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, referral to drug treatment, testing, and an array of other health services.
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 and obtaining authorization. The major changes to the previous law are:
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- 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.
- 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.
- 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.
- The number of mandatory core services has been reduced, which may enable smaller organizations to apply for authorization. Agencies seeking VDH funding, however, must still offer the full range of CHR services.
Authorized CHR Sites in Virginia
- Lenowisco Health District
- Daniel Hunsucker (276) 298-9957
- Mount Rodgers Health District
- Tammy Bise (276) 781-7450
- Health Brigade
- Colin King (804) 358-2437
- Council of Community Services
- Lisa Via (540) 982-2437
- Strength In Peers
- Jordan Fisher (540) 217-0869
- Chris Atwood Foundation
- Jason Purcell (703) 662-6076
- Virginia Harm Reduction Coalition
- Danny Clawson (434) 264-7510
- Minority AIDS Support Services
- Gwendolyn Ellis-Wilson (757) 247-1879

CHR Staff at Lenowisco Health District.
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Naloxone (Narcan) Partner Program
VDH is now offering free Naloxone to approved harm reduction partners
Virginia Opioid Resources
If you need assistance with substance use call:
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- National Helpline, 1-800-662-HELP (4357)
For questions about HIV or hepatitis contact the Virginia Disease Prevention Hotline at (800) 533-4148 or hiv-stdhotline@vdh.virginia.gov. For information about CHR programs, please email chr@vdh.virginia.gov.
Resources & Helpful Links
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- Naloxone (Narcan) Partner Program
- REVIVE! Opioid Overdose and Naloxone Education
- Curb the Crisis - Addiction Prevention and Recovery Resources
- VDH Opioid Dashboard
- CDC Program Guidance for Syringe Services Programs, 2016
- amfAR Fact Sheet on Public Safety, Law Enforcement, & Syringe Exchange
- FAQs for the Public
- FAQs for Providers
- Legislation Authorizing Comprehensive Harm Reduction in Virginia
- NASTAD Sex Worker and Harm Reduction Train the Trainer Resources (Zip File)
- Flu Shot Flyer (en Espanol)
Information for Agencies Seeking Approval to Operate a CHR Program
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- VA CHR Program Authorization Application
- Mid-Atlantic AIDS Education and Training Center-Inova Health System
- Mid-Atlantic AIDS Education and Training Center-Virginia Commonwealth University
- Virginia HIV/AIDS Resource and Consultation Centers
- OHSA Bloodborne Pathogens Standards (29 CFR 1910.1039)
- CDC Guide to Infection Prevention in Outpatient Settings: Minimum Expectations for Safe Care
- USPHS Guidelines for Management of Occupational Exposure
Last Updated: March 10, 2023