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Syringe Access: Questions & Answers
Syringe Access: Questions & Answers
Syringe Access: Questions & Answers
Are sterile syringes available in other states and cities to prevent the spread of disease?
• Yes. Most states allow some type of access to sterile syringes to prevent the spread of HIV/AIDS, hepatitis C and
other blood-borne diseases either through syringe access programs or non-prescription sale of syringes in pharmacies.5
Until the passage of the Blood-borne Disease Harm Reduction Act in December 2006, New Jersey was the only state
to allow no access whatsoever to clean needles to prevent the spread of HIV and other blood-borne diseases. Now
New Jersey has sterile syringe access programs in five cities around the state (Atlantic City, Camden, Jersey City,
Paterson and Newark).
• New Jersey is one of only two states that require a prescription to purchase a syringe in a pharmacy.6
• The first sterile syringe access program in the United States was started in Tacoma, Washington in 1988.7 As of
1999 there were over 160 syringe exchange programs in 39 U.S. states, the District of Columbia and Puerto Rico.8
Is sterile syringe access effective in reducing the spread of HIV, hepatitis C, and other blood-borne diseases?
• Yes. Every scientific, medical, and professional organization to study the issue has concluded that sterile syringe
access reduces the spread of HIV, hepatitis C, and other blood-borne diseases.
• A worldwide survey found that HIV rates among injection drug users decreased by 5.8% per year in cities with syringe
access programs, and increased by 5.9% a year in cities without syringe access programs.9
• In New York City, injection drug users who used sterile syringe access programs were 2/3 less likely to become
infected with HIV than those who did not.10
• Syringe access programs reduce the spread of hepatitis. Participants in a Tacoma, Washington syringe access
program were 6 to 7 times less likely to contract hepatitis B or C.11 A New Haven, Connecticut syringe access program
was associated with a 33% reduction in HIV incidence and a similar reduction in hepatitis B.12
Who supports sterile syringe access?
• National organizations that endorse sterile syringe access as a means to reduce the spread of HIV and other blood-
borne diseases include the National Institutes of Health Consensus Panel, the National Academy of Sciences, the
American Medical Association, the American Foundation for AIDS Research, the American Nurses Association, the
American Public Health Association, the American Academy of Pediatrics, the Association of State and Territorial
Health Officials and the National Conference of Mayors. continued
Does sterile syringe access increase the number of improperly discarded syringes?
• No. In fact, some neighborhoods report a decrease in improperly discarded syringes after syringe access programs
open. Studies in Portland, Oregon and Baltimore, Maryland found similar or decreased numbers of improperly
discarded syringes after the implementation of sterile syringe access programs.16
• A major evaluation was done by the New York Academy of Medicine after New York State changed its law to allow
for non-prescription sale of syringes in pharmacies. The report found no increase in improperly discarded syringes,
no increase in accidental needle sticks among law enforcement or sanitation workers, no increase in criminal activity
and no increase in drug use after the law changed.17
Do syringe access programs increase crime or criminal activity in areas where they are operated?
• No. No study has ever found an increase in crime associated with the establishment of a syringe access program.
A 1993 review of 16 syringe access programs reported no evidence of increased crime.21
• In 2000, another study in Baltimore compared arrest rates in areas with syringe access programs and those without
such programs. In all cases there was no significant increase in arrest rates in the areas with syringe access
programs compared to the areas without programs.22
• A detailed analysis of syringe access programs in New York City in 2001 found no relationship between reports on
robberies or assaults and the proximity to local syringe access programs.23
85:1531-1537 (1995).
12 E.H. Kaplan. Probability Models of Needle Exchange. Operations Research. 43:558-569 (1995); R. Heimer, K. Khoshnood, F.B. Jariwala, B. Duncan. Y. Harima. Hepatitis in Used Syringes: The Limits of Sensitivity of
Techniques to Detect HBV DNA, HCV RNA, and Antibodies to HB Core and HCV Antigens. Journal of Infectious Diseases. 173:997-1000 (1996).
