What do Syringe Service Programs (SSPs) meanfor Washington state?

“By restoring the ban on federal funding for syringe exchange, members of Congress undoubtedly believed they were striking ablow against drug use. As extensive experience has shown, nothing could be further from the truth. By withholding funding forsyringe exchange, Congress has made our communities less safe, made police officers and medical responders unsafe, undermined a

vital bridge to drug treatment, and hindered national efforts to address public health problems such as HIV and hepatitis C.”

- Assistant Chief James Pugel, Seattle Police Department

Why Washington?Washington was an early adopter of the harm reduction model to curb transmission of HIV and Hepatitis C from injecting drug use. Itsrate of cumulative AIDS cases attributable to injecting drug use (IDU) is the fifth lowest in the nation at 9.9% (compared to 25.2%nationally).1 The latest Washington quarterly report found that this percentage fell to 8% in 2011.2

Syringe Exchange Programs Work in Washington Seattle’s SSP program began operating in 1989.3

There are currently 20 publically listed SSPs in Washington, the third largest number of SSPs of any single state.4

In 2008, King County spent $1.1 million/year on SSPs. In contrast, life-time medical cost to treat one person who has HIV isestimated to be $385,200.5 If these programs were to prevent HIV infections in even just 1% of IDUs in King County, theywould save $70 million in HIV-related medical costs.6

From 2005-2008, King County’s SSP placed 691 people in drug treatment programs and provided emergency funding supportto keep an additional 307 people in treatment.3 HIV testing initiatives and other prevention modes are presented as anintegrated package at these service sites.7

In King County, only 3% of IDUs are HIV positive,3 a figure that has remained constant for the last 20 years,7 compared to anational average of 9%,8 thanks to early and consistent implementation of needle exchange and other prevention efforts.

Given that 86% of King County IDUs are infected with hepatitis C virus,3 (this statistic is approximately 75%-80% state-wide),9HIV's potential for rapid spread continues to be great.

Access to SSPs Disproportionately Affects African AmericansAmong injecting drug users living with HIV in Washington, 70% identify as White and 16% identify as African American (this contrastssharply with the state population breakdown, which reports 82% White and 3.8% African American).10

Data Source: Washington State HIV Surveillance Quarterly Report (January 2013).Available at: http://www.doh.wa.gov/Portals/1/Documents/Pubs/150-030-HIVSurveillanceQuarterlyReport-Fourth2012.pdf and

U.S. Census Bureau. State & County Quick Facts. Available at: http://quickfacts.census.gov/qfd/states/53000.html

Federal dollars went to SSPs in Washington (2011):Centers for Disease Control and Prevention: $79,500

Syringe Exchange is Cost-EffectiveWashington’s relatively small investment in syringe exchange funding can have huge returns. Studies have shown that every $1invested in syringe exchange programs results in $3-7 in savings.11 Thus, federal funds in 2011 used for syringe servicesprograms already saved the state of Washington $556,500.

1 Kaiser Family Foundation State Health Facts, Estimated Numbers of AIDS Diagnoses Among Adults and Adolescents, by Transmission Category (2010). Available at:http://www.statehealthfacts.org/comparetable.jsp?ind=845&cat=11

2 Washington State HIV Surveillance Quarterly Report (October 2012). Available at: http://www.doh.wa.gov/Portals/1/Documents/Pubs/150-030HIVSurveillanceQuarterlyReport-Third2012.pdf3 Public Health – Seattle & King County Needle Exchange Program. Available at: http://www.kingcounty.gov/healthservices/health/communicable/hiv/resources/aboutnx.aspx4 North American Syringe Exchange Network. Available at: http://www.nasen.org/programs/us/wa/5 Schackman, BR et al. (2006). The Lifetime Cost of Current Human Immunodeficiency Virus Care in the United States. Medical Care, 44,11:990-997.6 Public Health – Seattle & King County Needle Exchange Program. Available at: http://www.kingcounty.gov/healthservices/health/communicable/hiv/resources/aboutnx.aspx7 Strategic and Operational Plan for HIV Prevention in King County. Public Health – Seattle & King County HIV/AIDS Program. Available at:

http://www.kingcounty.gov/healthservices/health/communicable/hiv/publications.aspx8 HIV Infection and HIV-Associated Behaviors Among Injecting Drug Users – 20 Cities, United States, 2009. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report. Available

at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6108a1.htm9 Okanogan County Public Health. HIV Testing and Counseling. Available at: http://www.okanogancounty.org/ochd/hiv__aids.html10 Washington State HIV Surveillance Quarterly Report (October 2012). Available at: http://www.doh.wa.gov/Portals/1/Documents/Pubs/150-030HIVSurveillanceQuarterlyReport-Third2012.pdf; and U.S.

Census Bureau. State & County Quick Facts. Available at: http://quickfacts.census.gov/qfd/states/53000.html11 Nguyen TQ. Increasing investment in syringe exchange is cost-saving HIV prevention: modeling hypothetical syringe coverage levels in the United States. Nineteenth International AIDS Conference,

Washington DC, abstract MOAE0204, 2012.