Training Guide

Guide to Developing and Managing Syringe Access Programs

Appendix A: Additional Resources By Topic

Links can be accessed at harmreduction.org


San Francisco Syringe Access and Disposal Program Policy and Guidelines (2011)

San Francisco Department of Public Health (SFDPH)

Recommended Best Practices for Syringe Exchange Programs in the United States Consensus Statement (2009)

Recommendations from a New York City Department of Health and Mental Hygiene panel of syringe exchange experts

Needle and syringe programmes: providing people who inject drugs with injecting equipment (2009)

National Institute for Health and Clinical Excellence (UK)

Guide to Starting and Managing Needle and Exchange Programmes (2007)

Published jointly by UNAIDS, UNODC and the World Health Organization and prepared by the AIDS Project Management Group (APMG)

Ontario Needle Exchange Programs: Best Practice Recommendations (2006)

Strike C, Leonard L, Millson M, Anstice S, Berkeley N, Medd E.

Toronto: Ontario Needle Exchange Coordinating Committee (ONECC), a representative of the Ontario Needle Exchange Network (ONEN)

Needle and Syringe Program Policy and Guidelines for NSW (2006)

NSW Department of Health

Starting and Managing Needle and Syringe Programs: A guide for Central and Eastern Europe and the newly independent states of the former Soviet Union (2000)

International Harm Reduction Development (IHRD)


Talking Points – Top Five Studies Misused by Syringe Exchange Opponents

Drug Policy Alliance (DPA)

Government Studies in Support of Needle Exchange

Health GAP

SEP Research Update 2008

Daniel Raymond, Harm Reduction Coalition

NIMBY localism and national inequitable exclusion alliances: The case of syringe exchange programs in the United States

Barbara Tempalski, Risa Friedman, Marie Keem, Hannah Cooper, Samuel R. Friedman

Syringe access for the prevention of blood borne infections among injection drug users

Sharon Stancliff

Can Difficult-to-Reuse Syringes Reduce the Spread of HIV Among Injection Drug Users?

By Caulkins, Kaplan, Lurie, O’Connor, Ahn

Cost Effectiveness of Syringe Exchange Programs

Health GAP

Syringe Exchange: An Effective Tool in the Fight Against HIV

GMHC: Gay Men’s Health Crisis, 2009

Harm Reduction

Harm Reduction Protocol: As practiced by the Chicago Recovery Alliance; June 1996


Substance Use Management: A Harm Reduction-Principled Approach to Assisting the Relief of Drug-Related Problems


Background and Protocol for Harm Reduction Practice

Chicago Recovery Alliance


Nothing about us without us”: Greater, meaningful involvement of people who use illegal drugs: A public health, ethical, and human rights imperative, International edition


“Nothing About Us Without Us” — A Manifesto by People Who Use Illegal Drugs

2008 Canadian HIV/AIDS Legal Network, International HIV/AIDS Alliance,

Open Society Institute


Rapid Assessment and Response Guide on Injection Drug Use

The World Health Organization

Implementation of Rural Syringe Exchange: From Zero to Funded

Shari Weiss, B.A. SUNY Cortland, Capstone Project

Chapter 2: Assessing Community Needs and Framing Issues

Community Health Advocacy – Sana Loue; Linda S Lloyd; Daniel O’Shea

New York : Kluwer Academic/Plenum Publishers, 2003

Needs Assessment of Harm Reduction and Health Care Services for Substance Misusers Across Wales

Josie Smith , HPR Ltd, National Public Health Service for Wales


The Laws, State by State: The Project on Harm Reduction in the Health Care System

Temple University’s Beasley School of Law

Syringe Access Law in the United States: A State of the Art Assessment of Law and Policy

Scott Burris, Stephanie A. Strathdee and John S. Vernick, Center for Law and the Public’s Health at Johns Hopkins and Georgetown Universities, Johns Hopkins Bloomberg School of Public Health, November 30, 2002

The legal strategies used in operating syringe exchange programs in the United States

S Burris, D Finucane, H Gallagher, and J Grace; American Journal of Public Health. August 1996; 86(8 Pt 1): 1161-1166.

United States and the Politics of Syringe Exchange

Daniel Raymond, Erica Poellot and Allan Clear

State and Local Policies Regarding IDUs’ Access to Sterile Syringes

December 2005


Harm Reduction Coalition Syringe Access Newsletter

January 2008, Volume 1, Number 1

Potential Funders for SAP Programs


Fact Sheet: SEP Delivery Models

Harm Reduction Coalition

What’s community got to do with it? Implementation Models of Syringe Exchange Programs

Downing, Moher, Riess, Thomas H., Vernon, Karen et al., AIDS Education Prevention, 2005 February; 17 (1): 68-78.

