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Challenges, Inc.

A syringe service program operating in South Carolina, a state with ambiguous laws toward this harm reduction service

Recognizing the increasing rates of HIV and Hepatitis C in the state, Challenges, Inc. was started in Greenville, South Carolina by a peer in recovery, even though the state's laws toward syringe service programs (SSP) are somewhat ambiguous (syringe distribution is allowed for “legitimate medical purposes,” but there is no specific reference to exchange programs). Nationally, some states have laws that authorize SSP, other states have laws that explicitly prohibit SSP, and others have no laws toward SSP or they are locally permitted. More information on the legality and evidence for SSPs can be found here. 

Some of the services provided by Challenges, Inc. include: 

  • Syringe exchange
  • Overdose education and naloxone distribution
  • Fentanyl test strips
  • Community syringe pick-up
  • Scholarships to bridge people from addiction to recovery

Challenges, Inc. operates as a 501(c)3 through private donations and collaboration with other community-based organizations.This is an example of a program model where the state has a need for an SSP but the legality for this harm reduction service is not clear. More information on the program can be found in the news article here and the collection of news articles and blogs here. 

"Over 15,000 doses of naloxone distributed with over 500 deaths prevented and distribution of more than 100,000 sterile syringes, needles and other safe using supplies each year."

Continuum of Care
Harm Reduction
Type of Evidence
Implemented
Response Approach
Overdose prevention
Syringe service program / Needle exchange
Peer-reviewed Article
Urgent need to expand syringe services programs in South Carolina and beyond
Related Resources
Syringe Decriminalization Advocacy in Red States: Lessons from the North Carolina Harm Reduction Coalition
Peer-Delivered Syringe Exchange Toolkit: Models, Considerations, and Best Practices
Syringe Access & Law Enforcement: Building Alliances
A Guide to Establishing Syringe Services Programs in Rural, At-Risk Areas
Rural Syringe Service Program Website
Fentanyl Test Strips as an Opioid Overdose Prevention Strategy: Findings from a Syringe Services Program in the Southeastern United States
The Impact of COVID‑19 on Syringe Services Programs in the United States
Harm Reduction Coalition COVID-19 Page
Two Steps Forward, One Step Back: Current Harm Reduction Policy and Politics in the United States
Changing Course in the Overdose Crisis: Moving from Punishment to Harm Reduction and Health
A Systematic Review of Harm Reduction Strategies

Evidence of Program Effectiveness

This program has not been formally evaluated, although the program self-reports: 

  • Over 5,500 doses of naloxone distributed
  • 163 deaths prevented
  • 19,500 used syringes taken off the street
  • $5,250 in treatment scholarships distribute

"Through support and partnerships with the local community and state agencies, Challenges Inc. has reduced the spread of HIV and HCV through providing over 100,000 sterile syringes, needles and other safe using supplies each year, curbed overdoses by distributing over 15,000 doses of naloxone and fentanyl test strips, with a reported 500+ overdose reversals, connected participants to HIV and HCV treatment, and provided treatment for substance use disorders." (Pham et al., 2022)