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Developing Safe Syringe Exchange Programs

Role of the North Carolina Division of Public Health

Novick, Lloyd F., MD, MPH; Staley, Danny, MS; Novick, Carole G., BS

Journal of Public Health Management and Practice: July/August 2019 - Volume 25 - Issue 4 - p 390–397
doi: 10.1097/PHH.0000000000001003
Case Study

Syringe exchange programs became legal in North Carolina on July 11, 2016. A combination of forces led to this progressive public health measure, including advocacy of the State Health Official, in a state characterized by a conservative political climate. Data collected by the division of public health were a key contributor to the initiative. Nearly 5 North Carolinians died each day from unintentional medication or drug overdose. High rates of coinfection including hepatitis B and C, human immunodeficiency virus, and endocarditis were shown to have substantial economic consequences. The North Carolina Harm Reduction Coalition and use of Moral Foundations Theory in crafting messages were important in influencing legislation. North Carolina now has 30 active syringe exchange programs serving 40 counties. Individuals using intravenous drugs who take advantage of these syringe exchange programs are provided with clean needles to not only help prevent the spread of illness but also learn more about safe health practices.

Department of Public Health, East Carolina School of Medicine, Greenville, North Carolina (Dr Novick); Caribbean Operations, Association of State and Territorial Health Officials (ASTHO), Arlington, Virginia (Mr Staley); and Formerly, Medical & Health Sciences Foundation, East Carolina University, Greenville, North Carolina (Ms Novick).

Correspondence: Lloyd F. Novick, MD, MPH, 70 Forest St 17D, Stamford, CT 06901 (

The authors acknowledge the critical review and substantial contributions of Gene Matthews, JD, UNC Gillings School of Public Health, and Mike Fraser, PhD, chief executive director of the Association and State and Territorial Health Officials (ASTHO).

The authors declare no conflicts of interest.

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