This booklet summarises the literature on the provision of sterile needles and syringes to people who inject drugs and other related issues. The proportion of the Australian population thought to inject drugs is just under two percent, or approximately 313,500 people.1 The first case of HIV infection in a drug injector without other risk factors in Australia was detected in 1985. Needle and Syringe Programs started in Australia the following year. At that time, hepatitis C infection was already well established among drug injectors with more than half being infected.2

Workers at Needle and Syringe Programs do much more than just provide injecting equipment. They are often the first point of contact between health services and people who inject drugs. Needle and Syringe Program workers are able to provide education and information on healthcare issues and drug related harm and facilitate entry into drug treatment. Some Programs also provide primary medical care to this disadvantaged population who often have very poor health.

Australian Governments invested $130 million in Needle and Syringe Programs between 1991 and 2000. This resulted in the prevention of an estimated 25,000 cases of HIV and 21,000 cases of hepatitis C among injecting drug users. The savings to the health system in avoided treatment costs over a lifetime are estimated to be between $2.4 and $7.7 billion.3

While Needle and Syringe Programs enjoy strong public support in Australia, there have from time to time been misunderstandings about their role. In the past, Needle and Syringe Programs have been accused of encouraging drug use and increasing the number of inappropriately discarded needles and syringes in public places. However, Australian and international studies have shown that neither of these concerns are supported by impressive evidence. Research has shown that Needle and Syringe Programs do not increase injecting drug use. This could be attributed to the ability of health workers to offer health information, drug education and referral into treatment.

Some members of the public have also raised concerns about inappropriately discarded needles and syringes and the possibility of contracting HIV or hepatitis C from a discarded used needle. The chance of a member of the public contracting either HIV or hepatitis C from a discarded used needle is extremely low. Worldwide, there has never been a reported case of a member of the public contracting HIV in this way.

Countries where Needle and Syringe Programs have been implemented have averted HIV epidemics among injecting drug users, while countries that have not implemented these measures have often experienced uncontrolled epidemics. There is strong evidence that if HIV becomes endemic among injecting drug users it can then spread to their sexual partners and children resulting in high mortality rates and large social and economic costs to the entire community.Top of page

There is abundant evidence from Australia and international research of the substantial public health benefits of Needle and Syringe Programs. The Australian Medical Association supports Needle and Syringe Programs as one of a number of measures which prevent the spread of HIV and other blood borne diseases.4