Editing Needle sharing (section)

== Harm reduction ==
NEPs, also known as syringe exchange programs (SEPs), are a form of [[harm reduction]] policy that provide new needles to persons addicted to drugs in exchange for used ones in order to help control the spread of disease.<ref>{{Cite web|url=https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5945a4.htm/Syringe-Exchange-Programs-United-States-2008|title=Syringe Exchange Programs --- United States, 2008|website=www.cdc.gov|access-date=2019-11-14}}</ref> In the [[United States]], there are three distinct prohibitions on needle exchange programs at the federal level—the [[Ryan White CARE Act]], the [[Substance Abuse and Mental Health Services Administration]] (SAMHSA) authorization,<ref>{{cite web|url=http://baltimorehealth.org/nep.html|title=Needle Exchange Program|last=Clemons|first=Thomas|name-list-style=vanc}}</ref> and the 1997 Labor-Health and [[Human Services]] (HHS) Education appropriations legislation. However, many states still provide the service despite the federal legislation, especially in large cities where intravenous drug use is a major health concern. A study in New York State found that during the course of 12 months, NEP prevented roughly 87 infections of [[HIV]] by preventing needle sharing. In addition, NEP have decreased the spread of HIV by one third to two fifths.<ref>{{cite web|url=https://www.aclu.org/drug-law-reform/needle-exchange-programs-promote-public-safety|title=Needle Exchange Programs Promote Public Safety}}</ref>

One of the other harm reduction measurements in this regard is the [[Supervised injection site|Supervised Injection Sites]], also known as Safe Injection Sites. In these facilities, drug users have access to new needles and they can use substances under the supervision of staff trained to prevent and treat drug overdose and trained to prevent HIV and hepatitis. Some of these sites also provide help to their clients to ease their access to drug treatment and other additional social and medical services. <ref>{{cite web |url= https://www.yestoscscalifornia.org/theissue |title=THE ISSUE |website=YES TO SCS CALIFORNIA |language=en-US |access-date=2019-10-24 }}</ref> There are some countries around the world that have already established safe injection sites, including Australia and Canada. According to [[NPR]], since the start of this program in Canada in 2013, these sites have supervised over 3.6 million injections and have prevented more than 6,000 overdoses. <ref>{{cite web |url= https://www.npr.org/sections/health-shots/2018/09/07/645609248/whats-the-evidence-that-supervised-drug-injection-sites-save-lives |title=What's The Evidence That Supervised Drug Injection Sites Save Lives? |website=NPR.org |date=7 September 2018 |language=en |access-date=2019-10-31 |last1=Gordon |first1=Elana }}</ref> Additionally, in a cross-sectional survey performed in Glasgow from 1990 to 1996, the incidence of Hepatitis C had significantly decreased with the implementation of safe needle exchanges.<ref>{{cite journal | vauthors = Taylor A, Goldberg D, Hutchinson S, Cameron S, Gore SM, McMenamin J, Green S, Pithie A, Fox R | display-authors = 6 | title = Prevalence of hepatitis C virus infection among injecting drug users in Glasgow 1990-1996: are current harm reduction strategies working? | journal = The Journal of Infection | volume = 40 | issue = 2 | pages = 176–83 | date = March 2000 | pmid = 10841096 | doi = 10.1053/jinf.2000.0647 }}</ref>

The progression of supervised injection site implementation is currently not widely accepted due to social stigma, lack of government support, and health advocacy. Continued public health education, advocacy efforts, and further research may help encourage the expansion supervised injection sites.<ref>{{cite journal | vauthors = Kerr T, Mitra S, Kennedy MC, McNeil R | title = Supervised injection facilities in Canada: past, present, and future | journal = Harm Reduction Journal | volume = 14 | issue = 1 | pages = 28 | date = May 2017 | pmid = 28521829 | pmc = 5437687 | doi = 10.1186/s12954-017-0154-1 | doi-access = free }}</ref>