Needle exchange programs emerged as a way to address rapidly increasing rates of infection common to intravenous drug users. In many parts of the United States such programs have been illegal, often unwelcome in the very communities hardest hit by injection drug use, and opposed by leaders in public health and drug treatment (Lane, 1993). However, some states have concluded that the AIDS epidemic may warrant a loosening of the restrictions they once placed on possession of hypodermic needles in regards to the needle exchange programs (State Legislature, 2002). Needle exchange programs provide not only a harm reduction tool for intravenous drug users but also for society as a whole. Resistance by legislators to implement policy in favor of needle exchange programs does not help to promote but denotes the concept of social justice.
Concerns have been expressed that needle exchange programs, which provide injection drug users with sterile replacements for their used needles and syringes, might contribute to an increase in the quantity of discarded needles found in public locations, thus posing a risk of needle stick injury to community members and sanitation workers (Doherty, 2000). Studies have found that after a needle exchange program opens in a community, the number of observed needles discarded in the streets does not increase (Doherty, 2000). In order to participate in the program one must provide a used syringe in order to receive a new syringe from the needle exchange program. As a result, this one-for-one policy should not result in an overall increase in the number of needles in the community, since the number of syringes dispensed is equal to the number removed from circulation (Doherty, 2000). Some public officials as wells as community activist believe that this tactic promotes on-going drug abuse. The federal government states, "That needle exchange programs where injection drug users exchange used needles for sterile syringes does not promote drug abuse" (State Legislature, 2002).
