Joaquin Jay Gonzalez III, Ph.D., is vice provost for global affairs as well as chair and Mayor George Christopher Professor of Public Administration at Golden Gate University. He founded GGU’s law enforcement and security program and is a San Francisco advocate for the safety and security of Filipino American kids and their families. Mickey P. McGee, DPA, is professor of public administration and director of the Doctor of Business Administration Program at Golden Gate University. He co-developed GGU’s Urban Innovations Program including the course, Inclusion, Diversion, Equity, and Accessibility. He has consulted for the U.S. Agency for International Development and the International City/County Management Association.

• Table of ContentsAcknowledgmentsPrefacePart I. The Opioid Epidemic1. Opioid Epidemic Causing Rise in Hepatitis C Infections and Other Serious IllnessesThomas J. Stopka2. Syringe Services Programs (SSPs) Fact SheetCenters for Disease Control and Prevention3. An Ethical Dilemma for Doctors: When Is It OK to Prescribe Opioids?Travis N. Rieder4. The Opioid Epidemic Is Finally a National Emergency—Eight Years Too LateErin Winstanley5. As the Opioid Epidemic Continues, the Holidays Bring Need to Support Those in GriefEmily B. Campbell6. Keeping Away from CriminalizationSarah Sweeney7. Stepping Up, Then Stepping BackBrenda Bond-Fortier8. Needle Exchanges Find New Champions Among RepublicansVictoria KnightPart II. Syringe Use and Infection Risks• A. HIV •­ 9. Syringe-Exchange Programs Are Part of Effective HIV PreventionNational Institute on Drug Abuse10. Needle Exchanges Can Now Get Federal FundingAnna Gorman11. Trump Pledges to End HIV Transmission by 2030. Doable, But DauntingCarmen Heredia Rodriguez12. The Unexpected Public Health EmergencyJenna Tyler13. An Addiction Researcher Shares 6 Strategies to Address the Opioid EpidemicNabila El-Bassel14. Why Are HIV Survival Rates Lower in the Deep South Than the Rest of the U.S.?Susan Reif and Carolyn McAllaster15. Should You Be Tested for HIV? Why June 27 Is a Good Day to DoJodi Sutherland16. Violence Against Women Is Overlooked in Its Role in Opioid EpidemicNabila El-Bassel17. Fighting HIV in Miami, One Dirty Needle at a TimeAmy Driscoll• B. Hepatitis C •18. Addressing Increases in Hepatitis C Infections Linked to the Opioid EpidemicDon C. Des Jarlais19. Hepatitis C and Injection Drug UseU.S. Department of Health and Human Services20. A “Safe” Space to Shoot Up: Worth a Try?Stephanie O’Neill21. Treating the New Hep C Generation on Their TurfPauline BartolonePart III. Practices, Programs, and Policies of Governments and Nonprofits• A. Federal •22. New Rules for Safe and Secure Prescription Drug Disposal OptionsU.S. Drug Enforcement Administration23. Safely Using Sharps (Needles and Syringes) at Home, at Work and on TravelU.S. Food and Drug Administration24. HRSA Implementation Guidance of Syringe Services ProgramsU.S. Department of Health and Human Services25. Implementation Guidance for Syringe Services ProgramsU.S. Department of Health and Human Services26. Injection Drug UseCenters for Disease Control and Prevention27. Syringe Services Programs (SSPs) FAQsCenters for Disease Control and Prevention28. The Safety and Effectiveness of Syringe Services ProgramsCenters for Disease Control and Prevention29. CDC’s Role in Safe Injection PracticesCenters for Disease Control and Prevention30. CDC Program Guidance for Syringe Services ProgramsCenters for Disease Control and Prevention31. Medical WasteU.S. Environmental Protection Agency32. Opioid Overdose Reversal with NaloxoneNational Institute on Drug Abuse• B. State •33. Syringe Exchange Programs in California: An OverviewCalifornia Department of Public Health34. California Legal Code Related to Access to Sterile Needles and SyringesCalifornia Department of Public Health35. Florida Is the Latest ­Republican-Led State to Adopt Clean Needle ExchangesSammy Mack36. Syringe Exchange in Southern Indiana to Respond to an Increase in HIV CasesJeannie D. DiClementi37. HIV, STDs, and