| Summary: | People who inject drugs (PWIDs) are the most stigmatized and marginalized people in the general population (Ahern, Stuber, & Galea, 2007; Birtel, Wood, & Kempa, 2017). This group is not easily accessed by typical means of patient outreach and is one of the most underserved populations for primary care, mental health services, and care for chronic infectious diseases associated with injection drug use including HIV and HCV (Ahern et al., 2007; Dean et al., 2000; Livingston, Milne, Fang, & Amari, 2012; Zeremski et al., 2013). Syringe Service Programs (SSPs) can give public health and social support organizations and agencies access to an otherwise underserved population and give PWID potential access to a constellation of care to address multiple comorbidities associated with injection drug use (Barocas et al., 2014; Pollack, Khoshnood, Blankenship, & Altice, 2002; Zeremski et al., 2013). Additionally, the potential access to primary and secondary care that SSPs may connect PWID to, perceived social support is one of the strongest predictors of well-being and mental health among people with stigmatized conditions including HIV/AIDS, HCV, and PWID (Birtel et al., 2017). Wider adoption of SSPs and bridging of SSP clients to Medication Assisted Treatment providers is a potential tool in combating the current opioid epidemic in Tennessee. The Tennessee Poll by ETSU was conducted between March and April of 2017. The Tennessee Poll is an annual statewide public opinion poll conducted by the Applied Social Research Lab (ASRL). In the Tennessee Poll, questions were asked about attitudes and beliefs associated with SSPs and PWID in Tennessee. In a previous project, the research team, using generational demographic categories used in Pew surveys, looked at attitudes about both illicit and medical use of marijuana. In comparison of generations, Millennials were 15.62 times (95% CI 5.6, 43.56, p < .001) more likely to support recreational marijuana legalization versus the reference category (The Silent Generation or the generation before Baby boomers and sometimes called “The Greatest Generation”) and 3.7 times (95% CI 1.47, 9.3, p
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