Comprehensive Harm Reduction

Photo of the back of a t-shirt used by CHR staff. The shirt includes advice such as always having Narcan on hand and having a safety plan.
CHR Outreach Staff

What is Comprehensive Harm Reduction?

Comprehensive Harm Reduction (CHR) is a set of public health services. CHR is designed to reduce the negative impact of drug use. It helps prevent HIV, hepatitis C, other infections, overdose and death. It is intended for those who are unable to, or not ready to stop using drugs. CHR may also be called syringe services or needle exchange. Yet, CHR programs provide much more than just needles and syringes.

    • CHR includes:
    • the distribution of sterile and disposal of used hypodermic needles and syringes,
    • naloxone to reverse overdoses,
    • education,
    • peer support,
    • referral to drug treatment,
    • testing for HIV and hepatitis, and
    • linkage to medical care and support services.

Those receiving services from CHR sites have protection from prosecution for possession of paraphernalia acquired through programs.

CHR Sites

You can find a map of sites authorized to provide CHR services below.  Click on the pins/buttons around the map to access the CHR site information.  This will bring up location details for each site.  All CHR site are listed on the map.

CHR staff contacts and their phone numbers are given when you click on a site pin/button.  Please contact CHR staff for specific questions and needs such as service hours, etc.  Some sites offer mobile outreach in areas adjacent to their physical location.  If you are unable to make it to their physical location, please contact them and ask if they offer mobile services.

Please note: if you are a Virginia state employee viewing this page you may have issues viewing the site map if you have your agency profile logged into the browser.  Open this page in a new browser or log your profile out for the map to load accurately.  State employees needing additional help accessing the site map, please email Chris Barnett at christopher.barnett@vdh.virginia.gov.

Resources and Helpful Links

Virginia-Specific Resources

National Helpline

    • For help with substance use, call the National Helpline at 1-800-662-HELP (4357)

Fact Sheets/Frequently Asked Questions (FAQs)

Contact Us

For questions about HIV or hepatitis contact the Virginia Disease Prevention Hotline at (800) 533-4148.  You can also email the hotline at hiv-stdhotline@vdh.virginia.gov.

For information about CHR programs, contact chr@vdh.virginia.gov.

Information for Interested Sites

Comprehensive Harm Reduction (CHR) sites must be authorized by the State Health Commissioner.

CHR standards and application materials are available on this page.  As of July 1, 2020, organizations wishing to conduct CHR programs will have fewer restrictions in establishing services/obtaining authorization.   The major changes to the previous law are:

    1. CHR sites can be established in any jurisdiction in Virginia.  The previous law allowed sites only in specific communities at greatest risk for a hepatitis C or HIV outbreak.
    2. Potential sites are no longer required to obtain letters of support from law enforcement, local government, and the local health director in order to apply.
    3. CHR program participants now have protection from prosecution for possession of paraphernalia acquired through the program. Previously only CHR site staff and volunteers had this protection.
    4. The number of mandatory core services has been reduced.  This enables smaller organizations to apply for authorization. Agencies seeking VDH funding, however, must still offer the full range of CHR services.

Naloxone (Narcan) Partner Program

VDH offers free Naloxone to approved harm reduction programs.

Learn more about the program and how to apply.

Contact Us

For additional information about the CHR site application process, or to check on a submitted application, contact chr@vdh.virginia.gov.

Last Updated: January 30, 2025