Syringe service programs

What are syringe service programs?

Syringe services programs (SSPs), which have also been referred to as syringe exchange programs (SEPs), needle exchange programs (NEPs) and needle-syringe programs (NSPs), are community-based programs that provide access to sterile needles and syringes free of cost and facilitate safe disposal of used needles and syringes. As described in the CDC and U.S. Department of Health and Human Services (HHS) guidance, SSPs are an effective component of a comprehensive, integrated approach to HIV prevention among persons who inject drugs. These programs have also been associated with reduced risk for infection with hepatitis C virus. Most SSPs offer other prevention materials (e.g., alcohol swabs, vials of sterile water, condoms) and services, such as education on safer injection practices and wound care; overdose prevention; referral to substance use disorder treatment programs including medication-assisted treatment; and counseling and testing for HIV and hepatitis C. Many SSPs also provide linkage to critical services and programs, such as HIV care, treatment, pre-exposure prophylaxis (PrEP), and post-exposure prophylaxis (PEP) services; hepatitis C treatment, hepatitis A and B vaccinations; screening for other sexually transmitted diseases and tuberculosis; partner services; prevention of mother-to-child HIV transmission; and other medical, social, and mental health services.

What is the risk of HIV and other STDs among people who inject drugs?

The risk for getting or transmitting HIV is very high if an HIV-negative person uses injection equipment that someone living with HIV has used. This is because the needles or works may have blood in them, and blood can carry HIV. HIV can survive in a used needle for up to 42 days, depending on temperature and other factors.

Substance misuse can also increase the risk of getting HIV through sex. When people are high, they are more likely to have risky anal or vaginal sex, such as having sex without a condom or without medicines to prevent or treat HIV, having sex with multiple partners, or trading sex for money or drugs.

Sharing needles or works also puts people at risk for getting viral hepatitis. People who inject drugs should talk to a doctor about getting vaccinated for hepatitis A and B and getting a blood test for hepatitis B and C.

In addition to being at risk for HIV and viral hepatitis, people who inject drugs can get other serious health problems, like skin infections or abscesses. People can also overdose and get very sick or even die from having too many drugs in their body or from products that may be mixed with the drugs without their knowledge (for example, illegally made fentanyl).

Who can access SSPs?

Everyone can access SSPs, but they are intended to reduce HIV transmission among persons who inject drugs.

Who can run SSPs/what funds can be used?

HHS issued guidance in 2016 for HHS-funded programs regarding the use of federal funds to implement or expand SSPs for persons who inject drugs, which can be found here: The HHS guidance describes how health departments can request to use federal funds to start or expand SSPs in order to prevent new HIV and viral hepatitis infections and how those funds can be used. The guidance states that state, local, tribal, and territorial health departments must consult with the Centers for Disease Control and Prevention (CDC) and provide evidence that their jurisdiction is (1) experiencing, or (2) at risk for significant increases in viral hepatitis infections or an HIV outbreak due to injection drug use. After receiving a request for determination of need, CDC will have 30 days to notify the requestor whether the evidence is sufficient to demonstrate a need for SSPs.

What are the laws in MD?

 Syringe service programs are legal in Maryland as of 2016 (SB97), and state law authorizes the retail sale of syringes without a prescription with no direct prohibition on sales to people who inject drugs (Md. Code Regs.

Where can I find a syringe service program in MD?

 Although SSPs are now legal in MD as of 2016, no new programs are operating from this legislation. The only program currently in operation is the Baltimore City Needle Exchange Program (NEP; The program links individuals to drug treatment services, provides counseling and testing for HIV and syphilis, exchanges unclear syringes and offers clean syringes, and provides opioid overdose response training. The program operates at 16 different locations throughout the city at various different times through the week.


Additional services are available Thursdays from 7-10pm at Baltimore & Gay (“The Block”):

  • Overdose Response Program
  • Baltimore Healthcare Access Maryland
  • Vaccine clinic (influenza and hepatitis B)
  • Reproductive health services: contraceptive services, emergency contraception, STD testing and treatment, pregnancy testing, referrals to prenatal care, referrals to Johns Hopkins Center for Addiction and Pregnancy Program, and pap smears

Other counties are in talks to expand SSPs/NEPs throughout the state, and programs should be launching soon within Baltimore County and Washington county.

Questions about the Baltimore City Needle Exchange Program?

 Contact the office at 410-396-3731, or individual staff members at the following email addresses:

Derrick Hunt, Director at

Jeffrey Long, Health Program Administrator II at

Lisa Parker, Health Program Administrator I at