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Needle Exchange – Find a Program

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Nicole Arzt, M.S., L.M.F.T.
Nicole Arzt, M.S., L.M.F.T.
Nicole Arzt, M.S., L.M.F.T., is a licensed marriage and family therapist specializing in providing psychotherapy to individuals, families, and groups struggling with substance use disorders and psychiatric illnesses.
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Content Overview

Many intravenous drug users are at high risk of contracting numerous bloodborne infections, including HIV and hepatitis viruses.1 Needle exchange programs can help prevent the spread of these diseases by providing clean needles and disposing of used ones. Users can also get other services at these programs, such as medical care and screenings.

Evidence suggests that these programs do not encourage drug use or lead to more crime or used needles on the street.

Sites such as the North American Syringe Exchange Network feature directories where users can search for programs in their area.

Heroin. Meth. Cocaine. Injecting these into your system comes with any number of immediate health risks. But the added danger in contracting a viral or bacterial infection makes the use of consuming drugs this way even more perilous. At American Addiction Centers, we offer 24-hour medical detox, treatment, and ongoing care. If you’re battling a substance use disorder (SUD), please reach out to one of our admissions navigators at to get the help you need right now!

What Is a Needle Exchange Program?

heroin needle
Needle exchange programs—which are also known as syringe services programs or needle-syringe programs—provide new and sterile syringes to drug users.

Some programs also offer medical treatment for infectious diseases, substance use disorder treatment referrals, naloxone treatment, and enrollment in health care plans.2

Needle exchange programs can help decrease certain risks for drug users and their partners.

People who inject drugs face a greater risk for contracting HIV and hepatitis C. In fact, research shows that 1 in 23 women and 1 in 36 men who use drugs intravenously will contract HIV at some point during their lifetimes.2

Needle exchange programs can also help get users into treatment and help prevent overdoses through education and teaching users how to respond to an overdose.

This short video from The Wall Street Journal gives an inside look at a needle exchange program in San Francisco:

Needle Exchange Services

Needle exchange programs can offer comprehensive care and facilitate safer methods of drug use. Their services include:4

  • Providing sterile needles and other injection equipment
  • Safe and secure disposal containers for needles
  • Disease testing and referrals for medical treatment
  • Education about overdose awareness and prevention and safer injection practices
  • Referrals for substance use disorder treatment and medication-assisted treatment
  • Counseling services
  • Basic health services (providing vaccinations, giving out condoms)

Regardless of the services offered, all needle exchange programs are free.1 Some programs operate out of mobile units, while others are fixed sites located in community clinics. Some combine both a fixed site with a mobile outreach unit.5

In general, the programs vary in the number of needles provided and the types of services. For example, some programs use the “one-for-one” approach. This refers to trading in one used needle in exchange for a new one.5 This is a simple approach that enforces a sense of accountability, as the drug user must collect and bring back used needles.

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Other programs simply provide as many needles as the user needs between visits to the program. This specific number can vary depending on the person. But the Joint United Nations Programme on HIV/Acquired Immunodeficiency Syndrome (UNAIDS) recommends providing 200 sterile needs per person each year.5

Research shows that providing needles on an as-needed basis (as opposed to the one-to-one strategy) has higher efficacy rates. Limiting one’s needle availability creates the risk of sharing needles. 5

Do Needle Exchange Programs Work?

Yes, needle exchange programs do work—both in terms of harm reduction and promoting abstinence.

 needle exchange hands
In fact, research shows that people who inject drugs are 5 times more likely to enter a treatment program after visiting a needle exchange. Further, they are more likely to reduce or abstain from injecting when using a program.4

Additionally, these programs can prevent new HIV and viral hepatitis infections. With 1 in 3 young adult (aged 18-30) intravenous drug users having hepatitis C, stopping this epidemic is incredibly important.4 A study found that once Washington, D.C. lifted a ban on needle exchange programs, 120 HIV cases related to IV drug use were prevented, saving $45.6 million in treatment costs.2

Funding for Exchange Programs

Current provisions prohibit the use of federal funds for directly purchasing sterile needles solely for illicit drug use. However, the Consolidated Appropriations Act of 2016 permits local communities to use federal funding for other aspects of needle exchange programs.3 They must request permission for such funding, and the Centers for Disease Control and Prevention (CDC) will review each state or local community’s level of need.1

Overdose also remains an inherent risk for intravenous drug users. In recent years, there have been drastic and devastating spikes in death rates associated with drug use. Needle exchange programs reduce overdose death rates by teaching drug users how to prevent and respond appropriately to drug overdose via naloxone treatment.4

The Food and Drug Administration (FDA) has approved naloxone administration for opioid overdoses. In its various forms, this medication can be injected or administered nasally and works by blocking opioid receptor sites and reversing the lethal effects associated with overdose.6 Because time is of the essence when a drug user is overdosing, it is vital that both professionals and loved ones understand how to use this medication to save someone’s life.

Finally, it should be noted that despite the social stigmas and criticisms of harm reduction services, evidence shows that needle exchange programs do not actually increase drug use, crime, or the presence of discarded syringes.2

Though some may believe that needle exchange programs essentially enable and promote more needles on the street, the opposite effect has been shown to happen. If people must turn in needles for new ones, there is a greater incentive to find discarded or used ones. Many programs track the number of needles returned. In many cases, they come close to or even exceed the number of needles distributed.2

How Can I Safely Dispose of Drug Needles?

dispose of needles
According to the Henry J. Kaiser Family Foundation, there are about 300 needle exchange programs throughout the United States. However, these programs do not exist in every state. Some states have many programs (Kentucky has 23), while some have very few (Hawaii has 1).7

The North American Syringe Exchange Network (NASEN) provides a directory of needle exchange programs where users can enter a zip code, city, or state to find their nearest site.8

You can also visit your state’s or county’s public health or health department website for further information.


  1. Centers for Disease Control and Prevention. (2018). Syringe Services Programs.
  2. Harm Reduction Coalition. (2018). Rural Syringe Services Program: FAQs.
  3. Centers for Disease Control and Prevention. (2016). Program Guidance for Implementing Certain Components of Syringe Services Programs.
  4. Center for Disease and Control Prevention. (2017). Reducing Harms from Injection Drug Use & Opioid Use Disorder with Syringe Services Programs.
  5. Harm Reduction Coalition. (2018). About Syringe Services Programs.
  6. Substance Abuse and Mental Health Services Administration. (2016)
  7. Henry J Kaiser Family Foundation. (2017). Sterile Syringe Exchange Program.
  8. North American Syringe Exchange Network. Directory of Syringe Exchange Programs.

Last Updated on July 20, 2021
Nicole Arzt, M.S., L.M.F.T.
Nicole Arzt, M.S., L.M.F.T.
Nicole Arzt, M.S., L.M.F.T., is a licensed marriage and family therapist specializing in providing psychotherapy to individuals, families, and groups struggling with substance use disorders and psychiatric illnesses.
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