Reductions in federal funding for syringe service programs could result in significant increases in mortality among people who inject drugs, according to a study published on June 18 in JAMA Network Open.
Researchers from the University of Colorado Anschutz used a microsimulation model to assess the long-term effects of potential federal funding cuts to syringe service programs (SSPs) across the United States. The study examined various scenarios over a five-year period, modeling reductions of 11% and 80%—representing lower and upper estimates of federal contributions to SSPs nationwide. SSPs provide harm reduction services such as sterile syringes, naloxone distribution, wound care, access to medications for opioid use disorder, and connections to health and social services.
The results showed that all-cause mortality among people who inject drugs would increase by between 0.1% and 5%, while overdose mortality would rise by between 0.2% and 6.9%, depending on the extent of funding cuts over five years. In the scenario with an 80% sustained reduction in federal support, the model projected an additional 39,600 deaths overall among this population nationwide, including approximately 15,600 due to overdose.
"These estimates underscore the critical role that SSPs play in preventing overdose deaths and supporting the health of vulnerable populations," said Josh Barocas, MD, associate professor at CU Anschutz and senior author of the study. "Policies that reduce access to these services will have far-reaching consequences that extend well beyond the immediate funding cuts themselves and impede our ability to end the overdose crisis. This is a time we should be doubling down on evidence-based strategies to curtail overdoses, not cutting funding."
The researchers relied on data from sources such as the Centers for Disease Control and Prevention's National HIV Behavioral Surveillance system, along with other published materials to create a representative cohort for their analysis. Increased mortality was observed across most analyses conducted by the team.
"SSPs are a cornerstone of evidence-based harm reduction," said Pranav Padmanabhan, MPH, epidemiology PhD student at CU Anschutz and co-first author of the study. "This study provides important data for policymakers evaluating the public health implications of funding decisions affecting overdose prevention and related services."
