Needle Exchange Program


needle exchange program logoThe Needle Exchange Program (NEP) is an evidenced-based intervention program that provides clean needles to injection drug users in return for used syringes, which are destroyed. The purpose of the program is to reduce the frequency of infections passed through the use of unclean needles, infections that include HIV and hepatitis C.

NEP is the cornerstone of BCHD’s Harm Reduction Program. NEP began operations in 1994 and has grown exponentially over the last 19 years, currently operating at 17 locations around the city. More than 9 million clean syringes have been distributed to clients, and more than 10 million contaminated needles have been properly destroyed since it was started.

Research continues to define and support the role syringe exchange plays in curbing the HIV epidemic in vulnerable communities. As the only confidential syringe exchange program in the nation, and as the only risk reduction provider in Maryland, the Baltimore City NEP is responsible for using the means available to provide much-needed services to prevention priority populations. That group includes HIV-positive persons, high-risk heterosexuals, injection drug users, and special populations such as commercial sex workers and transgender individuals.

Needle Exchange Programs: Evidence-based Intervention

NEP’s advocates, including public health and HIV experts, point to studies showing that syringe exchange can reduce HIV transmission. A 2004 review by the World Health Organization (WHO) concluded that there is “compelling evidence” that syringe exchange programs reduce the number of HIV infections that occur.

In addition, the same WHO study noted, “providing access to and encouraging utilization of sterile needles and syringes for injection drug users is now generally considered to be a basic component of any comprehensive and effective HIV-prevention program.”

In 1994, it is estimated that approximately 650 incident cases of HIV in Baltimore were attributable to injection drug use, representing 60.3% of reported HIV diagnoses – between one half and two thirds.

Seventeen years later, the number of new HIV infections attributable to injection drug use dropped to 177 new cases per year, representing a 29.5% decrease in the proportion of new HIV diagnoses caused by injection drug use. This dramatic decrease in new infections saves the city more than $12.6 million annually.

The 2011 National Survey on Drug Use and Health estimates that 10.21% of Baltimore City residents aged 18 and older have either abused drugs or alcohol or been drug or alcohol dependent within the past year. That’s around 63,400 people based on 2010 Census data. There is no definitive data on how many of these people are injection drug users.

Demographics of Program Participants/Priority Populations

  • The NEP client population is approximately 48% Caucasian and 50% African-American, with Latinos and Asians making up 2%. Currently, only 12% of NEP clients are within the 18-24 age range. Women make up 35% of our client base.