HepatitisNew York State Department of Health38. Utah Syringe Exchange ProgramUtah Department of Health39. Arizona Declares Opioid Emergency, but Signals Are Mixed Over Best ResponseWill Stone40. Unable to Arrest Opioid Epidemic, Red States Warm to Needle ExchangesShefali Luthra• C. County and City •41. The Competing Views and a Way ForwardElissa Velez and Mickey P. McGee42. Harm Reduction Services in San Francisco: Executive SummarySan Francisco Department of Public Health43. Syringe Access and Disposal Programs in San FranciscoSan Francisco Department of Public Health44. Syringe Disposal Practices of Intravenous Drug Users in Monterey CountyJaime Teeter Householder and Mickey P. McGee45. How Did Ohio Local Government Leaders Dramatically Reduce Opioid Deaths?Gerald Young46. How Lowell Is Fighting the Opioid CrisisAudrey Fraizer47. How One City Went “All In” to Fight the Opioid EpidemicInternational City/County Management Association48. The High Cost of Opioid Abuse in Your CommunityMarty Harding49. Boston’s Heroin Users Will Soon Get a Safer Place to Be HighMartha Bebinger50. In Boston’s “Safe Space,” Surprising Insights into Drug HighsMartha Bebinger51. What’s Next for “Safe Injection” Sites in Philadelphia?Elana Gordon52. “Crackhouse” or “Safehouse”?Nina Feldman• D. Nonprofits and Associations •53. Offering Syringes Along with Prayers, Churches Help IV Drug UsersTaylor Sisk54. San Francisco AIDS Foundation’s Syringe Access Services Evaluation ResultsElissa Velez and Mickey P. McGee55. Leading the Fight Against the Opioid CrisisGeoff Beckwith56. Statement of Policy: Opioid EpidemicNational Association of County and City Health Officials57. Statement of Policy: Syringe Services ProgramsNational Association of County and City Health OfficialsPart IV. The Future58. Some Good News on Opioid Epidemic: Treatment Options Are ExpandingWilliam Greene and Lisa J. Merlo59. Sterile Needles Can Stop the Spread of Disease in Prisons—Here’s HowJack Wallace60. Meth vs. Opioids: America Has Two Drug Epidemics, but Focuses on OneApril Dembosky61. Big Data for Big DiseaseH. Daniel Xu62. Chittenden County’s Hub and Spoke Model for Combatting Opioid DeathsPaul C. PreveyAppendicesAppendix A. Glossary of Syringe Exchange and Opioid Terms, Abbreviations and AcronymsJoaquin Jay Gonzalez IIIAppendix B: Syringe Exchange Programs (2019): North American Syringe Exchange NetworkCenters for Disease Control and PreventionAppendix C. Adopting a Harm Reduction Policy for Substance Abuse, STD and HIVSan Francisco Health Commission Resolution No. 10–​00Appendix D. Press Release: Mayor Mark Farrell Announces Innovative Program to Fight Opioid Crisis on San Francisco StreetsCity and County of San Francisco, Office of the MayorAppendix E. Executive Summary: Secure and Responsible Drug Disposal Act of 2010Federal RegisterAbout the ContributorsIndex

“[A] useful compilation of reprinted short essays and government documents published from 2012 to 2019.... The editors, both public administration professors, present strong evidence for needle exchange and safe injection services to save lives from overdoses, provide vaccinations for hepatitis A and B, ensure testing and treatment for hepatitis C and HIV, and reduce financial burdens for treatment of infectious diseases and substance abuse.”—Choice

Joaquin Jay Gonzalez III, Ph.D., is vice provost for global affairs as well as chair and Mayor George Christopher Professor of Public Administration at Golden Gate University. He founded GGU’s law enforcement and security program and is a San Francisco advocate for the safety and security of Filipino American kids and their families. Mickey P. McGee, DPA, is professor of public administration and director of the Doctor of Business Administration Program at Golden Gate University. He co-developed GGU’s Urban Innovations Program including the course, Inclusion, Diversion, Equity, and Accessibility. He has consulted for the U.S. Agency for International Development and the International City/County Management Association.

