Fargo Syringe Program Sees Decline After Pipe Distribution Ends

FCPH leader says participation has dropped since halting pipe handouts in late 2025.

Apr. 11, 2026 at 1:07am

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An extreme close-up X-ray photograph showing the intricate internal structure of a syringe, with the delicate components glowing against a dark background, conveying the fragility and complexity of public health harm reduction initiatives.A revealing X-ray view of the tools used in Fargo's syringe services program, which has seen declining participation since the end of pipe distribution.Fargo Today

Fargo Cass Public Health (FCPH) has seen a decline in participation in its syringe services program after the organization stopped distributing pipes in November 2025. FCPH Substance Abuse Prevention Coordinator Robyn Litke Sall says "people who weren't even coming to us for pipes are afraid to come back" due to the "negativity and controversy" surrounding the pipe distribution.

Why it matters

Syringe services programs are an important harm reduction strategy, providing clean needles, overdose reversal medication, and connections to social services. The decline in participation could lead to increased risk of disease transmission and overdoses in the Fargo community.

The details

FCPH ended pipe distribution over potential concerns about the interpretation of state law. The syringe services program requires participants to work with harm reduction staff to receive needles, and also connects them to social services, mental health providers, and medical care. Prior to ending pipe distribution, the program had seen a 47% increase in visits, 98% increase in enrollment, and 38% increase in opioid overdose reversals.

  • FCPH stopped distributing pipes in November 2025.
  • From 2019 to 2025, the syringe services program reversed 2,705 overdoses using Naloxone.
  • From 2021 to 2024, the area saw a 67% reduction in new hepatitis C cases.
  • In 2025, 69% of the needles given out were returned to the Harm Reduction Center.

The players

Robyn Litke Sall

FCPH Substance Abuse Prevention Coordinator.

Fargo Cass Public Health (FCPH)

The public health organization that operates the syringe services program in Fargo, North Dakota.

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What they’re saying

“People who weren't even coming to us for pipes are afraid to come back and see us because of all of the negativity and controversy that they have seen and heard and read.”

— Robyn Litke Sall, FCPH Substance Abuse Prevention Coordinator

What’s next

FCPH officials said they are working to address the decline in participation and reassure the community about the importance of the syringe services program.

The takeaway

The discontinuation of pipe distribution in Fargo's syringe services program has led to a concerning drop in overall participation, which could have serious public health consequences if not addressed. This highlights the delicate balance between harm reduction policies and community perceptions, and the need for clear communication and education around the benefits of these vital programs.