Pennsylvania harm reduction activists will rally at the State Capitol in Harrisburg on April 8, demanding that state lawmakers protect public health by authorizing syringe service programs (SSP). Pennsylvania is one of just 10 states not to have done so; its six neighbors—including Ohio and West Virginia—all have. A bill currently being considered by the legislature could change that, although lawmakers have previously failed to pass similar measures.
“Pennsylvania is facing a public health crisis because of the record number of overdose deaths in our state,” said Carla Sofronski, executive director of the Pennsylvania Harm Reduction Network, in a press release. “Syringe services programs offer naloxone, drug checking strips and overdose prevention education. They reach the hardest to reach people and those least connected to services. Pennsylvania cannot effectively address the overdose crisis and reduce deaths without expanded syringe services programs.”
Pennsylvania also has the country’s ninth highest total of new HIV cases, based on 2019 data. Full access to sterile syringes means people who inject drugs have no need to risk transmissions of HIV or hepatitis C by sharing equipment.
“There is no county-level distribution taking place.”
In a state of over 13 million people, only a handful of SSP currently operate, through special authorization by city governments. Prevention Point in Philadelphia is the best known. Other groups supply syringes without authorization, but large swaths of the state don’t have legal or adequate access.
“There is no county-level distribution taking place,” Sofronski told Filter, meaning even local health agencies don’t give out syringes. “The folks who do unauthorized SSP work are smaller, nonprofits who have taken the lead and have been doing this for a long time and are just now coming out of the shadows to advocate for SSP. That’s about 10 counties; some of those are very rural, folks are traveling long distances to provide services and not being paid a dollar to do so.”
Advocates have for years been lobbying Pennsylvania lawmakers to authorize SSP, but a number of attempts have been blocked. In 2021, sponsors of Senate Bill 926 had the backing of groups like the Hospital and Healthsystem Association of Pennsylvania, and supportive testimony from leading experts. Despite this, the bill died in the Senate Judiciary Committee.
The current effort has some bipartisan support, in a legislature where Republicans control the Senate and Democrats have a wafer-thin majority in the House. In February, the House Judiciary Committee voted on an SSP bill for the first time. It voted 15-10 to advance House Bill 1245, with one Republican, Representative Jim Rigby, joining all Democrats in support.
A person with a syringe containing drug residue would be protected as a participant in an authorized program under the law.
The bill even has a Republican co-sponsor, Rep. Jim Struzzi, who described being opposed to harm reduction programs until he visited Prevention Point to see how it works. Struzzi, who lost his brother to overdose, also supported a bill to decriminalize fentanyl test strips in 2022.
The bill as proposed would make clear that criminal penalties for drug “paraphernalia” don’t apply to syringes or “other objects” provided by a harm reduction program to reduce the risk of disease. A person with a syringe containing drug residue would be protected as a participant in an authorized program under the law. Participants would be given identification cards, with the program’s contact information, which they could produce if stopped by police.
Authorized programs would be required to provide, at minimum, things that SSP around the country routinely provide: sterile syringes, safe disposal resources, information about prevention and treatment of substance use disorder, naloxone to avert opioid overdose, and other health care services or referrals.
SSP are supported by decades of research showing that they prevent deaths and improve lives. Participants are five times likelier to enter treatment programs than non-participants, thanks to referrals. Sterile syringe access not only cuts transmissions of blood-borne diseases, but protects people from other injection-related harms like endocarditis and infected wounds. And despite often being accused of causing “syringe litter,” SSP reduce it—both by hosting disposal boxes and by conducting their own local cleanups.
SSP also make fiscal sense. A study estimated that from 1993-2002, Prevention Point saved Philadelphia $2.4 billion in health care costs on HIV treatment alone, by preventing over 10,000 new cases.
“In the more rural areas, that would look like mobile units and buses, every day going to a different location.”
But achieving statewide authorization is only one part of the struggle. Another is ensuring widespread access in practice.
“The same challenge with all other support services is making things accessible to people, [meaning] transportation, especially in central Pennsylvania,” Sofronski said. “Philadelphia and Pittsburgh have had ordinances for 30 years, they’re doing okay and they know how to run an SSP. They can provide assistance to other organizations locally. In the more rural areas, that would look like mobile units and buses, every day going to a different location. There are a few clinics that said they would immediately implement syringe services into their locations, but that’s few and far between.”
During the April 8 rally, from 1 pm local time on the front steps of the capitol, attendees will hear from speakers including Dr. Debra Bogen, the state health secretary, representatives from harm reduction, recovery and treatment organizations, and elected officials including Rep. James B. Struzzi II, (R-Indiana County) and Rep. Emily Kinkead (D-Allegheny County).
Photograph via United States Department of Veterans Affairs