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.
Strengths:
♦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.
Limitations:
♦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.
Strengths:
♦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
Limitations:
♦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.
Strengths:
♦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.
Limitations:
♦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.
Strengths:
♦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
Limitations:
♦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.