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Syringe services is a public health program for people who inject drugs.
Syringe services provides new, sterile syringes, sharps containers, and clean injection equipment. This reduces the spread of HIV and other blood-borne infections among people who inject drugs, their families, and communities.
Syringe services include:
New, sterile syringes.
Referral to community resources, such as health care, behavioral health, housing, and food banks.
The Grays Harbor County Public Health and Social Services Department offers syringe services every Wednesday from 11:30am-3:30pm. These services are provided at an off-site location. For location information, call Kristina Alnajjar at (360) 500-4060. We do not exchange syringes at our clinic.
Questions and answers
What is the current situation?
On December 18, 2018, the Grays Harbor County Board of Health adopted a resolution to end Grays Harbor County Public Health & Social Services Department’s syringe services program on June 30, 2019.
On April 25, 2019, the Grays Harbor County Board of Health reversed this decision; Grays Harbor County Public Health & Social Services Department will continue to provide syringe services.
I have feedback about the syringe services program. How can I share my feedback with health department staff?
We appreciate the feedback we have received and we are committed to addressing concerns and aligning our services with best practices.
We value conversations with community members and other stakeholders so that we can understand concerns. In the weeks to come, we will be identifying ways to connect with community members in both group and individual settings. These opportunities will be announced widely (via newspaper, radio, Facebook). Please stay tuned.
In the meantime, if you would like more information about the syringe services program or would like to provide feedback, please contact Kristina Alnajjar at firstname.lastname@example.org.
What are syringe services programs?
Syringe services programs (SSPs) are community-based public health programs that serve people who inject drugs. SSPs generally have four core components:
Provide free, sterile syringes and other supplies to prevent the spread of infectious disease.
Facilitate safe disposal of used syringes.
Offer education about overdose prevention and safer injection practices, such as training on how to use naloxone (an overdose-reversal drug).
Provide referrals or access to additional medical, mental, or social services, including HIV and hepatitis C testing and drug treatment and counseling
SSPs reduce the risk of HIV, hepatitis C, and other bloodborne pathogens by increasing access to sterile syringes, removing used syringes from the community, and educating clients about how to prevent the spread of infectious disease and reduce their risk of abscesses and infections.
How long have syringe services existed in Grays Harbor County? Are there other syringe services programs in Washington State?
Grays Harbor County Public Health & Social Services Department has operated a syringe services program since 2004. The program was authorized by Resolution #BOH-04-01, approved by Grays Harbor County Board of Health on January 15, 2004.
According to Washington State Department of Health, there are currently 24 syringe services programs operating around Washington State that serve over 45 different locations.
Are syringe services programs legal?
In Washington State, local Boards of Health are given broad authority to “enact such local rules and regulations as are necessary in order to preserve, promote and improve the public health and provide for the enforcement thereof.” This allows local Boards of Health to approve syringe services programs within their jurisdiction. (RCW 70.05.060)
Washington State drug paraphernalia laws do not prohibit the legal distribution of syringes through public health, community based HIV prevention programs, and pharmacies. (RCW 69.50.4121) They also allow any person over the age of 18 to possess sterile syringes for the purpose of reducing bloodborne diseases. (RCW 69.50.412).
Why do syringe services programs make public health sense?
SSPs improve community health. (CDC)
• SSPs reduce HIV, Hepititis C, and other disease transmission.
• SSPs do not increase crime or drug use.
• SSPs connect people to other health services, including HIV testing and care services and drug treatment.
• SSPs facilitate safe syringe disposal, so that police officers, emergency medical responders, and community members are less likely to have a needlestick injury.
• SSPs save health care dollars by preventing infections from blood borne viruses and abscesses from dull, contaminated syringes.
• SSPs reduce overdose death through education about how to prevent and respond to overdose situations.
SSPs are an important part of a comprehensive strategy to reduce the harms of drug use. (Surgeon General Report On Alcohol, Drugs, and Health, 2016)
Historically, society has treated substance use disorders as a moral weakness or as a willful rejection of societal norms, addressing these problems primarily through the criminal justice system.
Evidence now shows that addiction to alcohol or drugs is a chronic, but treatable, brain disorder that requires medical intervention, and has the potential for both recurrence and recovery.
Building on the federal public health approach, many communities are developing public health approaches to address substance misuse. A public health approach seeks to understand the broad factors that influence substance misuse and substance use disorders and applies that knowledge to improve the health, safety, and well-being of the entire population.
In Grays Harbor County, the syringe services program is part of the health department’s comprehensive public health approach to reducing substance misuse.
• My Town and Harbor Strong coalitions are focused on preventing underage drug use. Coalition members represent multiple sectors of the community, including; schools, media, private business, city officials, law enforcement, medical, behavioral health treatment, parents and students. These efforts also include a school-based prevention component, which is conducted in partnership with ESD 113, Hoquiam School District and Aberdeen School District.
• Grays Harbor Therapeutic Court provides qualifying individuals who have abused substances with an opportunity for judicially supervised treatment as an alternative to incarceration.
