What is a Needle Exchange?

Mary McMahon

A needle exchange is a program which allows people to trade used needles for new, sterile needles. Needle exchanges are sometimes referred to as sterile needle access programs. A variety of cities around the world have needle exchange programs, often bundled in with service programs which more generally serve the drug using community, and such programs are not without controversy. Many critics of needle exchange programs argue that they should be banned because they encourage illegal drug use.

Woman with hand on her hip
Woman with hand on her hip

The idea of needle exchange programs is part of a larger philosophy in the public health community known as harm reduction. Advocates of harm reduction accept that people are always going to engage in certain behaviors which could be dangerous, whether or not such behaviors are legal, and that as public health advocates, they should focus on making such practices as safe as possible. The argument, essentially, is that people are going to be injecting drugs anyway, so one may as well reduce the risks involved.

Injection drug use has a number of potentially harmful effects which can be mitigated by needle exchange programs. Using fresh, sterile needles eliminates the risk of transmitting blood-borne diseases, and it also greatly reduces the risk of infection and abscess at the injection site. By providing a site to discard of used needles, needle exchange programs also reduce the risk of abandoned biohazardous materials, making life safer for garbage collectors and others who might come into contact with abandoned used needles.

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In addition to offering new needles in exchange for used ones, most needle exchange programs also offer other services, such as clinical treatment for infections, screening for blood-borne diseases, bandages, and other supplies. Many also offer support to drug users who would like to kick their habits, although patrons of a needle exchange program are not forced to participate in treatment programs.

The concept of needle exchange programs arose in the 1970s, and such programs are often greeted with opposition when they start in new locations. The provision of needles without a prescription may be illegal by law in some regions, making it easy for needle exchange programs to be prosecuted, and opponents fear that such programs will encourage drug use, result in an increased amount of litter around the exchange program's site, or add to drug-related crime. Proponents of such programs, however, argue that needle exchanges are often very successful, especially in low-income areas with high minority populations.

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