Access to Sterile Syringes and Needles (formerly "Needle Exchange")

Adoption Date:
October 1, 1994; rev. December 1, 2000

Public Policy Statement on Access to Sterile Syringes and Needles (formerly "Needle Exchange")


**Note: This historical policy statement is available as part of ASAM's Policy Archives, but it is no longer considered current ASAM policy. Please contact ASAM's advocacy staff at for questions related to ASAM's position on this topic.

Needle exchange programs have been shown to be a crucial component of a spectrum of HIV prevention services to injection drug users, resulting in an effective reduction in the transmission of the Human Immunodeficiency Virus as well as reductions in the incidence of new infections with Hepatitis B Virus. The preferred HIV prevention option is abstinence from the injection of drugs, and engagement of drug users with the addiction treatment system. Other options in the spectrum of HIV prevention services include teaching techniques for sterilization of injection equipment, teaching saver injecting practices, and the distribution of literature about HIV transmission.

International and U.S. evaluation studies of needle exchange programs, as an additional method of risk reduction, consistently show a decrease in equipment sharing and strongly suggest a decrease in incidence of new infections of blood borne pathogens such as HIV or Hepatitis B. There has not been an increase in drug use or an increase in injection as a route of drug administration as a result of implementation of needle exchange programs, nor has there been demonstration of an increase in contaminated injection equipment in the community. Instead, needle exchange programs serve as a point of contact between heretofore alienated drug dependent individuals and service providers who can help them to improve their health. In fact, the most requested service by needle exchange clients throughout the world is placement in drug treatment programs.

Distribution of sterile syringes and needles can be salutary: even more helpful can be programs that involve needle/syringe exchange, so as to minimize the inappropriate disposal of used needles and syringes and to remove used injection equipment from the environment.

For these reasons, ASAM recommends the following actions:

1. Modification or elimination of all federal and state laws and regulations which restrict the sale of sterile syringes and needles.

2. Removal of syringes and needles from drug paraphernalia laws.

3. Widespread establishment and promotion of sterile needle and syringe exchange programs for injection drug users in those jurisdictions in which deregulation of syringes and needles has not yet been established.

4. Renewed efforts to improve community strategies for the safe disposal of blood-contaminated syringes and needles from healthcare and other sources, in both healthcare and community settings.

5. Increased outreach to injection drug users who have not yet agreed to accept indicated addiction treatment services.

6. Increased access to treatment services for drug dependent individuals who agree to indicated addiction treatment, including injection drug users.