Syringe and Naloxone Access

Harm reduction can help. Find the resources you need here.

What is Harm Reduction?

Harm reduction is an evolving set of practical strategies to meet people where they are in their behaviors to promote safer options. This approach can reduce the risks that may be involved with the behavior and supports healthier practices more long-term.

For overdose prevention, harm reduction recognizes a range of drug use practices and promotes ways for people to manage their drug use with a variety of support options. Syringe
services programs, community-based naloxone distribution, and drug-checking are all harm reduction techniques that reduce the risks associated with drug use. Harm reduction is also a philosophy that people who use drugs deserve to protect themselves and their loved ones, regardless of whether they seek additional health services.

Meeting people where they are to provide services allows harm reduction programs to work with participants to address drug use and conditions of use in a tailored manner. It is an effective model: People engaged in syringe services programs are five times more likely to enter treatment for a substance use disorder than nonparticipants.

In North Carolina, you can access free harm reduction resources through our statewide network of syringe services programs, the North Carolina Safer Syringe Initiative.

Syringe Services Programs

As of July 2016, North Carolina allows for the legal establishment of syringe services programs. Syringe services programs, or SSPs, distribute sterile syringes and other injection supplies and encourage the secure disposal of used syringes to reduce sharing, reuse and public safety risks. Using a sterile syringe and new injection supplies for each injection can prevent infections, abscesses and the transmission of hepatitis C and HIV. Programs also provide overdose prevention and response education, including how to administer naloxone, and distribute this overdose reversal tool throughout their communities. These programs can help participants access other medical and social services, including treatment for substance use disorder and mental health conditions, often serving as the primary avenue to meet their health needs.

Most syringe services programs operate according to the practices and philosophy of harm reduction. Harm reduction is an evolving set of practical strategies that reduce the negative consequences of drug use and other high-risk behaviors. It recognizes a spectrum of drug use between chaotic use and abstinence and promotes ways for people to manage their use and to use more safely. Syringe programs, community naloxone distribution and drug-checking with fentanyl test strips are all harm reduction techniques that reduce the risks associated with drug use. Harm reduction is also a philosophy based on the belief that people who use drugs deserve to protect themselves and their loved ones, whether or not they are seeking treatment. “Meeting people where they are” to provide services allows harm reduction programs to work with participants to address drug use and conditions of use. It is an effective model: people engaged in syringe services programs are five times more likely to enter treatment for substance use disorder than non-participants.

Increasing access to syringe services programs is an important element of North Carolina’s Opioid and Substance Use  Action Plan to address the overdose crisis. All syringe services programs in North Carolina are required to provide the following services:

  • Syringe disposal
  • Distribution of sterile syringes and new injection supplies at no cost and in sufficient quantities to prevent sharing or reusing
  • Education materials concerning:
    o    Prevention of disease transmission, overdose, and substance use disorder
    o    Treatment options, including medication-assisted treatment and referrals to care
  • Naloxone distribution and training, or referrals to these services
  • Consultations/referrals to mental health or substance use disorder treatment

The NC Safer Syringe Initiative at the Division of Public Health maintains a list of syringe services programs in North Carolina.
For more information or for assistance in developing and operating syringe services programs contact SyringeExchangeNC@dhhs.nc.gov.

Naloxone Access

A standing order is a medical order that authorizes the dispensing or distribution of a medication, like naloxone or the flu vaccine, to any person who meets criteria designated by the prescriber. North Carolina’s statewide standing order for naloxone, signed by the State Health Director, authorizes any pharmacist practicing in the state of North Carolina and licensed by the North Carolina Board of Pharmacy to dispense naloxone to any person who meets set criteria. These criteria include:

  • Being at risk of opiate-related overdose due to medical conditions or history;
  • Being the friend or family of someone at risk of opiate-related overdose, thus being able to respond in case of overdose; and
  • Being in the position to assist another person at risk of opiate-related overdose.

Naloxone is available under the statewide standing order, without a prescription, at the majority of retail pharmacies in North Carolina and is covered under most insurance policies. First signed in June 2016, North Carolina is the third state in the country to adopt a statewide standing order for naloxone. NaloxoneSaves.org provides a map and contact information for pharmacists that have indicated to NCDHHS they are offering naloxone under the statewide standing order. Pharmacies can be added to the map by submitting the form on NaloxoneSaves.org.

In addition, naloxone is available at many syringe services programs and local health departments across the state at no or low cost. Please visit naloxonesaves.org to find your nearest access point.

For any questions regarding naloxone access, training, or starting a naloxone distribution program, please contact naloxonesaves@gmail.com