• Table of ContentsAcknowledgmentsPrefacePart I. The Opioid Epidemic1. Opioid Epidemic Causing Rise in Hepatitis C Infections and Other Serious IllnessesThomas J. Stopka2. Syringe Services Programs (SSPs) Fact SheetCenters for Disease Control and Prevention3. An Ethical Dilemma for Doctors: When Is It OK to Prescribe Opioids?Travis N. Rieder4. The Opioid Epidemic Is Finally a National Emergency—Eight Years Too LateErin Winstanley5. As the Opioid Epidemic Continues, the Holidays Bring Need to Support Those in GriefEmily B. Campbell6. Keeping Away from CriminalizationSarah Sweeney7. Stepping Up, Then Stepping BackBrenda Bond-Fortier8. Needle Exchanges Find New Champions Among RepublicansVictoria KnightPart II. Syringe Use and Infection Risks• A. HIV •­ 9. Syringe-Exchange Programs Are Part of Effective HIV PreventionNational Institute on Drug Abuse10. Needle Exchanges Can Now Get Federal FundingAnna Gorman11. Trump Pledges to End HIV Transmission by 2030. Doable, But DauntingCarmen Heredia Rodriguez12. The Unexpected Public Health EmergencyJenna Tyler13. An Addiction Researcher Shares 6 Strategies to Address the Opioid EpidemicNabila El-Bassel14. Why Are HIV Survival Rates Lower in the Deep South Than the Rest of the U.S.?Susan Reif and Carolyn McAllaster15. Should You Be Tested for HIV? Why June 27 Is a Good Day to DoJodi Sutherland16. Violence Against Women Is Overlooked in Its Role in Opioid EpidemicNabila El-Bassel17. Fighting HIV in Miami, One Dirty Needle at a TimeAmy Driscoll• B. Hepatitis C •18. Addressing Increases in Hepatitis C Infections Linked to the Opioid EpidemicDon C. Des Jarlais19. Hepatitis C and Injection Drug UseU.S. Department of Health and Human Services20. A “Safe” Space to Shoot Up: Worth a Try?Stephanie O’Neill21. Treating the New Hep C Generation on Their TurfPauline BartolonePart III. Practices, Programs, and Policies of Governments and Nonprofits• A. Federal •22. New Rules for Safe and Secure Prescription Drug Disposal OptionsU.S. Drug Enforcement Administration23. Safely Using Sharps (Needles and Syringes) at Home, at Work and on TravelU.S. Food and Drug Administration24. HRSA Implementation Guidance of Syringe Services ProgramsU.S. Department of Health and Human Services25. Implementation Guidance for Syringe Services ProgramsU.S. Department of Health and Human Services26. Injection Drug UseCenters for Disease Control and Prevention27. Syringe Services Programs (SSPs) FAQsCenters for Disease Control and Prevention28. The Safety and Effectiveness of Syringe Services ProgramsCenters for Disease Control and Prevention29. CDC’s Role in Safe Injection PracticesCenters for Disease Control and Prevention30. CDC Program Guidance for Syringe Services ProgramsCenters for Disease Control and Prevention31. Medical WasteU.S. Environmental Protection Agency32. Opioid Overdose Reversal with NaloxoneNational Institute on Drug Abuse• B. State •33. Syringe Exchange Programs in California: An OverviewCalifornia Department of Public Health34. California Legal Code Related to Access to Sterile Needles and SyringesCalifornia Department of Public Health35. Florida Is the Latest ­Republican-Led State to Adopt Clean Needle ExchangesSammy Mack36. Syringe Exchange in Southern Indiana to Respond to an Increase in HIV CasesJeannie D. DiClementi37. HIV, STDs, and HepatitisNew York State Department of Health38. Utah Syringe Exchange ProgramUtah Department of Health39. Arizona Declares Opioid Emergency, but Signals Are Mixed Over Best ResponseWill Stone40. Unable to Arrest Opioid Epidemic, Red States Warm to Needle ExchangesShefali Luthra• C. County and City •41. The Competing Views and a Way ForwardElissa Velez and Mickey