Orange County, Florida, launched its first syringe service program (SSP) on June 1. The county, home to the city of Orlando, first authorized SSP in February 2020 in an effort to combat steeply rising rates of HIV and overdose. As promising as that might seem, restrictive state laws continue to obstruct the actual services.
The new program is a partnership with a local nonprofit, Hope & Help. Founded in 1988, Hope & Help is an HIV/STI service provider focused on health care and specifically blood-borne disease testing. The newly opened SSP is distributing harm reduction tools like sterile syringes, safe injection equipment, naloxone and first aid supplies for wound care.
Officials were pushed to approve the SSP by a rapid spike in fatal overdose. Between 2014 and 2019, the county’s opioid-involved overdose deaths nearly doubled—from 175 to 342. The crisis worsened under the pandemic, with the county estimating a 70 percent increase in overdose deaths last year.
Orange County also has one of the highest rates of new HIV cases in Florida, second only to Miami-Dade County. Injection drug use is the primary contributing factor to HIV transmission within the county, according to state health data.
Before 2016, when the legislature finally approved a pilot program to open in Miami-Dade County, Florida had no legal SSP. After confirming that SSP would not make the sky fall, the state legislature took up a bill in 2019 to allow any county to opt in and create its own programs—Governor Ron DeSantis (R) signed the Infectious Disease Elimination Act (IDEA) in 2019, making Florida the 22nd state to legalize SSP.
The IDEA Act makes it almost impossible to provide services at the capacity that’s needed.
Of course, we have known for decades that SSP are safe, effective and lifesaving. But the IDEA Act includes provisions that make it almost impossible for Florida SSP to provide services at the capacity that’s needed.
First, it mandates that programs only give out syringes on a one-for-one basis; if a person comes to the clinic, they can receive one sterile syringe in exchange for one used syringe. Harm reduction experts and even the Centers for Disease Control and Prevention advocate giving people as many syringes as they need, whether or not they bring in any returns—the approach that has been shown most effective in improving public health of people who inject drugs as well as people who do not.
Second, the IDEA Act bars Florida SSP from receiving any state, county or local tax revenue. Counties have to vote to approve SSP, as well as oversee them, but the programs themselves operate independently and must raise their own funds through private donations.
And not just anyone can open a program. The IDEA Act specifies that only established entities like medical clinics, addiction treatment facilities or HIV/AIDS providers can provide syringes. Taken altogether, these provisions make it very difficult to open and effectively operate SSP in Florida, especially without a pre-existing funding source.
All this comes at the cost of Orange County residents, whether they use state-banned drugs or not. Like their counterparts elsewhere in Florida, they need a robust, supported and fully accessible SSP—one that’s allowed to do its job.