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Projected Outcomes of Reducing Federal Funding for Syringe Service Programs via Executive Order.

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Halting federal funding for syringe service programs (SSPs) could significantly increase mortality among people who inject drugs. This study modeled funding disruptions, projecting substantial rises in all-cause and overdose deaths over five years.

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Area of Science:

  • Public Health
  • Epidemiology
  • Health Policy

Background:

  • Syringe service programs (SSPs) are crucial for harm reduction among people who inject drugs.
  • Federal funding for SSPs faced a significant threat in July 2025, potentially disrupting essential services.

Purpose of the Study:

  • To estimate the long-term health outcomes, specifically mortality, associated with reduced federal funding for SSPs in the US.

Main Methods:

  • A decision analytical model using a closed cohort microsimulation approach.
  • Modeled natural history of injection drug use and health outcomes from August 2025 to August 2030.
  • Utilized data from CDC's National HIV Behavioral Surveillance and published literature.

Main Results:

  • Reduced SSP funding scenarios projected increases in all-cause and overdose mortality over five years.
  • The worst-case scenario (sustained disruption) estimated 39,600 additional deaths and 15,600 additional overdose deaths.
  • Most sensitivity analyses indicated increased all-cause and overdose mortality.

Conclusions:

  • Reduced federal funding for SSPs is associated with increased mortality among people who inject drugs.
  • Findings highlight the critical role of sustained SSP funding in mitigating harm.
  • Further research is needed to explore the clinical impact of funding changes on this population.