P. McGee42. Harm Reduction Services in San Francisco: Executive SummarySan Francisco Department of Public Health43. Syringe Access and Disposal Programs in San FranciscoSan Francisco Department of Public Health44. Syringe Disposal Practices of Intravenous Drug Users in Monterey CountyJaime Teeter Householder and Mickey P. McGee45. How Did Ohio Local Government Leaders Dramatically Reduce Opioid Deaths?Gerald Young46. How Lowell Is Fighting the Opioid CrisisAudrey Fraizer47. How One City Went “All In” to Fight the Opioid EpidemicInternational City/County Management Association48. The High Cost of Opioid Abuse in Your CommunityMarty Harding49. Boston’s Heroin Users Will Soon Get a Safer Place to Be HighMartha Bebinger50. In Boston’s “Safe Space,” Surprising Insights into Drug HighsMartha Bebinger51. What’s Next for “Safe Injection” Sites in Philadelphia?Elana Gordon52. “Crackhouse” or “Safehouse”?Nina Feldman• D. Nonprofits and Associations •53. Offering Syringes Along with Prayers, Churches Help IV Drug UsersTaylor Sisk54. San Francisco AIDS Foundation’s Syringe Access Services Evaluation ResultsElissa Velez and Mickey P. McGee55. Leading the Fight Against the Opioid CrisisGeoff Beckwith56. Statement of Policy: Opioid EpidemicNational Association of County and City Health Officials57. Statement of Policy: Syringe Services ProgramsNational Association of County and City Health OfficialsPart IV. The Future58. Some Good News on Opioid Epidemic: Treatment Options Are ExpandingWilliam Greene and Lisa J. Merlo59. Sterile Needles Can Stop the Spread of Disease in Prisons—Here’s HowJack Wallace60. Meth vs. Opioids: America Has Two Drug Epidemics, but Focuses on OneApril Dembosky61. Big Data for Big DiseaseH. Daniel Xu62. Chittenden County’s Hub and Spoke Model for Combatting Opioid DeathsPaul C. PreveyAppendicesAppendix A. Glossary of Syringe Exchange and Opioid Terms, Abbreviations and AcronymsJoaquin Jay Gonzalez IIIAppendix B: Syringe Exchange Programs (2019): North American Syringe Exchange NetworkCenters for Disease Control and PreventionAppendix C. Adopting a Harm Reduction Policy for Substance Abuse, STD and HIVSan Francisco Health Commission Resolution No. 10–​00Appendix D. Press Release: Mayor Mark Farrell Announces Innovative Program to Fight Opioid Crisis on San Francisco StreetsCity and County of San Francisco, Office of the MayorAppendix E. Executive Summary: Secure and Responsible Drug Disposal Act of 2010Federal RegisterAbout the ContributorsIndex

“[A] useful compilation of reprinted short essays and government documents published from 2012 to 2019.... The editors, both public administration professors, present strong evidence for needle exchange and safe injection services to save lives from overdoses, provide vaccinations for hepatitis A and B, ensure testing and treatment for hepatitis C and HIV, and reduce financial burdens for treatment of infectious diseases and substance abuse.”—Choice

Joaquin Jay Gonzalez III, Ph.D., is vice provost for global affairs as well as chair and Mayor George Christopher Professor of Public Administration at Golden Gate University. He founded GGU’s law enforcement and security program and is a San Francisco advocate for the safety and security of Filipino American kids and their families. Mickey P. McGee, DPA, is professor of public administration and director of the Doctor of Business Administration Program at Golden Gate University. He co-developed GGU’s Urban Innovations Program including the course, Inclusion, Diversion, Equity, and Accessibility. He has consulted for the U.S. Agency for International Development and the International City/County Management Association.

