Acknowledgments Preface Part I. The Opioid Epidemic 1. Opioid Epidemic Causing Rise in Hepatitis C Infections and Other Serious Illnesses Thomas J. Stopka 2. Syringe Services Programs (SSPs) Fact Sheet Centers for Disease Control and Prevention 3. An Ethical Dilemma for Doctors: When Is It OK to Prescribe Opioids? Travis N. Rieder 4. The Opioid Epidemic Is Finally a National Emergency—Eight Years Too Late Erin Winstanley 5. As the Opioid Epidemic Continues, the Holidays Bring Need to Support Those in Grief Emily B. Campbell 6. Keeping Away from Criminalization Sarah Sweeney 7. Stepping Up, Then Stepping Back Brenda Bond-Fortier 8. Needle Exchanges Find New Champions Among Republicans Victoria Knight Part II. Syringe Use and Infection Risks A. HIV 9. Syringe-Exchange Programs Are Part of Effective HIV Prevention National Institute on Drug Abuse 10. Needle Exchanges Can Now Get Federal Funding Anna Gorman 11. Trump Pledges to End HIV Transmission by 2030. Doable, But Daunting Carmen Heredia Rodriguez 12. The Unexpected Public Health Emergency Jenna Tyler 13. An Addiction Researcher Shares 6 Strategies to Address the Opioid Epidemic Nabila El-Bassel 14. Why Are HIV Survival Rates Lower in the Deep South Than the Rest of the U.S.? Susan Reif and Carolyn McAllaster 15. Should You Be Tested for HIV? Why June 27 Is a Good Day to Do Jodi Sutherland 16. Violence Against Women Is Overlooked in Its Role in Opioid Epidemic Nabila El-Bassel 17. Fighting HIV in Miami, One Dirty Needle at a Time Amy Driscoll B. Hepatitis C 18. Addressing Increases in Hepatitis C Infections Linked to the Opioid Epidemic Don C. Des Jarlais 19. Hepatitis C and Injection Drug Use U.S. Department of Health and Human Services 20. A "Safe" Space to Shoot Up: Worth a Try? Stephanie O'Neill 21. Treating the New Hep C Generation on Their Turf Pauline Bartolone Part III. Practices, Programs, and Policies of Governments and Nonprofits A. Federal 22. New Rules for Safe and Secure Prescription Drug Disposal Options U.S. Drug Enforcement Administration 23. Safely Using Sharps (Needles and Syringes) at Home, at Work and on Travel U.S. Food and Drug Administration 24. HRSA Implementation Guidance of Syringe Services Programs U.S. Department of Health and Human Services 25. Implementation Guidance for Syringe Services Programs U.S. Department of Health and Human Services 26. Injection Drug Use Centers for Disease Control and Prevention 27. Syringe Services Programs (SSPs) FAQs Centers for Disease Control and Prevention 28. The Safety and Effectiveness of Syringe Services Programs Centers for Disease Control and Prevention 29. CDC's Role in Safe Injection Practices Centers for Disease Control and Prevention 30. CDC Program Guidance for Syringe Services Programs Centers for Disease Control and Prevention 31. Medical Waste U.S. Environmental Protection Agency 32. Opioid Overdose Reversal with Naloxone National Institute on Drug Abuse B. State 33. Syringe Exchange Programs in California: An Overview California Department of Public Health 34. California Legal Code Related to Access to Sterile Needles and Syringes California Department of Public Health 35. Florida Is the Latest Republican-Led State to Adopt Clean Needle Exchanges Sammy Mack 36. Syringe Exchange in Southern Indiana to Respond to an Increase in HIV Cases Jeannie D. DiClementi 37. HIV, STDs, and Hepatitis New York State Department of Health 38. Utah Syringe Exchange Program Utah Department of Health 39. Arizona Declares Opioid Emergency, but Signals Are Mixed Over Best Response Will Stone 40. Unable to Arrest Opioid Epidemic, Red States Warm to Needle Exchanges Shefali Luthra C. County and City 41. The Competing Views and a Way Forward Elissa Velez and Mickey P. McGee 42. Harm Reduction Services in San Francisco: Executive Summary San Francisco Department of Public Health 43. Syringe Access and Disposal Programs in San Francisco San Francisco Department of Public Health 44. Syringe Disposal Practices of Intravenous Drug Users in Monterey County Jaime Teeter Householder and Mickey P. McGee 45. How Did Ohio Local Government Leaders Dramatically Reduce Opioid Deaths? Gerald Young 46. How Lowell Is Fighting the Opioid Crisis Audrey Fraizer 47. How One City Went "All In" to Fight the Opioid Epidemic International City/County Management Association 48. The High Cost of Opioid Abuse in Your Community Marty Harding 49. Boston's Heroin Users Will Soon Get a Safer Place to Be High Martha Bebinger 50. In Boston's "Safe Space," Surprising Insights into Drug Highs Martha Bebinger 51. What's Next for "Safe Injection" Sites in Philadelphia? Elana Gordon 52. "Crackhouse" or "Safehouse"? Nina Feldman D. Nonprofits and Associations 53. Offering Syringes Along with Prayers, Churches Help IV Drug Users Taylor Sisk 54. San Francisco AIDS Foundation's Syringe Access Services Evaluation Results Elissa Velez and Mickey P. McGee 55. Leading the Fight Against the Opioid Crisis Geoff Beckwith 56. Statement of Policy: Opioid Epidemic National Association of County and City Health Officials 57. Statement of Policy: Syringe Services Programs National Association of County and City Health Officials Part IV. The Future 58. Some Good News on Opioid Epidemic: Treatment Options Are Expanding William Greene and Lisa J. Merlo 59. Sterile Needles Can Stop the Spread of Disease in Prisons—Here's How Jack Wallace 60. Meth vs. Opioids: America Has Two Drug Epidemics, but Focuses on One April Dembosky 61. Big Data for Big Disease H. Daniel Xu 62. Chittenden County's Hub and Spoke Model for Combatting Opioid Deaths Paul C. Prevey Appendices Appendix A. Glossary of Syringe Exchange and Opioid Terms, Abbreviations and Acronyms Joaquin Jay Gonzalez III Appendix B: Syringe Exchange Programs (2019): North American Syringe Exchange Network Centers for Disease Control and Prevention Appendix C. Adopting a Harm Reduction Policy for Substance Abuse, STD and HIV San Francisco Health Commission Resolution No. 10–00 Appendix D. Press Release: Mayor Mark Farrell Announces Innovative Program to Fight Opioid Crisis on San Francisco Streets City and County of San Francisco, Office of the Mayor Appendix E. Executive Summary: Secure and Responsible Drug Disposal Act of 2010 Federal Register About the Contributors Index