Syringe Service Programs (SSPs)

Syringe services programs, often called SSPs, are community-based prevention programs that can provide a range of services. SSPs are a harm reduction intervention that have been in existence since the late 1980s and have been scientifically proven to reduce transmission of human immunodeficiency virus (HIV), hepatitis B and C and other bloodborne pathogens in person who inject drugs (PWID). SSPs provide a safe space to those struggling with substance use disorder. 

Services available at SSPs can include:

•  linkage to substance use disorder treatment; 
• access to and disposal of sterile syringes and injection equipment; and 
• vaccination, testing and linkage to care and treatment for infectious diseases. 

SSPs protect the public and first responders by facilitating the safe disposal of used needles and syringes. 

Providing testing, counseling, and sterile injection supplies also reduces the transmission of and prevents outbreaks of viral hepatitis, HIV and other infections. Nearly 30 years of research shows that comprehensive SSPs are safe, effective, cost saving, and do not increase illegal drug use or crime.

There are five authorized SSPs in North Dakota.  These programs are:

• Any Positive Change (APC) Project; Grand Forks, ND
• Harm Reduction Center; Fargo, ND
• Mandan Good Neighbor Project; Mandan, ND
• Minot Good Neighbor Project; Minot, ND
• The ROPES Project; Valley City, ND 

SSPs in North Dakota

The NDHHS has developed forms with the assistance of current authorized SSPs. The participant enrollment form template and participant log template can be used by SSP to collect data and provide a guide for participant visits. These two forms can be modified by SSP to ensure that they meet their needs. The SSP biannual report form is required to be submitted to the NDHHS twice per year. The biannual report for the reporting period of January 1 - June 30 is due on July 15 of that same calendar year and for the reporting period July 1 - December 31, the biannual report form is due January 15 of the following calendar year.

• SSP Participant Enrollment Form Template
• SSP Participant Log Template
• SSP Biannual Report Form

Implementing & Operating a SSP

The NDHHS along with NASTAD and the Harm Reduction Coalition provided a training on SSPs and how to work with persons who inject drugs. Below are recordings of the topics covered during this training. The training was held on September 4, 2018.

• Final Training Slides
• Recordings of Sessions
  • Introductions & Training Overview
  • Harm Reduction 101
  • Principles of Injection Drug Use
  • Drug User Health, Safer Injecting, and Overdose Risk
  • Stigma, Cultural Competency and Working with People Who Use Drugs

ND Vulnerability Index

A 2014 - 2015 outbreak of HIV infection among a rural network of persons who inject drugs (PWID) underscored the intersection of the expanding crise of opioid misuse, injection drug use, and associated increases in bloodborne infectious diseases. The North Dakota Department of Health identified counties potentially vulnerable to rapid spread of HIV, if introduced, and new or continuing high rates of hepatitis C virus infections among PWID. The North Dakota County Vulnerability Index Report identifies which counties are most at-risk for potential HIV or hepatitis C outbreaks among PWID.

• North Dakota County Vulnerability Index Report
• National Assessment of Counties and Jurisdictions Experiencing or At-Risk of Outbreaks

• SSP Technical Package: Effective Strategies and Approaches for Planning, Design and Implementation
• Safety and Effectiveness of SSPs
• CDC - Syringe Services Programs
• SSP Frequently Asked Questions
• Harm Reduction Technical Assistance (TA) Request Form
• ND Century Code 19-03.4-02; Drug Paraphernalia
• ND Century Code 23-01-44; Syringe or Needle Exchange Program - Authorization
• A Review: Pharmacy Nonprescription Syringe Distribution 
• Pharmacy Access to Syringes Among PWID