13 National Commission on AIDS, The Twin Epidemics of Substance Abuse and HIV (Washington DC: National Commission on AIDS, 1991); General Accounting Office, Needle Exchange Programs: Research Suggests Promise
as an AIDS Prevention Strategy (Washington DC: US Government Printing Office, 1993); Lurie, P. & Reingold, A.L., et al., The Public Health Impact of Needle Exchange Programs in the United States and Abroad (San Francisco,
CA: University of California, 1993); Satcher, David, MD, (Note to Jo Ivey Bouffard), The Clinton Administration's Internal Reviews of Research on Needle Exchange Programs (Atlanta, GA: Centers for Disease Control, December 10,
1993); National Research Council and Institute of Medicine, Normand, J., Vlahov, D. & Moses, L. (eds.), Preventing HIV Transmission: The Role of Sterile Needles and Bleach (Washington DC: National Academy Press, 1995);
Office of Technology Assessment of the U.S. Congress, The Effectiveness of AIDS Prevention Efforts (Springfield, VA: National Technology Information Service, 1995); National Institutes of Health Consensus Panel, Interventions to
Prevent HIV Risk Behaviors (Kensington, MD: National Institutes of Health Consensus Program Information Center, February 1997).
14 Shalala, D.E., Secretary, Department of Health and Human Services, Press release from Department of Health and Human Services (April 20, 1998).
15 US Surgeon General Dr. David Satcher, Department of Health and Human Services, Evidence-Based Findings on the Efficacy of Syringe Exchange Programs: An Analysis from the Assistant Secretary for Health and Surgeon
General of the Scientific Research Completed Since April 1998 (Washington, DC: Dept. of Health and Human Services, 2000).
16 J. Normand, D. Vahov, L.E. Moses, eds. Preventing HIV Transmission: The Role of Sterile Needles and Bleach. Washington, DC: National Academy Press; 1995237; K.J. Oliver, S.R. Friedman, H. Maynard, L. Magnusson,
D.C. Des Jarlais. Impact of a Needle Exchange Program on Potentially Infectious Syringes in Public Places. Journal of Acquired Immune Deficiency Syndromes. 5:380 (1992); P. Lurie, A. Reingold. The Public Health Impact of
Needle Exchange Programs in the United States and Abroad (prepared for the Centers for Disease Control and Prevention). Berkeley, CA: University of California, School of Public Health, and San Francisco, CA: University of
California, Institute for Health Policy Studies; 1993:388; M.C. Doherty, R.S. Garfein, D. Vlahov, et al. Discarded Needles Do Not Increase Soon After the Opening of a Needle Exchange Program. American Journal of Epidemiology.
145:730-737 (1997).
17 New York Academy of Medicine. New York State Expanded Syringe Access Demonstration Program Evaluation. January 15, 2003.
18 H. Hagan, D.C. Des Jarlais, D. Purchase, S.R. Friedman, et al. An Interview Study of Participants in the Tacoma, Washington, Syringe Exchange. Addiction. 88:1694-1695 (1993).
19 R. Brooner, M. Kidorf, et al. A Drug Abuse Treatment Success Among Needle Exchange Participants. Public Health Reports. 113(supplement 1):130-139 (1998).
20 R. Heimer, M. Lopes. Needle Exchange in New Haven Reduces HIV Risks, Promotes Entry Into Drug Treatment, and Does Not Create New Drug Injectors. Journal of the American Medical Association. 271:1825-1826 (1994).
21 P. Lurie, A.L. Reingold, B. Bowser (eds). The Public Health Impact of Needle Exchange Programs in the United States and Abroad: Summary, Conclusions and Recommendations (1993).
22 M.A. Marx, B. Crape, R.S. Bookmeyer, B. Junge, et al. Trends in Crime and the Introduction of a Needle Exchange Program. American Journal of Public Health 90:1933 (2000).
23 S. Galea, J Ahern, C. Fuller, N. Freudenberg, D. Vlahov. Needle Exchange Programs and Experience of Violence in an Inner City Neighborhood. Journal of Acquired Immune Deficiency Syndromes. 28:282 (2001).
24 New Jersey Economics. Access to Sterile Syringes and Public Health Costs in New Jersey: Suggestions for Public Policy. 2003.
25 Australian Commonwealth Department of Health and Aging. Return on Investment in Needle and Syringe Programs in Australia. 2002.
26 Schackman, Bruce R., et al. The Lifetime Cost of Current Human Immunodeficiency Virus Care in the United States. Medical Care. 44 (11):990-997 (2006).