Individuals with a history of injecting drugs are at significant risk. Those who have completed addiction recovery programs are at risk of relapse, for example. According to the National Institute of Drug Abuse, up to 60% of individuals who receive treatment for substance use disorder relapse at some point. Many doctors and experts consider relapse as a normal part of the recovery process. However, the high rate of relapse means that clients need assistance to maintain sobriety.

What Is a Needle Exchange Program?

For injectable drug users, relapse poses a particular threat. Injectable drugs carry a significant risk of overdose, blood-borne infections, and severe, even life-threatening wounds. To reduce the potential harm of injectable drug use, many communities have implemented a syringe exchange program, also known as needle exchange. Clients who inject drugs have a higher risk of infection from viruses, bacteria, and through their open wounds. Rather than use the same contaminated needles, clients can go to a community center and safely dispose of their dirty needles, and receive sterile ones.

Exchange sites come in all sizes and formats. Some centers have storefront locations with separate offices, others have a mobile unit, and others consist of mobile distribution only. Mail order programs, developed during the COVID-19 pandemic, can also deliver syringes at private residences. Some sites open during select hours while others provide 24/7 service.

Regardless of the format, at a community syringe exchange center, clients can expect anonymity and respect. Center staff do not judge clients, nor do they track the syringes they hand out. The exchange program generally has no cost, as many centers receive funds from federal and state programs. However, additional services, such as drug screenings and vaccinations, may have an additional charge.

Do Needle Exchange Programs Work?

At first, the concept of needle exchange might seem counterproductive for clients experiencing addiction. Even if clients lower their chance of infection from dirty needles, it might seem like communities sanction the use of drugs.

However, syringe exchange programs often have more services than just swapping needles. These sites offer additional services to help protect other community members and the clients themselves.

The CDC has also reported that communities that offer syringe exchange programs have not seen a rise in crime rates due to the programs. In addition to the lack of increase in crime rates, communities have witnessed a decrease in opioid overdoses.

For clients, exchange sites provide additional services besides sterile syringes. Many centers also provide first aid wound care, harm reduction kits that include naloxone, personal and sex hygiene materials such as condoms, vaccinations, and drug testing to clients. Larger centers might also feature counseling programs. Clients can also receive assistance regarding their recovery, such as literature and pamphlets, contact information for rehab services, and referrals to social services.

Studies have shown that needle exchange programs have increased the chances of recovery. The National Institute on Drug Abuse reports that clients who participate in needle exchange programs are more likely to enter rehab and commit to their recovery in the long term. One study featured in the National Institutes of Health points out that clients generally appreciate the support they receive from center personnel, which has encouraged them to seek out treatment. The CDC notes that clients are up to 5 times as likely to enter a drug treatment program than those who do not swap needles.

Preventing Disease Transmission

Needle exchange programs help prevent the spread of infection. The CDC reports that swapping dirty needles between clients is a major cause of HIV, hepatitis C, tuberculosis, and other blood-borne viruses. Removing dirty needles from clients can prevent the spread of infectious diseases in the community and protect clients and their loved ones.

Syringe exchange programs also localize substance use. The National Institute on Drug Abuse notes that clients tend to use needles within the vicinity of an exchange center. That way, they can swap out used needles right away. This leads to fewer discarded syringes littering parks, sidewalks, and other public spaces, where children and other community members might accidentally injure themselves.

However, please note that not all states have allowed needle exchange programs. According to the CDC, 44 states have a Syringe Service Program in place, including Washington, D.C. and Puerto Rico. The exceptions are Arkansas, Kansas, Mississippi, Nebraska, South Dakota, and Texas. Clients in these states should keep in mind that their respective court systems may consider syringe exchange a violation of the law; in Kansas, for example, the law classifies syringes as drug paraphernalia, which can carry fines and jail time. Syringe exchange programs are also available in selected Native American reservations and tribal lands.

Clients in states that have not legalized syringe exchange programs can still consult local and national harm reduction groups for support. The Texas chapter of the Harm Reduction Alliance, for instance, provides naloxone, personal hygiene supplies (but not syringes), and advocacy for individuals recovering from substance use disorder. Clients who lack access to syringes may also receive referrals for medication assisted treatment to reinforce their sobriety.