Editing Needle and syringe programmes (section)

==== General characteristics ====
As of 2011, at least 221 programmes operated in the US.<ref name="Green TC, Martin E, Bowman S, Mann M, Beletsky, L 2012 e9-e16">{{cite journal |vauthors=Green TC, Martin E, Bowman S, Mann M, Beletsky L |title=Life After the Ban: An Assessment of US Syringe Exchange Programs' Attitudes About and Early Experiences with Federal Funding|journal=Am. J. Public Health |volume=102 |issue=5 |pages=e9–e16 |year=2012 |doi=10.2105/AJPH.2011.300595|pmid=22420810|pmc=3484785}}</ref> Most (91%) were legally authorized to operate; 38.2% were managed by their local health authorities.<ref name="Green TC, Martin E, Bowman S, Mann M, Beletsky, L 2012 e9-e16"/><ref name="Des Jarlais DC, McKnight C, Goldblatt C, Purchase D. 2009 1441–6">{{cite journal |vauthors=Des Jarlais DC, McKnight C, Goldblatt C, Purchase D |title=Doing harm reduction better: syringe exchange in the United States. |journal=Addiction |url=http://www.nasen.org/site_media/files/nasec2010/ddj_2009DoingHarmReductionBetterSEPintheUS.pdf |access-date=2012-07-05 |volume=104 |issue=9 |pages=1441–6 |year=2009 |doi=10.1111/j.1360-0443.2008.02465.x |pmid=19215605 |archive-url=https://web.archive.org/web/20110929103921/http://www.nasen.org/site_media/files/nasec2010/ddj_2009DoingHarmReductionBetterSEPintheUS.pdf |archive-date=2011-09-29 |url-status=dead}}</ref> The CDC reported in 1993 that the most significant expenses for the NSPs is personnel cost, which reports it represents 66% of the budget.<ref>{{Cite web|title=The Public Health Impact of Needle Exchange Programs in the United States and Abroad Summary, Conclusions and Recommendations|url=https://stacks.cdc.gov/view/cdc/11203/cdc_11203_DS1.pdf?|date=1993|website=CDC}}</ref>

More than 36 million syringes were distributed annually, mostly through large urban programmes operating a stationary site.<ref name="Green TC, Martin E, Bowman S, Mann M, Beletsky, L 2012 e9-e16"/> More generally, US NEPs distribute syringes through a variety of methods including mobile vans, delivery services and backpack/pedestrian routes<ref name="Des Jarlais DC, McKnight C, Goldblatt C, Purchase D. 2009 1441–6"/> that include secondary (peer-to-peer) exchange.