The report discusses an increased interest in syringe exchange in the United States and describes the way it works and is evaluated, its potential for effectiveness, and the controversies and legal issues surrounding implementation of syringe exchange. Between 750,000 and 1.5 million people inject drugs in the United States, and 250,000 to 300,000 of these users are HIV positive. State laws on drug paraphernalia and syringe prescription drugs hinder legal implementation of needle exchange programs, but courts in California, Massachusetts, and New York have failed to convict people who conduct these illegal needle exchange programs. At least six States proposed changes in their drugs laws in 1992 to allow legal access to syringes. Evidence from programs operating in England, Scotland, the Netherlands, and Australia shows that syringe exchanges promote "safer" drug use. Available studies show that such programs also have residual effects such as helping addicts get treatment. 37 references