Comprehensive Harm Reduction

CHR Eligibility Map.
CHR Eligibility Map. Click on image to enlarge.

Comprehensive Harm Reduction (CHR) is a set of public health strategies intended to reduce the negative impact of drug use including HIV, Hepatitis C, other infections, overdose and death among people who are unable or not ready to stop using drugs.

CHR includes the distribution of sterile and disposal of used hypodermic needles and syringes, education, and referral to drug treatment, testing, and an array of other health services.

Effective July 1, 2017, the Code of Virginia Section 32.1-45.4, authorizes the State Health Commissioner to establish and operate local or regional comprehensive harm reduction programs during a public health emergency. Such programs shall be located in communities where data indicate a risk of transmission of, or increases in the transmission of, HIV, viral hepatitis, or other blood-borne disease as a result of injection drug use. On November 21, 2016, State Health Commissioner Marissa J. Levine declared the Virginia opioid addiction crisis a public health emergency.

All agencies interested in providing CHR services must complete an application process.

For general information on opioid addiction:  Opioid Addiction in Virginia.

If you need assistance with substance use:  VaAware-Addiction Prevention and Recovery Resources  or call the National Helpline, 1-800-662-HELP (4357)

For questions about HIV or Hepatitis call: Division of Disease Prevention Hotline at 1 (800) 533-4148 or by email at

Information for Agencies Seeking Approval to Operate a Comprehensive Harm Reduction Program

Resources & Helpful Links

For more information about Comprehensive Harm Reduction programming or syringe services, please contact Elaine Martin, Director of HIV Prevention Services, at