Needle Exchanges

Needle exchange programs (NEPs) are one of the principal harm reduction measures that aim to curb the spread of blood-borne viruses such as HIV and Hepatitis C among injecting drug users (IDUs). They provide access to sterile syringes to reduce the risk that IDUs come into contact with other users’ infected blood.

Increasing sterile syringe availability through needle exchange programs reduces needle sharing among injection drug users, which decreases transmission of HIV/AIDS and hepatitis. Needle exchange programs have also been shown to increase safe disposal of used syringes. In addition, these programs provide injection drug users with referrals to drug treatment, detoxification, social services, and primary health care.

Injection drug use is associated with a high risk of infection by blood-borne diseases such as HIV and hepatitis C. Since the AIDS epidemic began, 34% of all reported cases in the United States have been among injection drug users and their sexual partners. Up to 75% of new AIDS cases among women and children are directly or indirectly a consequence of injection drug use. Zero-tolerance drug policies, which in many states criminalize both the possession of syringes and the distribution of sterile syringes, exacerbate the problem. These policies result in the re-use and sharing of contaminated syringes, spreading blood-borne diseases and creating poor health conditions.

People of color are disproportionately impacted by the lack of access to sterile syringes. In 2004, African Americans accounted for 43% of all people in the United States living with AIDS, although they only comprised approximately 13% of the U.S. population. Injection drug use was the second leading cause of HIV infection for African American women and the third leading cause of HIV for African American men. Hispanics comprised over 20% of new AIDS cases in the United States. In 2002, 21% of the HIV/AIDS cases diagnosed among Hispanic males were attributed to injection drug use, and 17% of the HIV/AIDS cases among Hispanic women were due to injection drug use.

Numerous scientific studies as well as government-sponsored reports have shown that needle exchange programs reduce the spread of blood-borne diseases. Although many states and municipalities in the United States have taken steps to improve access to sterile syringes, the possession, distribution, and sale of syringes remain criminal offenses in much of the country, including Colorado. The federal government, though one of the largest funders of AIDS prevention in the world, refuses to fund needle exchange programs. This forces many programs offering these crucial services to operate largely underground. There are currently 185 needle exchange programs operating in 36 states as well as Washington D.C., Puerto Rico, and Native American lands. However, the legality of the programs often depends on a county-by-county certification of a State of Emergency that must be regularly renewed.