Statement of Purpose Syringe Services Programs (SSPs) provide sterile needles, health services, overdose prevention education, and naloxone to people who inject drugs, with the aim of preventing death and transmission of disease. As part of a larger needs assessment for SSPs in Colorado, we sent a survey to a sample of registered voters about perceptions of SSPs and overdose prevention.

Methods We randomly selected 250 registered voters from each of the eight counties in Colorado with SSPs. We mailed a machine-scannable paper survey with postage-paid return envelopes along with instructions to complete the survey online if preferred. We sent three reminders to complete the one-page survey that addressed topics such as familiarity with SSPs and naloxone, and perception of effectiveness of SSPs for overdose prevention. The project was IRB approved.

Results Of those eligible, 690 participants (52% female, mean age=53 years) completed the survey (response rate = 41%). Of respondents, 41.5% thought it was likely/very likely that a SSP would lead to fewer overdose deaths. When asked about supervised use sites (SUSs) where individuals can inject drugs under supervision, 62.0% thought it was likely/very likely a SUS would reduce overdose deaths. Of respondents, 74.6% had heard of naloxone. Knowledge of where one can get naloxone varied; 50% responded at the emergency department, 25.3% at the doctor’s, 18.3% at the county health department, 12.8% at a SSP, and 12.1% answered at the drugstore (not mutually exclusive). More registered Democrats (90.0%) than Republicans (61.1%) endorsed positive statements on consequences of a SSP program.

Conclusion Perceptions of effectiveness for overdose prevention were higher for SUSs than existing SSPs. Most respondents were aware of naloxone but respondents’ knowledge on where to obtain naloxone varied.

Significance Persuasive public messaging is needed about how harm reduction services such as SSPs can prevent or reduce overdose deaths.