What Is a Needle Exchange?

A row of hyperdermic needles distributed in a needle exchange
Needle exchange programs exist to distribute clean needles to drug users. Jean Scheijen / Freeimages

Question: What Is a Needle Exchange?

Needle exchange services provide injection drug users with clean needles, safe disposal of used needles, and sometimes other resources such as condoms, health advice, and access to treatment services.


A needle exchange is a community-based clinic or office where people can bring their used needles for safe disposal and are provided with clean needles for their own use.

Needle exchanges are part of the controversial harm reduction movement, which focuses on reducing harm resulting from alcohol, substance and other addictions, rather than enforcing abstinence.

Although drug possession is illegal, and needle exchanges clearly enable injection drug use and thus illegal behavior, they are based on the principle that the harm to the drug user and society by not supporting injection drug users in access to safe equipment is greater than the enabling that occurs as a result of providing this service.

The rise of HIV infection in the 1980s was a catalyst for needle exchanges, as provision of clean injection equipment reduces the spread of HIV and hepatitis C, and helps to prevent other health complications. Needle exchange services also reduce the number of discarded needles in the community and the incidence of needle-stick injuries.

Some needle exchanges encourage safer injecting practices by providing sterile water, alcohol wipes, condoms and related health information.

Needle exchange services are provided in a safe and anonymous manner. A central principle of this approach is that drug users are not judged and are treated with courtesy and respect. As drug users are a highly stigmatized group, it is important that they feel welcome at their needle exchange program and that they are respected for voluntarily participating in safer practices for themselves and the community.

Although most needle exchanges are office-based, some outreach workers provide needle exchange services to people in their own environments, for example, by approaching homeless people living on the streets.

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