White House Releases Model Law to Help States Ensure Access to “Safe, Effective, and Cost-saving” Syringe Services Programs

Model law supports Biden-Harris Administration’s ongoing efforts to expand evidence-based harm reduction services to address the overdose epidemic

WASHINGTON, D.C. – Today, the White House Office of National Drug Control Policy (ONDCP) announced the release of a model law for states to help expand access to syringe services programs (SSPs). These programs have a proven track record of reducing disease, increasing access to addiction treatment, improving public safety, and reducing costs. However, the availability of these programs is limited in many areas and some programs are hampered by outdated legislation. The release of this model law comes at a critical time when overdose deaths have reached a record high, and gives states a tool to help prevent overdoses. 

“At a time when overdose deaths have reached an unprecedented number, we must meet people where they are and do everything we can to save lives,” said Dr. Rahul Gupta, Director of National Drug Control Policy. “This model law provides states with a framework to make sure syringe services programs are available wherever they are needed. High-quality syringe services programs can prevent the spread of disease, save lives, and connect people to other health services, including treatment for substance use disorder.”

As detailed in the model law overview, the Centers for Disease Control and Prevention reported that “nearly 30 years of research has shown that comprehensive SSPs are safe, effective, and cost-saving, do not increase illegal drug use or crime, and play an important role in reducing the transmission of viral hepatitis, HIV and other infections.” New participants in SSPs “are five times more likely to enter drug treatment and about three times more likely to stop using drugs than those who don’t use the programs.” Furthermore, “studies show that SSPs protect first responders and the public by providing safe needle disposal and reducing community presence of needles.” A study published in Drug and Alcohol Dependence found that syringes were eight times more likely to be improperly discarded in cities without an SSP than in communities with an SSP.

SSPs are an evidence-based intervention in reducing opioid overdoses by teaching participants overdose prevention, recognition, and response; distributing naloxone to those most likely to benefit from it; and providing real-time information on drug market trends that can drive overdose. According to a study conducted by the CDC, as of 2019, 94% of responding SSPs in the United States had implemented overdose education and naloxone distribution as part of the services provided to program participants. It is undisputed that naloxone saves lives that might otherwise have been lost to overdose, and “[e]nsuring that all SSP participants are provided access to a sufficient and consistent supply of naloxone over time can optimize efforts to reduce opioid overdose deaths.” SSPs may be the only place for program participants to access such health information and resources.

This model law provides a template of suggested legislative provisions that can be enacted in states across country so that they can expand access to syringe services programs. Specifically, the model law, if fully implemented, would:

• Authorize the establishment of comprehensive syringe services programs within states;
• Delineate the required components for syringe services programs operating within states, including that such programs directly provide, or offer referrals to, expanded services including substance use disorder treatment;
• Reduce needlestick injuries to law enforcement, emergency services personnel, sanitation workers, and members of the community;
• Provide data collection and reporting requirements for syringe services programs;
• Provide immunity from criminal arrest, charge, and prosecution for the possession, distribution, or furnishing of hypodermic needles and syringes and other supplies;
• Provide education and training materials for members of the community, including law enforcement and other first responders;
• Provide a mechanism for funding of syringe services programs.

The research and drafting of the Model Syringe Services Program Act was funded through ONDCP’s Model Acts Program and authored by its cooperative agreement award recipient, the Legislative Analysis and Public Policy Association (LAPPA).

Last month, ONDCP announced the release of the Model Expanded Access to Emergency Opioid Antagonists Act, a state model law that would help make access to naloxone consistent across the country. Previously through this initiative, states have introduced the Model Overdose Fatality Reviews Teams Act, a LAPPA model law that would establish county-level multidisciplinary overdose fatality review that can be used to identify and respond to overdose deaths; and the Model Overdose Mapping (ODMAP) and Response Act, a LAPPA model law that would establish a system to track overdose incident reporting and improve public health and public safety responses.

BACKGROUND ON THE BIDEN-HARRIS ADMINISTRATION’S ACTIONS ON ADDICTION AND THE OVERDOSE EPIDEMIC

In its first-year drug policy priorities, the Biden-Harris Administration outlined a strategy that includes expanding access to evidence-based prevention, treatment, harm reduction, and recovery support services, as well reducing the supply of illicit drugs. Since January, the Office of National Drug Control Policy has worked with other agencies across the government to advance President Biden’s drug policy priorities. Among the actions taken in the first ten months of the Biden-Harris Administration are:

