Syringe exchange programs (SEPs) are harm reduction programs where intravenous drug users can exchange their old syringes for new sterile syringes. The first government approved SEP started in the Netherlands in the mid 1980’s but SEPs were soon adopted around the world following massive Hepatitis B outbreaks and the AIDs pandemic. These programs do not only supply clean needles but they also often times provide other services such as HIV counseling and testing, Hepatitis C counseling and testing, Hepatitis B counseling and testing, Hepatitis B vaccination, TB screening, STD screening and other medical services. Social services such as food, transportation, legal assistance, and housing services can also be found at some SEPs. Although many SEPs operate legally with state, city, or county funding, a number of SEPs still operate illegally without support from their local governments. Some believe that SEPs encourage illegal drug use and other nefarious activity, while others argue that this is a necessary service allowing intravenous drug users to more easily avoid diseases such as hepatitis or HIV.
The problem lies in that when there is a scarcity of clean needles and syringes, intravenous drug users will share needles- causing the spread of blood-borne diseases. In a study reported in March of 1997, the National Institute of Health reported that SEPs “show a reduction in risk behaviors as high as 80% in injecting drug users, with estimates of a 30% or greater reduction of HIV”. Studies described in the National Research Council’s review of SEPs credited New Haven’s SEP with a 35% reduction in HIV incidence. In Baltimore after eight years of follow-up, HIV incidence decreased 35%. In Pierce County, Washington research shoed that Hepatitis B and C cases due to intravenous drug use decreased by more than 75% within two years after a SEP was established.
Clearly the success of these programs is backed by evidence, but that still leaves those heavily opposed to drug use upset with their existence. Some belief that the existence of SEP will only make using drugs easier, therefore increasing the rate of drug injection. A clinical trial published in 2003, though, showed that the existence of SEPs did not increase drug injection at all among the 653 intravenous drug users who participated in the study.
If you are interested in participating in a SEP but you don’t have one near you, our friends at NEXT Distro can help you get access to clean needles through their mail-based organization.