Syringe Exchange Programs & Harm Reduction

Syringe exchange programs (also known as syringe access programs and needle exchanges) provide preventative healthcare for people who use drugs. They offer sterile syringes and disposal services to prevent sharing and reuse of syringes and other supplies among people injecting drugs and medications. These programs also typically provide wound care supplies, safer sex supplies, and hygiene supplies.

Syringe exchange programs are effective at preventing the spread of HIV and hepatitis C infections, and at connecting people with these conditions to treatment and care through testing and referral or case management services. They are evidence-based programs purposefully structured to welcome and serve people who use drugs and to reduce barriers to services, care, and support.

All SEPs in North Carolina are required to provide:

• Syringes and supplies at no cost and on an as-needed basis
• Secure disposal services for syringes, injection supplies, and other “sharps”
• Education on the prevention and treatment of drug overdose, HIV, hepatitis C, other infections, and substance use disorder
• Naloxone access (at the syringe exchange program or at identified local pharmacies and/or health departments) and training on identifying and responding to opioid overdose with naloxone medication
• Referrals for mental health and substance use disorder treatment and care

A provision in the North Carolina syringe exchange program law protects staff, volunteers, and participants from being charged or prosecuted for possession of syringes or other injection supplies, including syringes and supplies with residual amounts of drugs present if obtained from or returned a syringe exchange program. Staff, volunteers, and participants must provide written verification (usually in the form of a participant card) to receive the limited immunity protection.

Syringe exchange programs follow a “harm reduction” approach. Harm reduction-based services involve practical strategies to reduce or mitigate the negative consequences associated with drug use and other criminalized and stigmatized behaviors, which can affect access to healthcare and the quality of care received.

Harm reduction programs engage people at different stages of drug use—people who use drugs; people with substance use disorders; people seeking treatment, including medication-assisted treatment like methadone and buprenorphine; and people in recovery, including abstinence-based recovery. Programs to help people care for themselves and their communities through safer behaviors, relationship-building, and connections to care. Harm reduction-based health services include syringe exchange, community naloxone distribution, overdose prevention, and safer use education, drug-checking services, and low-barrier access to treatment.

Harm reduction is also a philosophy built on a belief in, and respect for, the humanity of people who use drugs. When compassionate and supportive services seek to foster participants’ sense of dignity and self-determination, the effects can be transformative.

You can find a list of all actively operating syringe exchange programs in North Carolina at the Department of Health and Human Services website.

For more information, visit the North Carolina Safer Syringe Initiative or contact SyringeExchangeNC@dhhs.nc.gov.