Higher Syringe Coverage Is Associated with Lower Odds of HIV Risk and Does Not Increase Unsafe Syringe Disposal Among Syringe Exchange Program Clients

  1. N. Bluthenthal et al., Drug and Alcohol Dependence [Epub Feb 3], 2007

Policies and Procedures

The following are sample Policy and Procedure Manuals from harm reduction programs around the country. We extend our thanks to all of the programs who have allowed us to make their materials available. Please credit any material borrowed or adapted.

Washington Heights Corner Project Policy and Procedure Manual

New York, NY (2007)

Brandywine Consulting, Inc. Needle Exchange Handbook for Staff and Volunteers

Wilmington, DE (2007)

Lower East Side Harm Reduction Center Syringe Exchange Policy and Procedure Manual

New York, NY (2007)

Prevention Point Philadelphia Staff and Volunteer Handbook

Philadelphia, PA (2006)

Lifepoint Guidelines and Operating Procedures Manual

Milwaukee, WI (2005)

Drop-In Center Policy and Procedure Manual

Santa Cruz, CA (2004)

New York State Department of Health AIDS Institute Policies and Procedures for Syringe Exchange Programs

New York, NY (January 2009)


Guide for Assisting Management of Volunteers in Harm Reduction Practice


Harm Reduction Outreach with Syringe Exchange – Guidelines and Operating Procedures

Chicago Recovery Alliance


Getting Off Right: A Safety Manual For Injection Drug Users

Harm Reduction Coalition

Positive Change Postcard Series

Chicago Recovery Alliance


Community Options for Safe Needle Disposal

Environmental Protection Agency


Coalition for Safe Community Needle Disposal


Overdose Prevention and Response: A Guide for People Who Use Drugs and Harm Reduction Staff in Eastern Europe and Central Asia

Matt Curtis and Lydia Guterman, 2009

Key summary of six US-based naloxone distribution programs

Traci C. Green et al, Yale University

From Chicago Recovery Alliance:


AIDS Director Planning Guide And Toolkit: Key Elements of Managing a State HIV/AIDS Program

NASTAD Member Services,September 2009 Edition

Guidelines for Evaluating Harm Reduction Services

Manitoba Harm Reduction Network


TOOLKIT: Integrated, Collaborative or Merged Prevention and Care Planning Processes

National Alliance of State and Territorial AIDS Directors (NASTAD), May 2007

NASTAD Fact Sheet: Health Departments Role in Expanding Syringe Access

National Alliance of State and Territorial AIDS Directors (NASTAD), 2010


OHRDP Communication and Information Toolkit for Needle Exchange Programs (NEPs)

The Ontario Harm Reduction Distribution Program developed this communications strategy to engage and support the broad network of Needle Exchange Programs and affiliated Harm Reduction organizations.

Dealing with the National Media

2007 National Conference on Injecting Drug Use presentation, “Experience from Australia”. A very brief overview including: “When and why should you use the media?” and the “5 Golden Rules” for print, radio, and television interviews.


Harmonizing Harm Reduction and Law Enforcement

Law Enforcement and Harm Reduction Network

Policing for Healthy Communities

Just Cause Law Collective

Syringe Possession Information for California Law Enforcement Officers

New Mexico Syringe Exchange Program – Law Enforcement Training

New York Police Academy Training (2004)

Injection Drug Users Health Alliance, November 2004

COPS HR: Coalition of Police Supporting Harm Reduction

Do Not Cross: Policing and HIV Risk Faced by People Who Use Drugs

Canadian HIV/AIDS Legal Network – March, 2007

Needle Exchange Program: Considerations for Criminal Justice

Center for Innovative Public Policies

Attitudes of Police Officers Towards Syringe Access, Occupational Needle-Sticks, and Drug Use: A Qualitative Study of One City Police Department in the United States (2005)

Leo Beletsky, MPH, Grace E Mascalino, Ph.D., Scott Burris, JD.

Law Enforcement and Harm Reduction: Advocacy and Action Manual

Relationships of deterrence and law enforcement to drug-related harm among drug injectors in U.S. metropolitan areas

Samuel R. Friedman, Hannah L.F. Cooper, Barbara Tempalski, Maria Keem, Risa Friedman, Peter L. Flom and Don C. Des Jarlais

Law Enforcement and Harm Reduction



Youth R.I.S.E.

A Youth-Led Perspective: Best Practices for Youth Harm Reduction Programming



Sex Workers Outreach Project (SWOP)

Desiree Alliance


Best Practices Policy Project

The Sex Workers Project

$PREAD Magazine


Minnesota Transgender Health Coalition

Gender Spectrum

Transgender Care

Transgender Health Empowerment

Transsexual Road Map: Facts About Silicone Injection

Sylvia Rivera Law Project

National LGBT Tobacco Network

National Coalition for LGBT Health

SAGE – Services & Advocacy for GLBT Elders

Intersex Society of North America

NALGAP – Association of LGBT Addiction Professionals & Their Allies