Needle and syringe programmes NSPs for HIV prevention KEY POINTS Needle and syringe programmes provide access to sterile needles and syringes to reduce transmission of HIV and other blood borne viruses from sharing injecting equipment Needle and syringe programmes can be provided through fixed sites, mobile sites, outreach services, vending machines and pharmacies Global coverage remains inadequate. Only 12 countries are providing the WHO-recommended clean needles per person who injects per year Criminalisation, legal restrictions on those under 18, and stigma and discrimination are key barriers to effective needle and syringe programmes Funding for needle and syringe programmes is inadequate, largely due to lack of political support Explore this page to find out more about how needle and syringe programmes are deliveredcoverage of programmes across geographical regionsand barriers to accessing these programmes. Needle and syringe programmes NSPs are a type of harm reduction initiative that provide clean needles and syringes to people who inject drugs sometimes referred to as PWID to reduce transmission of HIV and other blood borne viruses such as hepatitis B and C.
Ad hoc or informal distribution International experience Countries where these programmes exist include: In the United States such programmes may not receive federal funding, but this ban was briefly lifted in before being re-instated in The Burnet Institute research organisation completed the 'North Richmond Public Injecting Impact Study' in collaboration with the Yarra Drug and Health Forum and North Richmond Community Health Centre and recommended hour access to sterile injecting equipment due to the ongoing "widespread, frequent and highly visible" nature of illicit drug use in the areas.
Between and a four-fold increase in the levels of inappropriately discarded injecting equipment was documented for the two suburbs. In the surrounding City of Yarra, an average of 1, syringes per month were collected from public syringe disposal bins in Paul Dietze stated, "We have tried different measures and the problem persists, so it's time to change our approach".
The Institute's research concluded that public injecting behaviour is frequent in the area and injecting paraphernalia has been found in carparks, parks, footpaths and drives. Furthermore, people who inject drugs have broken into syringe disposal bins to reuse discarded equipment.
NICE previously published needle exchange guidelines inin which needle and syringe services were not advised for people under 18, but the organisation's director Professor Mike Kelly explained that a "completely different group" of people were presenting at programs.
Current Colorado laws leave room for interpretation over the requirement of a prescription to purchase syringes.
Based on such laws, the majority of pharmacies do not sell syringes without a prescription and police arrest people who possess syringes without a prescription.
Due to the illegal nature of the organization, the USED website specifies that new clients must be referred in order to exchange syringes. According to The Works website, between January and Marchthe group received over 45, dirty needles and distributed around 45, sterile syringes. Changes in syringe and drug control policy can be ineffective in reducing such barriers if police continue to treat syringe possession as a crime or participation in NEP as evidence of criminal activity.
This raises concerns about extrajudicial confiscation of personal property. In this region as well as elsewhere, reports of syringe confiscation are correlated with increases in risky behaviors, such as groin injecting, public injection and utilization of pharmacies.
These findings suggest that systematic surveillance and interventions are needed to address police interference. A study of police officers in an urban police department four years after the decriminalization of syringe purchase and possession in the US state of Rhode Island suggested that up to a third of police officers were not aware that the law had changed.
Training and interventions to address law enforcement barriers US NEPs have successfully trained police, especially when framed as addressing police occupational safety and human resources concerns.
On average, training was seen as moderately effective, but only four programs reported conducting any formal evaluation. Needle exchange programs have faced opposition on both political and moral grounds.
Advocacy groups including the National District Attorneys Association NDAA Drug Watch International,  The Heritage Foundation Drug Free Australia,  and so forth, religious organizations such as the Catholic Church and many individuals in important policy-making positions have united to oppose these programs.
Internationally, needle exchange is widely accepted. The weak evidence on the programs' disease prevention effectiveness is due to inherent design limitations of the reviewed primary studies and should not be interpreted as the programs lacking preventive effects.
Sebelius, Kathleen, Secretary of Health and Human Services, "Determination That a Demonstration Needle Exchange Program Would be Effective in Reducing Drug Abuse and the Risk of Acquired Immune Deficiency Syndrome Infection Among Intravenous Drug Users," Federal Register, February 23, , Vol. 76, No. 36, p. Syringe exchange, in which intravenous drug users can obtain fresh syringes, has been a controversial program in large part because it is perceived as promoting drug . Needle and syringe programmes (NSPs) are a type of harm reduction initiative that provide clean needles and syringes to people who inject drugs (sometimes referred to as PWID) to reduce transmission of HIV and other blood borne viruses (such as hepatitis B and C).
The Wodak and Cooney review had, from 11 studies of what they determined as demonstrating acceptable rigour, found 6 that were positive regarding the effectiveness of NSPs in preventing HIV, 3 that were negative and 2 inconclusive.
In such packages, it is unclear what the relative contribution of needle exchange may be to reductions in risk behavior and HIV incidence. For example, David Noffs of the Life Education Center wrote, "I have visited sites around Chicago where people who request info on quitting their habit are given a single sheet on how to go cold turkey -- hardly effective treatment or counseling.
It also showed how needle exchange workers were a common first contact for distressed drug users. Perhaps the most concerning finding was that workers were not legally allowed to provide Naloxone should it be needed.
IDUs are typically reluctant to use conventional health services. Harm reduction based health care centers, also known as targeted health care outlet or low-threshold health care outlet for IDUs have been established to address this issue.
Drug-addicted mothers will still deliver drug-addicted babies. Training drug addicts in safer injection protocols enables them to continue to support the violent and criminal drug trade. The root causes of addiction continue to be untreated. Police were not allowed to enter the park or make arrests.
However, lack of control over what went on in the park caused a multitude of problems. Drug dealers and users arrived from all over Europe, and crime became rampant as dealers fought for control and addicts who numbered up to 20, stole to support their habit.Among the 1, adults sampled, 29 percent supported legalizing safe consumption sites in their communities, and 39 percent supported legalizing needle exchange programs in their communities.
As stated above, many people do not believe in needle exchange programs. Addiction and addicts as a rule as misunderstood by the masses, so it comes as no surprise that there is extreme discord among support for a program specifically centered around addiction.
ETHICS OF THE NEEDLE EXCHANGE PROGRAM The needle exchange program is a very controversial issue among people. It is controversial because some people think that the needle exchange program encourages illicit drug use and that junkies get special treatment.
A needle and syringe programme (NSP), syringe-exchange programme (SEP), or needle exchange program (NEP) is a social service that allows injecting drug users (IDUs) to obtain hypodermic needles and associated paraphernalia at little or no cost. "A lot of people wanted needle exchange because of the role of dirty needles in [infecting] drug users, but the opposition to it was simply overwhelming," explained former President Bill Clinton.
NICE previously published needle exchange guidelines in , in which needle and syringe services were not advised for people under 18, but the organisation's director Professor Mike Kelly explained that a "completely different group" of people were presenting at programs.