Providing human connection while maintaining physical distance
Washington’s syringe service programs serve our communities in the time of COVID-19
Department of Health is grateful for the valuable efforts of those who work at Syringe Services Programs (SSPs) across the state. These programs continue to provide dedicated service while maintaining the physical distance necessary to prevent the spread of COVID-19. As always, SSPs are providing compassionate human connection to some of the most marginalized and vulnerable communities in Washington. These programs offer access to nonjudgmental health education and lifesaving supplies to people who use drugs.
Washington state has a long history of programs providing sterile syringes, going back more than 30 years. In fact, the first publicly funded SSP in the United States was located in Tacoma. Syringe access is among the most researched and effective strategies to prevent HIV, viral hepatitis, and other blood-borne pathogens. SSPs are also a key access point for naloxone, a medication that prevents opioid overdose deaths. SSPs are a crucial part of our efforts to meet the goals of End AIDS Washington, Hep C Free Washington, and the state Opioid Response Plan. Without syringe access, communities risk serious outbreaks of infectious disease, similar to the one experienced in Scott County, Indiana in 2015.
Preventing the spread of COVID-19
Due to the ongoing pandemic, SSPs needed to change how they operate. Some of the changes these programs made to remain open and prevent the spread of COVID-19 include:
- Moving services outdoors
- Providing more supplies than usual to reduce the frequency of visits
- Pre-packing supplies to allow for contactless delivery
- Shifting from onsite services to mobile or delivery services
- Restricting bathroom access
- Changing operating hours
- Limiting face-to-face services (e.g., suspending HIV/hepatitis C testing and case management services)
- Offering written materials about COVID-19 prevention
- Increasing the amount of basic hygiene supplies provided
- Implementing comprehensive sanitizing protocols
Continuing to serve those hit hardest
COVID-19 disproportionately affects communities served by SSPs, including those experiencing homelessness and marginally housed people. Sarah Deutsch, Director of Programs at the Hepatitis Education Project, shares, “Staff had to make exceedingly difficult decisions about how to best serve our community when both opening and closing our doors carried risk. This experience has taken a significant emotional toll on our staff and community members alike. Initially, community members voiced frustration over the changes to program access, but the staff communicated the need for these changes. Now, community members frequently express their appreciation for our continued commitment to service continuity. Even so, there is a visible change in many of the SSP clients’ well-being because of the reduced access to supportive services and face-to-face contact with people who care.”
Unfortunately, with the current COVID-19 epidemic, overdose deaths are likely to increase due to the unpredictability of street drugs and the physical distancing requirements that make it difficult to observe and respond to overdoses. Helen Kenoyer, Prevention and Linkage to Care Coordinator at Clallam County’s SSP, notes, “I think the biggest challenge we are facing in our community is the amount of overdoses we are experiencing. Trying to respond to this COVID-19 pandemic we are all facing and simultaneously dealing with such a huge increase in overdoses has been a very frustrating challenge.”
This challenge makes SSPs all the more important as a critical safety net for people to access naloxone. In addition, a number of SSPs throughout the state provide low-barrier access to medications for opioid use disorder, which helps many people stabilize their lives and improve their health. Programs offering low-barrier access to these treatments report a greater demand for this service in light of COVID-19 and the changes the pandemic response has caused in their communities.
Hanna Day, Lead Community Health Outreach Worker at the Tacoma Needle Exchange, operated by Dave Purchase Project, describes how difficult adjustments made by SSPs have affected staff and participants: “Our staff has to work hard to keep a positive attitude and demeanor when dealing with people who are frustrated and may lash out because of that. I also feel like the lack of close contact with participants has negatively affected [them] and the outreach workers. One of the things that distinguishes harm reductionists from other service providers is the close contact we have with participants. Participants want to get close, for a variety of reasons. Unfortunately, during this time, close contact is exactly what this virus needs to spread and thus, places both the outreach workers and the participants at risk. Also, wearing masks all day/every day, a necessary precaution and new outreach requirement, is a pain.”
Human connection is a major component of effective SSPs
SSP staff are dedicated to supporting people without the stigma associated with their behavior. Building these relationships has a positive impact because when people feel someone cares about them they are more likely to seek help, including health care, mental health care, and treatment for substance use disorder. Department of Health conducted focus groups in April 2019 that discovered that program participants felt the SSP staff were some of the first people to show that they cared about them. One participant noted, “A lot of people think, ‘Oh, all they’re doing is enabling use.’ Well, you have to have people care about you and your health to recover, and if it wasn’t for their care, I probably wouldn’t be doing it.”
We are aware that public perception around SSPs is not always positive, and that people may have strong feelings about supporting people who are actively using drugs. Some benefits of SSPs are not so intuitive to the public. For example, SSPs actually decrease syringe litter in the environment by providing safe disposal services. Additionally, access to syringes significantly reduces the risk of bacterial infections like endocarditis and cellulitis that are extremely costly to treat. The availability of sterile equipment reduces use of emergency rooms to treat these infections, and decreases healthcare costs. We promote health equity and human dignity for all Washington residents and support SSPs, as they are backed by sound research.
Thank you SSPs for your ongoing hard work!
We graciously thank the dedicated and caring SSP staff members and volunteers who continue to help our most marginalized and vulnerable communities, especially during these exceptionally challenging times as we all cope with COVID-19.
To learn more:
- Visit our drug user health webpage.
- Read this recent article to learn more about The Impact of COVID-19 on Syringe Services Programs in the United States.
- See the results of the 2019 Syringe Exchange Health Survey, a biennial survey of people who inject drugs in Washington.
- Save the date for an upcoming virtual conference, Transforming our Communities: Health, Equity, and Justice for People Who Use Drugs. The conference will be held via Zoom on June 22nd and July 7th, from 9am-12:30pm. For more information reach out to Lisa Rey Thomas, lrthomas@uw.edu.
More information
Stay tuned to our blog for more information on how you can help stop the spread of COVID-19. Sign up to be notified whenever we post new articles.
Information in this blog changes rapidly. Check the state’s COVID-19 website for up-to-date and reliable info at coronavirus.wa.gov.
Answers to your questions or concerns about COVID-19 in Washington state may be found at our website. You can also contact our call center at
1–800–525–0127. Hours: 6 am-10 pm, seven days a week.
Department of Health call center: 1–800–525–0127, 6 a.m. to 10 p.m, seven days a week
Please check our website for the most up-to-date info on Washington’s response to COVID-19 at www.doh.wa.gov/coronavirus.