• Table of ContentsAcknowledgmentsPrefacePart I. The Opioid Epidemic1. Opioid Epidemic Causing Rise in Hepatitis C Infections and Other Serious IllnessesThomas J. Stopka2. Syringe Services Programs (SSPs) Fact SheetCenters for Disease Control and Prevention3. An Ethical Dilemma for Doctors: When Is It OK to Prescribe Opioids?Travis N. Rieder4. The Opioid Epidemic Is Finally a National Emergency—Eight Years Too LateErin Winstanley5. As the Opioid Epidemic Continues, the Holidays Bring Need to Support Those in GriefEmily B. Campbell6. Keeping Away from CriminalizationSarah Sweeney7. Stepping Up, Then Stepping BackBrenda Bond-Fortier8. Needle Exchanges Find New Champions Among RepublicansVictoria KnightPart II. Syringe Use and Infection Risks• A. HIV •­ 9. Syringe-Exchange Programs Are Part of Effective HIV PreventionNational Institute on Drug Abuse10. Needle Exchanges Can Now Get Federal FundingAnna Gorman11. Trump Pledges to End HIV Transmission by 2030. Doable, But DauntingCarmen Heredia Rodriguez12. The Unexpected Public Health EmergencyJenna Tyler13. An Addiction Researcher Shares 6 Strategies to Address the Opioid EpidemicNabila El-Bassel14. Why Are HIV Survival Rates Lower in the Deep South Than the Rest of the U.S.?Susan Reif and Carolyn McAllaster15. Should You Be Tested for HIV? Why June 27 Is a Good Day to DoJodi Sutherland16. Violence Against Women Is Overlooked in Its Role in Opioid EpidemicNabila El-Bassel17. Fighting HIV in Miami, One Dirty Needle at a TimeAmy Driscoll• B. Hepatitis C •18. Addressing Increases in Hepatitis C Infections Linked to the Opioid EpidemicDon C. Des Jarlais19. Hepatitis C and Injection Drug UseU.S. Department of Health and Human Services20. A “Safe” Space to Shoot Up: Worth a Try?Stephanie O’Neill21. Treating the New Hep C Generation on Their TurfPauline BartolonePart III. Practices, Programs, and Policies of Governments and Nonprofits• A. Federal •22. New Rules for Safe and Secure Prescription Drug Disposal OptionsU.S. Drug Enforcement Administration23. Safely Using Sharps (Needles and Syringes) at Home, at Work and on TravelU.S. Food and Drug Administration24. HRSA Implementation Guidance of Syringe Services ProgramsU.S. Department of Health and Human Services25. Implementation Guidance for Syringe Services ProgramsU.S. Department of Health and Human Services26. Injection Drug UseCenters for Disease Control and Prevention27. Syringe Services Programs (SSPs) FAQsCenters for Disease Control and Prevention28. The Safety and Effectiveness of Syringe Services ProgramsCenters for Disease Control and Prevention29. CDC’s Role in Safe Injection PracticesCenters for Disease Control and Prevention30. CDC Program Guidance for Syringe Services ProgramsCenters for Disease Control and Prevention31. Medical WasteU.S. Environmental Protection Agency32. Opioid Overdose Reversal with NaloxoneNational Institute on Drug Abuse• B. State •33. Syringe Exchange Programs in California: An OverviewCalifornia Department of Public Health34. California Legal Code Related to Access to Sterile Needles and SyringesCalifornia Department of Public Health35. Florida Is the Latest ­Republican-Led State to Adopt Clean Needle ExchangesSammy Mack36. Syringe Exchange in Southern Indiana to Respond to an Increase in HIV CasesJeannie D. DiClementi37. HIV, STDs, and