens, Canton, Greene County, Jefferson County, and Summit County. These interviews paint a picture of a diverse group of programs. For instance, three of the syringe exchange programs are open once a week, while one is open twice a month and the other operates three times a week. They see, on average, a range from 6-90 PWIDs per week and have exchanged from 1,300 to almost 82,000 needles over the course of their existence. Each of these exchanges provide a number of additional services, ranging from access to treatment and hepatitis testing and vaccines to all those things plus wound assessment, Narcan, HIV testing, and hot food. Those that track this information have seen the number of cases of hepatitis B and C in their jurisdictions hold steady or decrease since the exchange was established, often reversing what had been a trend of sharp increases over the previous few years. Another thing they have in common is they could all benefit from additional funding. Some would use these funds to provide a navigator, someone who would help PWIDs find employment, adequate food and housing, while others would like to provide additional services at additional locations, while still others are simply in need of funding to purchase additional syringes.
I have enjoyed my experience thus far looking into syringe exchange programs.
I have enjoyed my experience thus far looking into syringe exchange programs. I have learned a lot about what syringe exchanges are, how they work, and why they are beneficial. I have also learned a decent amount about the layout of the websites of several local health departments in Ohio. All in all, I have learned a lot about this policy area, and have also gained important insight into how to do policy research in a real world setting.
For additional information on syringe exchanges in Ohio and some of the laws and federal guidelines governing them, please see this previous Community Solutions report, Federal and State Changes Raise Possibility of New or Expanded Syringe Services Programs in Ohio.