NEED volunteer

Based in Berkeley, California, NEED is unique among needle exchange programs because we are a volunteer-based collective. We started in September 1990 by a group of HIV+ persons, people in recovery, and health activists as an underground program operating out of a baby carriage on the corner of Hearst and San Pablo Avenues in Berkeley.

Currently, we operate from a black van with our logo and title written on the side at three neighborhoods sites each week. We offer free, anonymous services in a client-centered manner, and we are dedicated to the prevention of infectious diseases and to improving the physical, spiritual, and political health of drug users. We also offer overdose prevention began an overdose prevention and education component to address the rising number of overdoses among injection drug users.


Across the street from our Sunday site, the Berkeley Free Clinic provides free, anonymous hepatitis testing and vaccination. We provide information and referrals for medical, housing, social support and treatment programs.


In an average week, NEED has approximately 50 service contacts and distributes over 11,000 syringes. However, clients still report being afraid of targeting by police while traveling to or from an exchange site. As a result, many of NEED's contacts occur through secondary exchangers, or individuals who come to obtain syringes for themselves and others who are unable to come to site. According to a NEED client input survey, made possible by the California Endowment (2004), our average participant exchanges syringes for five other persons, meaning NEED actually makes closer to 245 service contacts in an average week. We have been able use secondary exchange as an effective way to reach out to communities that were previously inaccessible. Aggregate utilization data show that NEED exchanges over 600,000 syringes annually!


We carry five different types of syringes, including syringes for individuals who inject steroids and hormones. In addition to carrying an assortment of harm reduction supplies, we also have tables of additional resources for clients, including safer-sex supplies. A fundamental part of NEED's mission is responding to the needs of our participants. NEED is still a volunteer-run collective, with deep and effective connections in the user, medical, public health research, and recovery communities. We constantly strive to respond to the actual needs of users, their friends, and families in the community, by improving and changing our services in response to client feedback.

NEED Now and Then — A Timeline