Syringe Exchange Delivery Models via the National Harm Reduction Coalition
Fixed Site Exchanges – The exchange is located in a building. This could be a storefront, an office, or other similar space.
♦Shelter from street-based activities/safe space.
♦Room for other services such as medical care, referrals, psychosocial.
♦Out of view of local residents, businesses
♦Privacy for exchange participants.
♦Participants have to come to you.
♦Limited hours of operation.
♦Higher overhead and upkeep.
Mobile/Street Based Vehicle based exchange – The exchange is conducted via a van or RV that drives to exchange sites and neighborhoods.
♦Flexibility if the drug scene or neighborhood changes.
♦Easier negotiations with larger community if they know you are not a permanent fixture.
♦Informal and low threshold if actually on the sidewalk or in a park.
♦Reaches harder to reach IDUs who may not have transportation or feel comfortable walking into a fixed site exchange
♦Harder to deliver ancillary services than with a fixed site.
♦Van involves higher overhead because of insurance, upkeep, driver, etc.
Home Delivery or Peer-Based Exchange - Participants call a phone number to arrange delivery of services, which can be done in their home or at another agreed upon site. Can happen on a regular schedule, or by appointment via cell phone.
♦Safer for participants.
♦Peer knowledge of drugs, drug use, and the local drug scene.
♦Increases access to new syringes for socially isolated injectors who do not access services such as syringe exchange.
♦Can involve a lot of driving, resulting in high overhead.
♦ Harder to offer wrap around services such as HIV testing, wound care, referrals, etc
Integrated syringe exchange - An organization adds syringe exchange into their ongoing services.
♦Pre-existing organizational infrastructure and client base.
♦Multiple ways of getting syringes to participants, depending on the type of services provided by the agency.
♦May offset operational and human resource costs
♦Staff may be resistant to new programs & new ideas, especially if the agency follows a traditional abstinence approach.
♦Cost of training and supervision of peers.
♦Possible conflicting identities as peer worker and IDU community member.