“It always needs a higher level of care than what I can provide”: Practical, ethical, and administrative tensions arising from the integration of wound care services into syringe service programs in Maryland

Original research
by
Sisson, Laura N. et al

Release Date

2025

Geography

USA

Language of Resource

English

Full Text Available

No

Open Access / OK to Reproduce

No

Peer Reviewed

Yes

Objective

The emergence of xylazine into the U.S. drug supply has increased demand for wound care services among people who inject drugs (PWID). Syringe service programs (SSPs) have created wound care services to fill the gap. In doing so, many SSPs are extending the scope of their services beyond health promotion into a quasi-medical space that is largely unregulated.

Findings/Key points

There is a significant unmet need for increased resources, administrative support, and mentorship to guide the integration of medicalized wound care into SSP programs. Additionally, efforts to expand access to community-based wound care services for PWID should not replace efforts to promote timely access to services in more traditional healthcare settings.

Design/methods

We conducted 10 qualitative interviews with staff employed by eight SSP programs across six counties in the state of Maryland to explore how they have navigated shifting demand for more intensive wound care services.

Keywords

Barriers and enablers
Harm reduction
Illegal drugs
Injecting drugs
Policy/Regulatory
Wrap-around services