• The American Rescue Plan invested nearly $4 billion to allow the Department of Health and Human Services’ (HHS) Substance Abuse and Mental Health Services Administration (SAMHSA) and Health Resources and Services Administration to expand access to vital mental health and substance use disorder services. The funding also included $30 million in supports for harm reduction services—a historic amount that will enhance interventions like syringe services programs.
• HHS announcement of the new HHS Overdose Prevention Strategy, which focuses on expanding primary prevention, harm reduction, evidence-based treatment, and recovery support services for all Americans. The HHS Overdose Prevention Strategy builds on the Biden-Harris Administration’s year one drug policy priorities and actions taken by the Administration to address addiction and the overdose epidemic since January. 
• ONDCP released a model law for states to help expand access to naloxone, which saves lives by reversing opioid overdoses. 
• HHS released the Practice Guidelines for the Administration of Buprenorphine for Treating Opioid Use Disorder, which exempt eligible health care providers from federal certification requirements related to training, counseling and other ancillary services that are part of the process for obtaining a waiver to treat up to 30 patients with buprenorphine. This action expands access to evidence-based treatment by removing a critical barrier to buprenorphine prescribing.
• DEA lifted a decade-long moratorium on opioid treatment programs that want to include a mobile component. This rule change will help provide treatment to rural and other underserved communities, including incarcerated individuals.
• CDC and SAMHSA announced that federal funding may now be used to purchase fentanyl test strips in an effort to help curb the dramatic spike in drug overdose deaths.
• CDC launched four complementary education campaigns that provide information about the prevalence and dangers of fentanyl, the risks and consequences of mixing drugs, the life-saving power of naloxone, and the importance of reducing stigma around drug use to support treatment and recovery.
• National Institutes of Health is supporting research to accelerate scientific solutions to the overdose crisis, including research on prevention of substance use and use disorders; novel treatment strategies for addiction and overdose reversal; interventions to reduce drug harms and infection transmission; models of recovery support; and implementation of evidence-based practices in healthcare, community and justice settings.

• ONDCP designated six new counties as part of its High Intensity Drug Trafficking Areas (HIDTA) program. These counties, located in states like California, Illinois, Kentucky, and Pennsylvania, will receive support for regional law enforcement efforts to disrupt and dismantle drug trafficking organizations.
• ONDCP provided funding for the nationwide expansion of the HIDTA Overdose Response Strategy to all 50 states, Puerto Rico, the U.S. Virgin Islands, and the District of Columbia. The Strategy brings together drug intelligence officers and public health analysts at the local and regional level to share information and develop evidence-based intervention and support services that reduce overdoses.
• ONDCP provided funding to support the establishment of state-level model legislation that advances efforts to expand access to harm reduction services, as well as promote equity in access to treatment and drug enforcement efforts for underserved communities.
• ONDCP hosted more than 300 State, local, and Tribal leaders from all 50 States, Washington, D.C., American Samoa, Virgin Islands, Puerto Rico, and the Northern Mariana Islands for a virtual convening entitled “Opioid Litigation Settlement: Using Evidence to Lead Action.” At the convening, government officials, researchers, and experts discussed how State, local, and Tribal governments can use evidence and data to guide decisions about how funds from opioid litigation can be spent to address addiction and the overdose epidemic, while advancing equity.
• ONDCP, HHS, and DOJ presented to Congress the Biden-Harris Administration’s recommendations for a long-term, consensus approach to reduce the supply and availability of illicitly manufactured fentanyl-related substances (FRS), while safeguarding against racial disparities in prosecution and sentencing and reducing barriers to scientific research for all Schedule I substances.
• ONDCP announced $13.2 million in grants for 106 Drug-Free Communities (DFC) Support Programs (managed by CDC) across the country working to prevent youth substance use, including prescription drugs, marijuana, tobacco, and alcohol. In June, ONDCP announced $3.2 million for 65 communities nationwide for its Community-Based Coalition Enhancement Grants to Address Local Drug Crisis Program to reduce youth substance use.
• ONDCP announced the release of a model law for state legislatures that would help ensure opioid litigation settlement funds are directed to addressing addiction and the overdose epidemic in impacted communities and with public accountability.
• DEA issued a national public safety alert, launched a “One Pill Can Kill” public awareness campaign to raise awareness of the dangers of counterfeit pills laced with fentanyl, and coordinated a major enforcement operation to rid American communities of significant quantities of counterfeit pills laced with deadly fentanyl.
• ONDCP released a new, holistic U.S.-Colombia counternarcotics strategy developed by the Counternarcotics Working Group between the United States and Colombian governments that broadens focus to include specific actions on rural security and development, environmental protection, and supply reduction.

In addition to these actions, the President’s FY22 budget request calls for a $41.0 billion investment for national drug program agencies, a $669.9 million increase over the FY 2021 enacted level. The largest increases in funding are for critical public health interventions to expand research, prevention, treatment, harm reduction, and recovery support services, with targeted investments to meet the needs of populations at greatest risk for overdose and substance use disorder. The FY22 budget request also includes significant investments in reducing the supply of illicit substances.