IDEA Exchange

The first syringe service program in Florida, which is staffed predominantly by medical students from the University of Miami

The Infectious Disease Elimination Act (IDEA) Exchange began as a pilot in 2016, operating within the University of Miami Miller School of Medicine. In 2017, the pilot program began mobile outreach. In 2014, Florida had one of the highest rates of HIV in the United States largely driven by injection drug use. In response, a group of healthcare professionals advocated for legislation that would create the IDEA Exchange. In part to the success and policy advocacy of the IDEA Exchange, Florida now has legalized syringe service programs statewide. 

Services provided by the IDEA Exchange include: 

  • One-to-one needle exchange
  • Naloxone distribution
  • Harm reduction and safe injection kits
  • HIV and Hepatitis C screening and linkage to treatment
  • Wound care
  • Referrals to addiction treatment (including medications for opioid use disorder), healthcare, and housing

An important and innovative attribute of the IDEA exchange is a free clinic predominantly run by medical students. In addition to providing low threshold services for people who inject drugs (PWID), the clinic addresses the need to produce a new generation of healthcare professionals who can treat PWID with compassion and without judgment. Operating within an academic healthcare system has also given ample opportunity to engage in research (see peer-reviewed papers below). 

More information on the program can be found in the presentation here

The syringe service program was forced to temporarily halt services during the coronavirus pandemic. However, the medical students that run the program created a telehealth program to deliver medications for opioid use disorder during COVID-19 as a way to serve their clients. This low-threshold tele-harm reduction program has been shown to be promising for initiating and retaining PWID with opioid use disorder on buprenorphine within a syringe services program setting. 

A significant decrease in the number of improperly discarded syringes in public in Miami after the implementation...serves a large group of minorities with challenges related to social determinants of health. 

Continuum of Care
Harm Reduction
Type of Evidence
Response Approach
Comprehensive services
COVID / Coronavirus related
Overdose prevention
Syringe service program / Needle exchange
Peer-reviewed Article

Evidence of Program Effectiveness

"The earliest success of the IDEA syringe service program (SSP) was the distribution of over 2,000 boxes of nasal naloxone, which the authors believe positively contributed to a decrease in the number of opioid-related deaths in Miami-Dade County for the first time since 2012. The second was the early identification of a cluster of acute HIV infections among program participants." (Hansel et al., 2020)

"There was a significant decrease in the number of improperly discarded syringes in public in Miami after the implementation of an SSP...A total of 191 syringes/1000 blocks were found post-implementation versus 371/1000 blocks pre-implementation, representing a 49% decrease after SSP implementation." (Levine et al., 2019)

The SSP serves a large group of minorities (primarily Hispanic) and a vulnerable population in terms of social determinants of health: "Among 718 first-time enrollees, 74.8% were male, 52.1% were non-Hispanic White, 85.9% completed high school, 59.8% were unemployed, 42.1% were homeless, 54.2% reported an annual income of less than $15,000, and the mean age was 38 years." (Iyengar et al., 2019)

"Through December 20, 2018, the IDEA SSP has served 982 individuals, exchanged 253,096 syringes, distributed 1859 boxes of nasal naloxone, and administered 1576 screening tests for HIV and HCV." (Tookes et al., 2020)