What is harm reduction?

Harm reduction programs work with people who use drugs. These programs offer strategies to reduce the health risks to those people who use drugs and the people around them. The county’s syringe exchange program works with people who inject drugs to reduce the spread of serious infections like HIV/AIDS, hepatitis B and hepatitis C and reduce the risk of drug overdose. Syringe exchange is a federally and internationally recognized element of a comprehensive response to drug misuse.

What is syringe exchange?

Sharing syringes spreads serious diseases. Syringe exchange provides a way for people who inject drugs to safely dispose of used syringes and obtain new syringes on a one-for-one basis. Clients also receive sharps containers, opioid overdose prevention education, and referrals to medical, mental health and social services, as well as drug treatment programs.

Why do we need syringe exchange?

People suffering from a substance use disorder can only stop using drugs when they’re ready. Until they are ready for drug treatment and recovery, Multnomah County’s Harm Reduction Program helps protect those who inject drugs from contracting or passing along diseases such as Hepatitis or HIV by sharing syringes and other injection equipment. In addition to training on how to administer the overdose-reversal drug naloxone, Multnomah County staff offer harm-reduction counseling, and health and social service referrals. For many clients, contact with exchange staff is often the first, or only, link they have to health and social services.

Do syringe exchange programs really work?

Yes. Research has shown that:

  • Syringe exchange programs connect users to drug treatment and other health services (National Research Council).
  • Those who participate in syringe exchange programs are more likely than non-participants to report a reduction in injection, enter drug treatment, and stop injecting altogether. (US Department of Health and Human Services).
  • Prevalence of HIV increased in cities without syringe exchange programs, while HIV rates decreased in cities with syringe exchange programs (World Health Organization).
  • Needle Exchange programs save taxpayers money by preventing infection. The estimated lifetime cost of treating one person living with HIV is nearly $400,000. (National Institute on Drug Abuse and the CDC).
  • Communities with syringe exchange programs were found to have fewer improperly disposed needles than cities without exchange programs. (National Institute of Health).
  • Syringe exchange programs protect first-responders and members of the public from being inadvertently stuck by discarded needles. (Centers for Disease Control and Prevention).

What does syringe exchange have to do with preventing overdoses?

Overdose occurs when a person takes more of a drug than the body can process. When the drug is an opioid, overdose can be fatal because breathing slows or stops. People who inject drugs are often the first to witness a drug overdose and can be the first to respond. Clients of the syringe exchange are trained in how to recognize and respond to opioid overdoses and we offer training and  overdose rescue kits which include naloxone, a medication that reverses the effects of opioid overdose.

Are used syringes dangerous?

Seeing discarded syringes is upsetting, especially for parents of young children. However, while people who share syringes can transmit infections, there is little proven risk to someone who is accidentally poked or scratched by a discarded syringe. According to the CDC, there have been no reported transmission of HIV following injuries by syringes discarded in public places. There have been single case reports of Hepatitis B and Hepatitis C transmission.

How do syringe exchanges support proper syringe disposal?

Syringe exchange programs improve the odds that people who inject drugs will dispose of used syringes in a proper manner. The syringe exchange programs offered through Multnomah County and Outside In served more than 6,500 clients in calendar year 2017, and collected more than 5.5 million syringes, with a return rate of about 100 percent.

Syringe exchange services are offered on a one-for-one basis: clients bring their used syringes to be disposed of and receive new syringes. Exchange programs also provides a small number of health kits, which include 10 syringes, as an engagement tool for new clients or those who struggle with safe storage. This strategy creates opportunities to work with clients on proper and safe disposal including how to use sharps containers.

About 70 percent of exchange clients report experiencing homelessness or unstable housing. Exchange staff worked with clients to reduce the size and type of safe disposal “sharps” containers to make them easier to carry. As more clients use these containers, exchange sites report improved return rates.

The County is working with the City of Portland and other partners to expand safe public disposal options across our community.

What should I do if I find a used syringe?

  • Wear gloves and use tongs or pliers to pick up the syringe.
  • Use a hard plastic container, such a 20-ounce soda or juice bottle with a lid.
  • Place the container on the ground and drop the syringe without holding onto the container.
  • Tape the bottle shut.
  • Write on the outside “SHARPS. DO NOT RECYCLE.”

How can I dispose of used syringes?

  • It’s against the law to throw used syringes into the trash
  • Please do not take used syringes to an exchange site. These are confidential services for people who inject drugs.
  • Dispose of syringes in the Healthy Streets bin on the west side Waterfront Esplanade, under the Burnside Bridge
  • To dispose of diabetic or medical syringes, contact Metro at 503-234-3000.
  • For more disposal options, call 503-988-3030 or read more on our disposal page.