Peer delivered needle and syringe programmes

This article explains the different ways in which injecting drug users can get involved in the distribution of injecting equipment in order to maximise the effectiveness of needle and syringe programmes.

By involving current and former injecting drug users, Needle Exchanges and Needle and Syringe Programmes can harness the access wider networks, and at it's simplest this simply means giving people in contact with services enough equipment for themselves and the people they know. By doing this, services will reach levels of coverage that are not possible if services insist on seeing everyone they give equipment to.

In some areas - probably most notably in Australia - this has been taken one step further with current and former drug users running and delivering services. There are subtle but important differences in the way that services are delivered. To help further the debate in the UK we have outlined the meaning (as we understand it) of the terms that are used.

  • Peer led - should mean that current/former injectors are in charge of the scheme (but may not be delivering all aspects of it);
  • Peer delivered - means current (or possibly ex, although if people are ex-drug injectors, it is important that they are seen as peers by service users, or it's not 'peer delivered') injectors are doing the needle exchanges, but may be part of a service that is not peer led;
  • Peer led and peer delivered - the model with the greatest potential, and the greatest risks, and certainly the most difficult to build the infrastructure for and to get the necessary support to sustainably deliver.

In Australia they've been much more deliberate about funding and supporting peer led and peer delivered needle and syringe provision - it's a model that has great potential for improving coverage and getting syringes to margianlised groups.

There are risks with structuring services in this way, but it does often seem to be the case that people tolerate serious shortcomings in service delivery from services run by professionals much more readily than they tolerate shortcomings in services run by users. There are challenges raised by setting up services using peer led and/or peer delivered, but the potential benefits mean that we should be prepared to deal with these rather than giving up at the first hurdle.


Exchange Supplies,
1 Great Western Industrial Centre,
Dorchester, Dorset DT1 1RD, UK

01305 262244