EDITORS/NEWS DIRECTORS:

President Donald Trump’s executive order on homelessness also impacts syringe exchange programs, which decades of research show are extremely effective at preventing infectious disease among intravenous drug users and referring them to treatment.

Under the order, grants from the U.S. Substance Abuse and Mental Health Services Administration can’t pay for supplies that “only facilitate illegal drug use,” such as cookers, tourniquets and sterile water. Needles already couldn’t be purchased with federal money.

In some places, the order is galvanizing support for syringe exchanges. In others, it’s changing practices and fueling opposition that threatens the existence of local programs.

In Republican-led Indiana, for example, state officials told syringe exchanges to comply with the order and even to discard existing federally funded supplies provided by the state. Indiana passed a law allowing exchanges a decade ago after the tiny city of Austin became the epicenter of the worst drug-fueled HIV outbreak in U.S. history. Barring legislative action, that law is due to sunset next year, and the number of exchanges has been dwindling.

Democratic-led California, meanwhile, has continued to pay for supplies such as pipes and syringes. California is home to a rising number of exchanges, with 70 of the 582 listed by the North American Syringe Exchange Network.

Some public health experts lament that these programs — part of a strategy known as harm reduction — have become the subject of growing politicization and dissent.

Below you can find reporting tips and learn more about syringe exchanges and how to track the effects of federal action on local programs.

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READ AP’S COVERAGE

Addiction-stricken community struggles to keep a syringe program going after Trump’s order

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FIND LOCAL SYRINGE EXCHANGES

A total of 43 states, plus Washington, D.C., and Puerto Rico, have syringe exchanges, according to the health care research nonprofit KFF.

The North American Syringe Exchange Network is viewed as the most comprehensive list of syringe exchanges, which are also known as syringe services programs. You can view a list that can be filtered by state, ZIP code, type and service and a map showing the location of programs listed.

Syringe programs — which can be run by local health departments or community groups and nonprofits — generally provide more than needles and supplies for safer drug use. Other services include infectious disease testing, health education, referrals to drug treatment and information about housing, jobs and area social services. Ask which services your local program provides.

The exact services and items affected by Trump’s executive order are spelled out in a federal letter.

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FIND OUT ABOUT LOCAL OUTCOMES

At a national level, research shows syringe programs curb disease, get people into treatment and don’t increase crime or syringe litter. For example, The U.S. Centers for Disease Control and Prevention said last year that syringe exchanges are associated with an estimated 50% reduction in the incidence of HIV and hepatitis C, which can be spread by sharing needles.

To look at the impact in your own community, get statistics from the city, town, county or nonprofit that runs the syringe program on how many people are served each year, how many referrals they make to drug treatment and how many people are tested for infectious disease. Regardless of whether your community has a such a program, state health departments track case numbers and rates of HIV or hepatitis C, and state reports may also include statistics on the method of transmission.

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CONSIDER THESE REPORTING THREADS

— How has your locality or state reacted to Trump’s executive order? Have syringe programs changed what they give out or how they operate? Speak with program leaders, state or local officials and ask for any correspondence sent from governments to syringe program operators. Get reactions from program participants as well as other community members, including those critical of syringe exchanges.

— What kinds of bills on syringe exchanges have lawmakers in your state proposed or passed in recent years? For example, The Associated Press found that Hawaii passed a law this year that allows people to get as many clean needles as they need rather than just one for one. In West Virginia this year, legislators introduced two bills that propose making syringe programs illegal. If your state legislative websites allow, you can search bills with keywords including “syringe,” “needle,” “syringe services program” or “syringe exchange program.” This U.S. Congress website contains links to each state’s legislative websites.

— What sorts of efforts are proponents of local syringe exchanges making to preserve and bolster the programs? How are opponents registering their concerns? What do local leaders and lawmakers think about them? What about local doctors, social service workers and public safety officials?

— In places where syringe exchanges are changing or closing, how is that affecting people? Are there other programs that can provide some of the services they may be losing? Talk with current and former program participants.

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READ AP’S PAST COVERAGE

In South Africa, a needle exchange program for drug users feels the effects of Trump’s aid cuts

Democrats and advocates criticize Trump’s executive order on homelessness

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

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