Syringe exchange programs are one of the most effective public health interventions for decreasing the transmission rates of HIV and other blood borne diseases such as hepatitis C, as well as connect users to treatment and other important needs such as housing or food assistance.

In states with legalized syringe exchange programs, people who use injection drugs turn in their used or “dirty” needles in exchange for unused, clean needles.

By expanding access to clean syringes and ensuring a safe way to dispose of bio-hazardous materials, syringe exchange programs create safer environments for the community at large. Additionally, syringe exchange programs are shown to lead to a 66% reduction in needle-stick injury to law enforcement. Click here to read more on why law enforcement in North Carolina support syringe exchange programs.

While it is a common myth that syringe exchange programs encourage, enable or increase drug use, as well as crime, decades of research from organizations including the World Health Organization and the American Medical Association, show that syringe exchange programs do none of those. In fact, many studies demonstrate that syringe exchange programs decrease drug use by connecting otherwise marginalized people to treatment. It is estimated that syringe exchange program participants are five times more likely to enter drug treatment than non-participants.

The Ohio Valley’s addiction crisis has brought another health problem, as rising numbers of needle drug users are contracting a serious form of heart infection called endocarditis. The rate of endocarditis doubled in the region over a decade, and many patients require repeated, expensive treatment and surgery as they return to drug use and once again become infected.

According to the Centers for Disease Control and Prevention, annual Medicaid spending on endocarditis is more than $700 million, a number likely to rise if treatment does not change to also address the growing health impact of substance abuse.


  • Sharing a needle or syringe to inject any type of substance (including steroids, hormones or silicone) puts you at risk of HIV and other infections found in the blood like hepatitis C. This applies whether injecting under the skin or directly into the blood stream.
  • Sharing needles and syringes is not the only risk. Sharing water to clean injecting equipment, reusing containers to dissolve drugs, and reusing filters can also transmit HIV.
  • To reduce transmission risk avoid shared needles and other injecting equipment, use a new or disinfected container and a new filter each time you prepare drugs, and use clean water when preparing drugs.

If I use drugs, how can I reduce my risk of HIV?

  • If you inject drugs, don't share needles, syringes or other injecting equipment like spoons or swabs, as this exposes you to HIV and other viruses found in the blood like hepatitis C. In many countries, used needles can be exchanged for clean ones at pharmacies and needle exchanges.
  • If you take heroin, consider joining a methadone or buprenorphine program. These substances are swallowed as a liquid, reducing your risk of HIV as well as helping you to manage your drug addiction. A doctor or healthcare worker can advise you about the availability of needle exchanges and methadone/buprenorphine programs.

There are other things you can do to reduce your risk of HIV from injecting drugs:

  • use sterile water to prepare drugs (e.g. boiled water)
  • use a new or disinfected container (“cooker”) and a new filter (“cotton”) each time you prepare drugs
  • before you inject, clean the area of your body with a new alcohol swab
  • safely dispose of needles and syringes after one use so you don’t use them again.

There’s clear evidence that, once a needle has penetrated the skin, that the tip is deformed and that tissue products adhere to the damaged metal: we photographed some used needles to demonstrate this. The mechanical force required for insertion of the needle and the resulting pain are directly correlated to the sharpness of the needle,  so these blunt, used needles will cause both unnecessary pain and tissue damage. In addition, reusing needles increases the chances of spreading infection between. 

What is Narcan™ (naloxone)?

Narcan™ (naloxone) is an opiate antidote. Opioids include heroin and prescription pain pills like morphine, codeine, oxycodone, methadone and Vicodin. When a person is overdosing on an opioid, breathing can slow down or stop and it can very hard to wake them from this state. Narcan™ (naloxone) is a prescription medicine that blocks the effects of opioids and reverses an overdose. It cannot be used to get a person high. If given to a person who has not taken opioids, it will not have any effect on him or her, since there is no opioid overdose to reverse. 

How does Narcan™ (naloxone) work?  

If a person has taken opioids and is then given Narcan™ (naloxone), the opioids will be knocked out of the opiate receptors in the brain. Narcan™ (naloxone) can help even if opioids are taken with alcohol or other drugs. After a dose of  Narcan™ (naloxone), the person should begin to breathe more normally and it will become easier to wake them. It is very important to give help to an overdosing person right away. Brain damage can occur within only a few minutes of an opioid overdose as the result of a lack of oxygen to the brain. Narcan™ (naloxone) gives concerned helpers a window of opportunity to save a life by providing extra time to call 911 and carry out rescue breathing and first aid until emergency medical help arrives.