In April 2024, San Diego County launched its Harm Reduction Services Program (HRSP), the region’s first government-run syringe service initiative. Designed to address the intersecting crises of overdose, HIV, and hepatitis C among people who use drugs, HRSP operates through a mobile delivery model, providing low-barrier, stigma-free services in underserved communities identified through a comprehensive Community Readiness Assessment. Services provided include sterile syringe access and disposal, safer sex and smoking supplies, naloxone distribution and education, fentanyl and xylazine test strips, HIV and hepatitis C testing and linkage to care, basic medical consults, and connection with housing, transportation, mental health, and substance use treatment services.

In alignment with harm reduction principles, HRSP does not require any formal identification and prioritizes meeting participants where they’re at, with dignity and respect. In its first year, HRSP reached 618 unique participants and facilitated 1,823 program visits. Nearly 75% of program participants are unhoused, underscoring the importance of the program’s personal care supplies. Notably, in 63% of program visits, participants reported collecting supplies for others in addition to themselves, highlighting HRSP’s extended reach into the community. Over the course of the year, a total of 2,305 boxes of naloxone were dispensed, and 517 overdose reversals were reported by program participants. These early outcomes reflect both the program’s meaningful impact and its success in building trust within the community. As HRSP enters its second year, the program continues to grow while remaining grounded in its commitment to providing compassionate, person-centered care for San Diego County residents.