Tennessee Syringe Services Programs

Harm reduction is a public health approach that uses practical, evidence-based strategies to reduce the risks associated with drug use and sexual activity. It is non-judgmental, client-centered, and focused on meeting people where they are—supporting safer behaviors based on individual goals, needs, and readiness for change.

Syringe services programs provide comprehensive harm reduction services to prevent disease, reduce overdose deaths, and connect participants to care. Services may include:

• Sterile syringe and injection equipment distribution
• Safe disposal of used syringes
• HIV and hepatitis C testing and linkage to care
• Overdose prevention education and naloxone distribution
• Referrals to substance use disorder treatment, medical care, mental health services, and social support
• Tools to prevent bloodborne pathogens and sexually transmitted infections (STIs)

Under T.C.A. Title 68, Chapter 1, non-governmental organizations and local health departments (in partnership with county government) may operate SSPs with approval from the Tennessee Department of Health (TDH).

By law, syringe services program locations must be:

• At least 1,000 feet from any school or public park
• At least 2,000 feet from a school or public park in municipalities with populations between 55,440–55,450

• Free distribution of unused syringes and injection equipment
• Collection and safe disposal of used syringes and equipment
• Education on overdose prevention, bloodborne pathogens, and substance use and mental health treatment
• Referrals to substance use disorder and mental health treatment upon request
• Referral to or direct provision of naloxone
• Referral to or direct provision of HIV and hepatitis C testing

Syringe services programs serve people who often face barriers to healthcare due to stigma, cost, or fear of legal consequences. In addition to reducing HIV and hepatitis C transmission. The programs:

• Lower overdose deaths through naloxone distribution and education
• Reduce needle-stick injuries among first responders
• Connect participants to medical care and social services
• Save healthcare costs by preventing infections such as HIV, hepatitis C, skin abscesses, and endocarditis

Tennessee faces intersecting crises of opioid use, overdose deaths, HIV, and hepatitis C particularly in central Appalachian regions. High opioid prescribing rates, rising overdose deaths, increasing hepatitis C infections, and barriers to healthcare place many counties at high risk for disease transmission. SSPs reduce these risks by providing sterile syringes, overdose prevention tools, and pathways to treatment and care.

Anyone may visit an syringe services program location, including:

• People who use drugs (PWUD), including those who inject drugs (PWID)
• Individuals seeking naloxone or overdose prevention education
• People using syringes for prescribed or non-prescribed medications (e.g., insulin, hormones, steroids)
• People seeking safer sex supplies or HIV/hepatitis C testing
• Family and friends of someone who uses drugs
• Individuals seeking information on STI or bloodborne pathogen prevention

Any non-governmental organization or county legislative body may apply to operate an syringe services program with Tennessee Department of Health approval.

Local health departments (with county government):

• Submit a syring services program application for local health departments
• Include a petition or letter of support from the local governing body
• Confirm that local law enforcement has been notified

Non-governmental organizations:

• Submit a syringe services program application for non-government and community-based organizations
• Confirm notification of local law enforcement
• Additional requirements are detailed in the online application.

Questions may be sent to SSP.Health@tn.gov.

Approved syringe services programs must submit an annual report, including:

• Syringes distributed and collected
• Total participant visits
• Naloxone kits distributed
• Referrals to substance use disorder and mental health treatment
• HIV and hepatitis C tests performed
• Participant demographic data

Approved programs must also participate in a site visit 30 days after operations begin and annually thereafter.

Syringe services programs are funded either by non-governmental organizations or by county funds. Non-governmental organizationscan secure funding for syringes and injection supplies through private grants, donations, and fundraising. For additional information, please find funding opportunities here.

In Tennessee, syringe services programs are allowed to operate as a fixed site and/or a mobile site. A fixed site is located in a building or specific location, such as a storefront, office, or other space with street-level access. A mobile site operated from a van, bus, or other mobile unit to deliver services. If operating as a mobile site, the program is required to have a consistent location when delivering services due to zoning requirements.