HepatitisNew York State Department of Health38. Utah Syringe Exchange ProgramUtah Department of Health39. Arizona Declares Opioid Emergency, but Signals Are Mixed Over Best ResponseWill Stone40. Unable to Arrest Opioid Epidemic, Red States Warm to Needle ExchangesShefali Luthra• C. County and City •41. The Competing Views and a Way ForwardElissa Velez and Mickey P. McGee42. Harm Reduction Services in San Francisco: Executive SummarySan Francisco Department of Public Health43. Syringe Access and Disposal Programs in San FranciscoSan Francisco Department of Public Health44. Syringe Disposal Practices of Intravenous Drug Users in Monterey CountyJaime Teeter Householder and Mickey P. McGee45. How Did Ohio Local Government Leaders Dramatically Reduce Opioid Deaths?Gerald Young46. How Lowell Is Fighting the Opioid CrisisAudrey Fraizer47. How One City Went “All In” to Fight the Opioid EpidemicInternational City/County Management Association48. The High Cost of Opioid Abuse in Your CommunityMarty Harding49. Boston’s Heroin Users Will Soon Get a Safer Place to Be HighMartha Bebinger50. In Boston’s “Safe Space,” Surprising Insights into Drug HighsMartha Bebinger51. What’s Next for “Safe Injection” Sites in Philadelphia?Elana Gordon52. “Crackhouse” or “Safehouse”?Nina Feldman• D. Nonprofits and Associations •53. Offering Syringes Along with Prayers, Churches Help IV Drug UsersTaylor Sisk54. San Francisco AIDS Foundation’s Syringe Access Services Evaluation ResultsElissa Velez and Mickey P. McGee55. Leading the Fight Against the Opioid CrisisGeoff Beckwith56. Statement of Policy: Opioid EpidemicNational Association of County and City Health Officials57. Statement of Policy: Syringe Services ProgramsNational Association of County and City Health OfficialsPart IV. The Future58. Some Good News on Opioid Epidemic: Treatment Options Are ExpandingWilliam Greene and Lisa J. Merlo59. Sterile Needles Can Stop the Spread of Disease in Prisons—Here’s HowJack Wallace60. Meth vs. Opioids: America Has Two Drug Epidemics, but Focuses on OneApril Dembosky61. Big Data for Big DiseaseH. Daniel Xu62. Chittenden County’s Hub and Spoke Model for Combatting Opioid DeathsPaul C. PreveyAppendicesAppendix A. Glossary of Syringe Exchange and Opioid Terms, Abbreviations and AcronymsJoaquin Jay Gonzalez IIIAppendix B: Syringe Exchange Programs (2019): North American Syringe Exchange NetworkCenters for Disease Control and PreventionAppendix C. Adopting a Harm Reduction Policy for Substance Abuse, STD and HIVSan Francisco Health Commission Resolution No. 10–​00Appendix D. Press Release: Mayor Mark Farrell Announces Innovative Program to Fight Opioid Crisis on San Francisco StreetsCity and County of San Francisco, Office of the MayorAppendix E. Executive Summary: Secure and Responsible Drug Disposal Act of 2010Federal RegisterAbout the ContributorsIndex

“[A] useful compilation of reprinted short essays and government documents published from 2012 to 2019.... The editors, both public administration professors, present strong evidence for needle exchange and safe injection services to save lives from overdoses, provide vaccinations for hepatitis A and B, ensure testing and treatment for hepatitis C and HIV, and reduce financial burdens for treatment of infectious diseases and substance abuse.”—Choice