If the Trump administration’s termination of federal funding for U.S. syringe-exchange programs continues, it could result in nearly 40,000 additional deaths—including 16,000 preventable overdose deaths—among people who inject drugs over the next five years, according to a modeling
study issued today by
JAMA Network Open.
Why It’s Relevant
Comprehensive syringe service programs are a key component of harm reduction for the estimated
3.7 million individuals in the United States who inject drugs. These programs provide sterile equipment, wound care, naloxone, infectious disease care, and linkage to medications for opioid use disorder. In July 2025, an
executive order halted all funding for harm-reduction services and threatened to bring court cases against organizations that offer them.
By the Numbers
- The researchers simulated the potential five-year impact of various funding-cut scenarios for the 3,694,500 people (57% male) who inject drugs.
- If federal funding prior to August 2025 had remained unchanged through five years, there would have been 784,900 all-cause deaths and 226,900 overdose deaths.
- In the lowest service-disruption scenario—which assumed that federal funding comprised just 11% of syringe service programs’ total budgets and would be reinstated in one year—there were an estimated 1,100 additional all-cause deaths and 500 excess overdose deaths.
- In the worst-case scenario—assuming federal funding accounted for 80% of the programs’ total budgets and wasn’t reinstated as of August 2030—there were an estimated 39,600 excess all-cause deaths and 5,600 excess overdose deaths.
The Other Side
The researchers were unable to account for the impact of bloodborne infections such as HIV or hepatitis C virus. Because syringe service programs are often the only location where people who inject drugs access screening and treatment services, the funding cuts may lead to more downstream morbidity and mortality than estimated.
Takeaway Message
These federal funding cuts “leave more people at risk for death, and so the same people who might otherwise experience a non-fatal overdose and then go onto recovery through treatment, will now die of a fatal overdose or serious infection,” Joshua Barocas, M.D., deputy director at the Injury and Violence Prevention Center at the University of Colorado, told Psychiatric News. “These harm-reduction services help keep people alive so that they can enter treatment or recovery. Without them, more people die.”
Related Information
Source
Kirk B. Fetters, et al. Projected outcomes of reducing federal funding for syringe service programs via executive order. JAMA Network Open. Published June 18, 2026. doi:10.1001/jamanetworkopen.2026.19402.
(Image: Getty Images/iStock/Margarita-Young)