North Carolina Safer Syringe Initiative

COVID-19 Information and Resources

SSP Essential Services Memo: This memo informs interested parties that the NC Division of Public Health considers syringe service programs an “Essential Business and Operation” under Governor Cooper’s Executive Order #121 “Stay at Home Order and Strategic Directions for North Carolina in Response to Increasing COVID-­19 Cases.

SSP COVID-19 Letter Template: Local programs can adapt this template for use in their communities. Agents and participants of syringe service programs are not required to carry letters with them to demonstrate that they are engaging in essential services. They are covered whether or not they carry a letter. However, they may carry the letter to communicate with law enforcement.


Welcome to the North Carolina Safer Syringe Initiative. Here you will be able to find information about existing syringe exchange programs in the state, resources for healthcare providers and law enforcement agencies, testing and treatment programs, details about the limited immunity provided under the syringe exchange law, and information for health departments, community-based organizations, and other agencies interested in starting their own exchanges.

Please click here for the list of active syringe services programs and contact information.

NC Safer Syringe Initiative Annual Report 2019-2020
NC Safer Syringe Initiative Annual Report 2018-2019


North Carolina Safer Syringe Initiative Assistance

As of July 11, 2016, North Carolina (G.S. 90-113.27) allows for the legal establishment of hypodermic syringe and needle exchange programs. Any governmental or nongovernmental organization “that promotes scientifically proven ways of mitigating health risks associated with drug use and other high risk behaviors” can start a syringe exchange program (SEP). The Division of Public Health and the Department of Health and Human Services do not operate syringe exchanges in North Carolina.

Included in the law is a provision that protects SEP employees, volunteers, and participants from being charged with possession of syringes or other injection supplies, including those with residual amounts of controlled substances present, if obtained or returned to a SEP. SEP employees, volunteers and participants must provide written verification (including a participant card or other documentation) to be granted limited immunity.

Syringe exchange 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
  • Site, personnel and equipment security, including annual written plans to police and/or sheriff’s departments within whose jurisdictions they operate
  • Education materials concerning:
    • Prevention of disease transmission, overdose and addiction
    • Treatment options, including medication-assisted therapy (MAT) and referrals
  • Naloxone (Narcan or Evzio) distribution and training, or referrals to these services
  • Consultations/referrals to mental health or substance use disorder (SUD) treatment

The law encourages syringe return to ensure that they are disposed in a safe and secure manner, but does not require participants to return used syringes.

Prior to commencing operations, NC SEPs are required to register with the NC Department of Public Health (DPH), by completing and submitting the form Starting a Syringe Exchange Program in NC to Each SEP is required to submit annual reports to DPH.

Treatment resources can be found through the Division of Mental Health, Developmental Disabilities and Substance Abuse Services. HIV and Hepatitis C testing and treatment resources can be found through the Communicable Disease Branch.

Please contact with any further questions.


NCSSI Annual Reports

2016-17 Annual Reporting Summary
2017-2018 Annual Reporting Summary: Building up and strengthening syringe exchange in North Carolina