• The Overdose Prevention Project distributes naloxone and conducts overdose response education to those at risk of witnessing or experiencing an opioid overdose. This includes community health workers, lay responders, and law enforcement officers. Project staff also collaborated with other community organizations to write and carry out the Grays Harbor County Opioid Needs Assessment and Response Plan, written in 2018.
What happens at the syringe services program in Grays Harbor County?
Grays Harbor County Public Health & Social Services Department offers syringe services every Wednesday from 11:30am-3:30pm. The program is operated out of a converted recreational vehicle that parks under the Chehalis River Bridge near downtown Aberdeen.
• Clients are given 1 new, sterile syringe for every used syringe they bring in. If clients bring in a large container of uncounted syringes, staff will use established guidelines to make an educated estimate of the number of needles in the container. To prevent needlestick injuries, staff are prohibited (and clients are discouraged) from handling the needles to do a precise count.
• Clients are also provided other supplies to prevent infections and the spread of infectious diseases, which may include male condoms, band aids, antibiotic ointment, cottons, cookers, tourniquets, alcohol wipes, and hand sanitizer.
• Clients who are at risk of having or witnessing an opioid overdose are provided naloxone and are trained to recognize and intervene in an overdose.
• Using motivational interviewing techniques, staff will assess clients’ readiness for change and make appropriate referrals to community and drug treatment services. Depending on availability, staff from local drug treatment providers may also be on site to help clients directly access treatment services.
How much does the syringe services program in Grays Harbor County cost? Who pays for it?
In 2017, Grays Harbor County Public Health & Social Services Department used resources from three different funds to support the syringe services program.
Treatment Sales Tax
In 2009, Grays Harbor County commissioners approved a one-tenth of one percent (.001) sales tax increase to be used for chemical dependency or mental health treatment services; collection of the Treatment Sales Tax began on January 1, 2010. In 2017, just under $53,000 from the county’s Treatment Sales Tax fund was used to support the syringe services program. Specifically, the Treatment Sales Tax funds pay for:
• staff time to operate the program.
• disposal of contaminated needles.
Washington State Project to Prevent Prescription Drug/Opioid Overdose grant
In 2016, Grays Harbor County Public Health & Social Services Department became a partner in a statewide grant to prevent opioid overdose. Funds for this grant come from the federal government and are distributed by University of Washington’s Alcohol and Drug Abuse Institute. These federal grant funds pay for:
• staff time to provide overdose response training.
• naloxone overdose rescue kits.
Washington State Department of Health
The Washington State Department of Health provides infection-prevention supplies, including the syringes, free of charge to the Grays Harbor County syringe services program.
Are there other ways that people can get new, sterile syringes?
Syringes may be available for purchase at retail pharmacies. Washington State does not require a prescription to purchase syringes at a retail pharmacy.
Do syringe services programs increase syringe litter? What should I do if I find a syringe?
We share everyone’s desire for a clean, safe community. Research shows that cities with syringe services programs have less syringe litter than cities without syringe services programs.
Our syringe services program is working to decrease the amount of syringe-related trash in our community. We emphasize proper disposal with our clients. We also offer technical assistance to local municipalities.
It can be unsettling to find a syringe; it is a reminder of the complex problems our community is experiencing.
If you find a syringe, you can help make sure it is disposed of safely.
• If the syringe is on public property, like a city park, call the city or town to report it.
• If the syringe is on private property, tell the landlord or business owner.
• If you want to clean up the syringe yourself, use a pair of tongs to pick up the syringe and put it into a sharps container or some other thick-walled container that can be sealed. Call your local trash collector for disposal instructions.
Visit SeeANeedle.com for resources that can help you teach children what to do if they find a syringe.
Who are our community partners?
City of Aberdeen
Evergreen Treatment Center
Grays Harbor Treatment Solutions
Summit Pacific Medical Center
Grays Harbor Community Hospital
Emergency Medical Services
The CDC recommends that health care providers test everyone between the ages of 13 and 64 for HIV at least once as part of routine health care. Please see your health care provider for more information about HIV testing.
The CDC recommends that health care providers test all adults born from 1945 through 1965 for Hepatitis C at least once as part of routine health care. Those who are currently injecting drugs or who have ever injected drugs should also be tested for Hepatitis C. Please see your health care provider for more information about Hepatitis C testing.
There are reports that fentanyl is in the Grays Harbor drug market.
Fentanyl is being sold in:
pill form as fake oxycodone, Xanax, and other club drugs
powder form as heroin or fent
powder form mixed into drugs like crystal meth and cocaine
Fentanyl is 50-100 times more potent than heroin or morphine. The high potency of fentanyl greatly increases the risk of overdose, especially if a person who uses drugs is unaware that a powder or pill contains fentanyl.
If someone overdoses, always call 911 first. If you have naloxone, follow protocols for using it. Give them one dose, wait 2-3 minutes to see if they respond, then give a second dose. Because fentanyl is so strong, the help of emergency responders, who will have more naloxone, is critical.