Abstract:
Needle exchange programs, or NEPs, are community-based organizations that provide
clean syringes and other harm reduction resources to people who inject drugs (PWID). While
NEPs began with grassroot organizations and civil disobedience Sweden and the United States
have begun implementing NEPs in the last two to three decades. A rich body of research has
emerged in this time, indicating that NEPs are effective for decreasing injecting risk behaviors
(IRB) like sharing and re-using syringes, as well as decreasing HIV and other bloodborne illness
transmission rates across countries. This research paper aims to compare the efficacy, benefits,
and challenges associated with the implementation of NEPs in the United States and Sweden.
Additionally, recent legislative and community responses to harm reduction policies will be
compared between Stockholm, Sweden, San Francisco, California, US, and New York City, New
York, US. Data indicates that, across countries, NEPs are effective at reducing IRBs and disease
transmission among PWID. However, a number of factors, including lack of model programs,
lack of funding, and legislative opposition, have limited NEP implementation. Data also
indicates that efforts to reduce homelessness may also be an important component of
comprehensive harm reduction.
