Studies of needle exchange programs in Vancouver and Montreal have been used by opponents to assert that needle exchange programs do not work. 

That was not the conclusion of Bruneau and Schechter, authors of the Vancouver and Montreal studies.  Instead, Bruneau and Schechter called for an expansion of needle exchange programs in their cities, a recommendation which their local governments followed.^{(1), (2)}

The Canadian situation with regard to syringe availability is very different from that in the United States.  According to Julie Bruneau:

Needle exchange programs are legal and fully implemented in both urban and rural areas in Canada.  Syringes are widely available in pharmacies, and the concept of optimal syringe accessibility for injecting drug users is accepted and integrated in public health policies in Canada.⁽³⁾

Footnotes

(1)	Julie Bruneau and Martin T. Schechter. 1998. "The politics of needles and AIDS." New York Times, April 9.
(2)	For the academic research discussing what happened in Vancouver and Montreal, see:
	Montreal and Vancouver
	Satcher, David, Surgeon General, 2000, "Evidence-based findings on the efficacy of syringe exchange programs: an analysis of the scientific research completed since April 1998", Review dated March 17.   Ricky N. Bluthenthal, Alex H. Kral, Lauren Gee, Elizabeth A. Erringer and Brian R. Edlin, 2000, "The effect of syringe exchange use on high-risk injection drug users: a cohort study," AIDS, vol. 14, pp.605-611.
	Montreal
	Julie Bruneau, N. Lachance and others, 1999, "Changes in HIV seroconversion rates of IDUs attending needle exchange programs in Montreal: The Saint-Luc Cohort," Canadian Journal of Infectious Diseases, (Supplement) May. (Abstract)
	Robert S. Remis, Julie Bruneau, and Catherine A. Hankins, 1998, "Enough sterile syringes to prevent HIV transmission among injection drug users in Montreal?" Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, vol. 18 (supplement 1), pp. S57-S59.
	Julie Bruneau, Eduardo Franco, and Francois Lamothe, 1997, "Assessing harm reduction strategies: the dilemma of observational studies," American Journal of Epidemiology, vol. 146, no. 12, pp. 1007-1010.
	Peter Lurie, 1997, "Invited commentary: le mystere de Montreal," American Journal of Epidemiology, vol. 146, no. 12, pp.1003-1006.
	Julie Bruneau, Francois Lamothe, Eduardo Franco, Nathalie, Lachance, Marie Desy, Julio Soto, and Jean Vincelette, 1997, "High rates of HIV infection among injection drug users participating in needle exchange programs in Montreal: results of a cohort study," American Journal of Epidemiology, vol. 146, no. 12, pp. 994-1002.
	Vancouver
	M. T. Schechter, S.A. Strathdee, P.G..A. Cornelisse, and others, 1999, "Do needle exchange programs increase the spread of HIV among injection drug users?: an investigation of the Vancouver outbreak, AIDS, vol. 13, pp. F45-F51. (Abstract)
	Chris P. Archibald, Marianna Ofner, Steffanie A. Strathdee, David M. patrick, Donald Sutherland, Michael L. Rekart, Martin T. Schechter, and Michael V. O'Shaughnessy, 1998, "Factors associated with frequent needle exchange program attendance with injection drug users in Vancouver, Canada,  Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, vol. 17, pp. 160-166.
	Steffanie A. Strathdee, David M. Patrick, Sue L. Currie, Peter G. A. Cornelisse, Michael L. Rekart, Julio S. G. Montaner, Martin T. Schechter, and Michael V. O'Shaughnessy, 1997, "Needle exchange is not enough: lessons from the Vancouver injecting drug use study," AIDS, vol. 11, pp. F59-F65.
(3)	Julie Bruneau, Eduardo Franco, and Francois Lamothe, 1997, "Assessing harm reduction strategies: the dilemma of observational studies," American Journal of Epidemiology, vol. 146, no. 12, pp. 1007-1010.
For a list of other materials used on this website, see References.