How to Find Needle Exchange Programs

Needle exchange programs (NEPs) provide people who inject drugs with free sterile needles to reduce the risk of acquiring infectious diseases.¹ These programs are available in many states throughout the country, but there are several states that do not currently have them.

NEPs—also called syringe services programs, syringe exchange programs, or needle-syringe programs—have been shown to reduce HIV rates. Despite concerns, they do not lead to increased drug use, and people who visit them are more likely to seek drug treatment.²

What Is a Needle Exchange Program?

NEPs hand out free, sterile needles and syringes to drug users and dispose of used needles and syringes.¹

These programs also provide injection drug users with other services, such as:¹

• Sterile water and alcohol swabs for injection.
• Education on overdose prevention.
• Referrals to substance abuse treatment, including medication-assisted treatment, to help injection drug users quit heroin.
• Interventions such as testing, treatment referrals, counseling, and condoms to prevent the spread of HIV, hepatitis, and other sexually transmitted diseases.
• Pre- and post-exposure medication, known as prophylaxis, to help minimize the risk of HIV infection.

At least half of all people who inject drugs received services through an NEP in 2015, and 1 in 4 received all of their syringes and needles from an exchange program that year.³

NEPs are not without controversy. Some people think that they encourage drug use, and federal funding has been taken away and given back over the past decade depending on the political climate.⁴

How Do They Work?

Programs often work on an exchange basis. They give sterile needles and syringes to users in exchange for used ones.⁵

Several types of programs are available to reach as many people as possible, and include:⁶

• Fixed programs, which are housed in permanent locations where drugs are typically bought and used openly. They may be in a converted shop or office. Fixed programs often have other services in the same locations, such as healthcare and counseling for HIV and other infectious diseases.
• Mobile programs, in which staff travel by van or bus and meet people who are in harder-to-reach areas. Fixed programs often have a mobile outreach component. Some more advanced mobile programs may offer many of the same services as a fixed program.
• Outreach programs, in which staff provide services through a mobile unit, a backpack, or home deliveries. They are normally active in areas with little funding for NEPs or where NEPs exist but are underused. In the latter case, outreach workers encourage users to access the existing NEP sites.

Where Are They Located?

Needle exchange programs are available in many states, but not all.   

A few online directories exist, including the North American Syringe Exchange Network, which has a directory of approximately 255 searchable programs by state.

State and county public health or health departments often provide information on local programs on their websites.

Are They Legal?

NEPs are legal, but their funding is heavily debated in the United States.

A ban on federal funding for NEPs was lifted in 2009, but the funding was banned again in 2010. However, in 2016, federal funding was reinstituted for NEPs for costs, such as staff salary, vans, and gas if the funds were not spent directly on needles and syringes.⁴  

Programs must meet various criteria to qualify for federal funding, and communities must demonstrate that they are at risk for, or experiencing, significant increases in HIV or hepatitis due to injectable drug use.¹

Programs also receive funding from state and local government, and foundations.⁷

Are They Effective?

Evidence suggests that NEPs are effective in a number of different areas and do not lead to the problems opponents believe they will cause.

NEPs face public opposition in some communities due to the belief that such programs increase crime. But studies, including one conducted in Baltimore, Maryland, found that NEPs were not associated with more crime.⁸  

Another concern is that giving needles to people who inject drugs will lead to them discarding the needles on the street. However, studies have not shown this to be the case. Many programs track the number of needles returned and have found that in many cases they come close to the number of needles handed out. Further, one study showed that needles on the street were less likely in cities with NEPs than in cities without them.⁵

 

NEPs have also been found to reduce HIV rates. CNN reported that significant reductions in HIV rates among African American and Latino drug users were due to needle exchanges.⁹ One study estimated that $10 million spent on NEPs could save more than $70 million in HIV treatment costs.¹⁰

In addition, research demonstrates that people who inject drugs are 5 times more likely to enter drug treatment and stop injecting drugs when they use an NEP.¹¹

The American Academy of Family Physicians endorsed NEPs, noting that they decrease rates of HIV, hepatitis, and other diseases; encourage people to enter addiction treatment; and do not increase drug use.²

If you or someone you love is struggling with heroin or other injectable drugs, a needle exchange program can help you practice safer drug use. You may also want to consider a heroin rehab program, which can help you stop using drugs and break the cycle of addiction.

Sources

[1]. Centers for Disease Control and Prevention. (2018). Syringe services programs.

[2]. American Academy of Family Physicians. (2016). Needle exchange programs.

[3]. Centers for Disease Control and Prevention. (2016). Vital signs: HIV and injection drug use: Syringe services programs for HIV prevention.

[4]. Avert. (2016). US partially lifts ban on government funded needle exchange programmes.

[5]. Harm Reduction Coalition. (2018). Rural syringe services program. FAQs.

[6]. Avert. (2017). Needle and exchange programmes (NSPS) for HIV prevention.

[7]. Harm Reduction Coalition. (2018). Rural syringe services program. Funding.

[8]. Marx, M.A., Crape, B., Brookmeyer, R.S., Junge, B., Latkin, C., Vlahov, D., and Strathdee, S.A. (2000). Trends in crime and the introduction of a needle exchange program. American Journal of Public Health, 90(12), 1933.

[9]. CNN. (2016). Syringe exchanges help reduce rates of HIV, CDC says.

[10]. Katz, J. (2018). Why a city at the center of the opioid crisis gave up a tool to fight it. The New York Times.

[11]. Center for Disease Control and Prevention. (2017). Reducing harms for injection drug use and opioid use disorder with syringe services programs.