Year of Publication



Public Health

Degree Name

Dr. of Public Health (Dr.P.H.)

Committee Chair

Dr. Tyrone Borders

Committee Member

Dr. Joseph Benitez

Committee Member

Dr. Richard Ingram


In 2015, syringe exchange programs (SEPs) were legalized in Kentucky as part of a response to the high and rising morbidity and mortality associated with injection drug use, particularly opioids. In addition to their primary function of preventing the spread of some infectious diseases by providing injection drug users (IDUs) with easy access to sterile injection equipment, SEPs may also offer ancillary services such as referrals to primary care providers and substance abuse and mental health treatment, as well as safe injection education and naloxone training. These ancillary services are intended to improve the overall health of IDUs and the community, and they may specifically help to reduce fatal and non-fatal overdoses (ODs). This capstone project had two specific aims. The first is to describe the location of SEPs in Kentucky in relation to areas of the state with the most need and to assess the supply of treatment providers in counties with and without SEPs. The second is to explore the association between the opening of SEPs and county-level hospital emergency department utilization for drug ODs. Moreover, extensive background on SEPs is provided, including a discussion about their history and a review of the literature regarding the effectiveness of the programs. This capstone is one of if not the first to evaluate SEP effectiveness across Kentucky and has generated valuable evidence for policymakers across the country as they search for ways to address the damages caused by injection drug use.

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