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The needle exchange program (NEP) is a service offered to injection drug users so that they can receive clean, hypodermic needles at little to no cost. Because injection drug users hold an increased risk of acquiring blood-borne diseases such as Hepatitis B/C and HIV, NEPs have been put into place to limit the spread of these diseases.

The Facts

Globally, injection drug users represent:

  • 8% of new HIV infections
  • 16% of new hepatitis B infections
  • 90 % of new hepatitis C infections

“Washington D.C. has a higher AIDS diagnosis rate than any U.S. state, with about 2.4 percent of residents living with HIV/AIDS. Just over 14 percent of those cases are linked to injection drug use” (as stated in the Huffington Post). Prior to 2007 there was a ban against the use of federal funds for NEPs and therefore many cities would have to use local revenues to provide exchange programs. At the end of 2007, that ban was lifted so that NEPs could begin to be established in Washington D.C., yet the ban was reinstated in 2012. A recent study that investigated the efficacy of the NEP program in DC has proven it to be both successful in the prevention of new cases of HIV and general cost effectiveness (Ruiz et al., 2015). Washington D.C. calculated only 176 injection drug-related cases of HIV, as compared to an expected 296 if the ban had remained in place. The program cost approximately $1.3 million over the course of two years. The district was able to prevent 120 new cases of infection and by doing so saved roughly $44.3 million in as little as two years.

Quitting an addiction is challenging. The NEP offers addicts a means to remain healthy while engaging in their use but also has the resources ready if at any time they decide they want to begin recovery. Many people have already begun to use the exchange program as yet another door into the recovery lifestyle.

While many legislators stand by the idea that NEPs cause higher crime rates and encourage drug use, these are just a part of the stigma of addiction and have not been confirmed. Though, what has been confirmed is the success of the program in reducing the new cases of infections and the cost-effectiveness that follows. After all, “A lot of these beliefs are based on misinformation and just a dogmatic approach to addiction—not understanding addiction is a medical issue and not just a bad habit,” said Dr. Ruiz, who led the study. She continues in saying that the study truly shows the impact of policy change. To let the D.C. needle exchange program be an example and more so, a reason to keep the ban against exchange programs lifted. Members of congress have since begun to look past their biases and are discussing the creation of legislation within the budget that would be used towards the establishment of NEPs. However, the funds would not be used to actually buy the sterile needles, that would be left up to local funds as they were previously. While this is not the exact goal many hoped for, many such as Greg Millett, the vice president of AIDS Research, see it as great progress.

For locations and other information on D.C.’s Needle Exchange Program you can visit their Department of Health website or call them at (202) 442-5955.


  1. Ruiz, M. S., O’Rourke, A., & Allen, S. T. (2015). Impact Evaluation of a Policy Intervention for HIV Prevention in Washington, DC. AIDS and Behavior, 1-7.