LESNEP Logo in 1993

LESHRC and Syringe Exchange History

Needle exchanges started in the 1980s in Rotterdam, Holland to address the growing spread of Hepatitis among injection drug users.  The effectiveness of that program opened the eyes of other nations to a possible solution to their growing Hepatitis, and now HIV, issues.

In the early 80’s at the start of the AIDS epidemic, a group of epidemiologists identified who in New York was going to be devastated by HIV/AIDS. They identified the gay community, injection drug users, people of color, people who sell sex for drugs or money, and the homeless.  This group of people was quickly labeled the "Throwaway Class".

In 1987 Mayor Koch started the first needle exchanges in NYC to address the growing epidemic.  Unfortunately with the change in administration, needle exchange programs were banned. 

Lower East Side Harm Reduction Center (LESHRC) traces its origins to the early 1990s and the AIDS Coalition to Unleash Power (ACT UP).  During this period, needle exchange continued to be illegal in New York State.

ACT UP initiated an underground needle exchange program in the Lower East Side of Manhattan in February 1990 and called it the Lower East Side Needle Exchange Program (LESNEP), catering to the high prevalence of injection drug users in the area. In LESNEP's early beginnings, local residents, IDUs, and non-drug users all played an integral role in selecting needle exchange sites, forming teams of volunteers to exchange needles and act as "look outs" to warn those involved of nearby police.  

ACT UP march on Washington in 2005In 1991, LESNEP combined forces with the Lower East Side AIDS Strategy Group (LESASG), a local consortium of HIV / AIDS service providers, founded by Raquel Algarin.  Together, LESNEP and LESASG provided outreach services including needle exchange, education of safe-use practices, and distribution of information regarding preventive HIV / AIDS strategies.

In 1992, ACT UP decided the only way to change the laws around needle exchange would be to break them and challenge them in court.  They performed a variety of activities to highlight AIDS as a national issue such as organizing marches in midtown Manhattan and confronting political leaders at town hall meetings. ACT UP activists and supporters also challenged the legality of the New York State syringe possession laws.  NYC Courts made a landmark ruling in favor of ACT UP, citing the medical necessity of syringe exchange in curbing the rising HIV / AIDS epidemic.

In May 1992, the State Health Commissioner waived the restrictions on Section 3381 of the New York State public health law, which prohibits the sale, possession, and distribution of syringes without a prescription, to allow syringe exchange programs to obtain, possess, and distribute hypodermic syringes and needles without prescription for the purpose of preventing the transmission of HIV.

Lower East Side Needle Exchange Program “officially” opened its doors at 39 Avenue C in 1992.   With mission in hand, our first Executive Director Allan Clear, staff and volunteers began the important work of addressing the HIV/AIDS epidemic on the Lower East Side.  With meager beginnings, LESNEP provided syringe exchange, outreach, mobile health services, case management, and peer groups.

Harm Reduction and Syringe Exchange was not widely accepted nor embraced.  Staff and volunteers struggled with community boards, police, store owners and local residents.  Located around “known” drug spots, authorities and residents felt that the exchange was there solely to promote drugs and drug use.

In 1994, the Needle Exchange Program, with the assistance of Trinity Lutheran Church received its 501(c)(3) IRS determination as a not-for-profit organization and officially change its name to Lower East Side Harm Reduction Center (LESHRC).


Watch our staff and residents talk about Harm Reduction on the Lower East Side in 1994:

Junk TV: Harm Reduction on the Lower East Side: Part I


Junk TV: Harm Reduction on the Lower East Side: Part III

The community doing their part to inform about our move


The need to acquire more space became an issue early in the history of LESHRC.  In 1999 steps were taken to address the space needs.  After a short search, a site was found and renovations began immediately at 25 Allen Street.

With a new space, LESHRC quickly expanded its programs and services.  As syringe exchange effectiveness became apparent, additional funding began to become available.  We currently offer syringe access, health services, testing, overdose prevention, mental health services, case management, substance use counseling, housing services, and much more.

None of the positive changes that have happened in syringe exchange, at LESHRC and to our participants, could have happened without the hard work of our dedicated and committed staff members, volunteers, peers and supporters, past and present.  LESHRC will continue its spirit of advocacy and fight for the rights of the disenfranchised and marginalized – the “Throwaway Class.” 

New York Through the Eye of a Needle: State of the Lower East Side in 1992 (PDF)177.91 KB