Harm reduction efforts combating opioid crisis more limited outside of cities

Communities where injection drug use has been increasing tend to have the most limited access to harm reduction programs such as needle exchange, according to a study published online last week in Morbidity and Mortality Weekly Report.

The study, conducted by researchers at the New York-based Mount Sinai Health System's Icahn School of Medicine, found that 69% of syringe service programs in the U.S. are located in urban areas, with 20% in rural communities and 9% in suburban areas. Rural and suburban communities have seen sharp increases in injection use of opioids, particularly among individuals transitioning from use of oral prescription opioids.

The study also found that access to the opioid overdose reversal medication naloxone is more limited in rural communities, with only 37% of needle exchange programs in these areas offering naloxone (compared with 61% of urban needle exchange programs offering the drug).

“Our data show that rural and suburban [syringe service programs] face some special challenges in recruiting clients, funding, and staffing, but that these programs can provide the needed services when they are implemented,” study lead author and Icahn School of Medicine psychiatry professor Don Des Jarlais, PhD, said in a Dec. 10 news release.