Implementation of an Interdisciplinary Syringe Services Program Within a Primary Care Clinical Setting

Syringe services programs (SSPs) are evidence-based harm reduction programs for persons who inject drugs that offer sterile injection equipment and linkages to care including substance use disorder (SUD), medical, and mental health care. Integrating an SSP into a primary care setting may increase engagement and reduce stigma.

We sought to describe the purpose, preimplementation, and implementation steps of a primary care-based SSP. We report on the facilitators and barriers in implementation, along with early clinical outcomes.

We identified the need to establish an SSP within a primary care setting and its purpose through stakeholder input. We formed a project facilitation group to execute early implementation and examine facilitators and barriers throughout development.

Barriers to implementation included legal implications of the SSP and facility restrictions on harm reduction supplies. Utilizing specific facilitators, such as collaboration with stakeholders, facility leadership, and community and national resources, aided in overcoming such barriers. Additional facilitators included creating a nurse- and pharmacist-driven workflow to allow patient walk-ins, triage appropriately, and increase accessibility. The primary care SSP had 18 persons who inject drugs from July 2022 to March 2023. In addition to receiving comprehensive harm reduction services, patients utilized primary care visits, wound care, referrals to specialty care, and SUD medication management within the same visit.

Through the implementation of a primary care-based SSP, patients accessed harm reduction resources and SUD, medical, and mental health care services. Our SSP provides a model for other primary care SSPs to be developed in the future.