I'm not sure if needle exchanges operate this way in general, but that was definitely the policy where I volunteered. FWIW, the ten needle limit without trade-ins didn't stop the incessant bitching by cracked out people, and lots of people would walk around collecting needles for a few minutes waiting for us to arrive so they could get extras, so there is definitely still a value to the used needles. The vast majority of people brought in (some of) their old needles. Still, I myself am definitely not sold on this being the best system.

If you don't have a 10 needle freebie, for a newcomer the incentives are exactly the same as if there is no needle exchange whatsoever. This means the same secondary market applies to these people, at least until they find out they can collect needles in a water bottle or something. Maybe the better way would be to give 10 needles or X needles where X is the exchange amount, whichever is larger. This would have the negative effect of pissing confused drug addicts off, however.

It's a tricky issue, but the fact that most stable addicts always had an additional 10 needles thrust upon them was not a comforting one.

Not my experience. There are numerous 'models' of needles out there, but at least 95% of the ones we picked up came straight from our program. The people who just got their first fix of the day just don't think like that some of the time.


And here's a curveball: some of the people who regularly used the program weren't even using the needles themselves, but actually were running an underground "shooting gallery" in their houses or wherever. How do we feel about that?

This is a benefit of the program then.
The exchange rewards you for being responsible and bringing the dangerous dirty needles in. You have to get the original needles yourself somehow.

Same story. It's more work and more responsible to make sure the needles are disposed of properly so I would like to see that behavior rewarded.

BTW: Prescriptions are needed for needles in 7 states (AK, CN, DA, ME, MA, NJ, PA)

I don't disagree with you. I was just walking through the logic of the different philosophies in whether to give away some and exchange others, or purely an exchange.

Another more practical reason for ten needles free is that when you're out on the street it's tough to tell a jonesin' addict they can't have a needle.