Comprehensive Harm Reduction

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.

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 because of injection drug use. On November 21, 2016, State Health Commissioner Marissa J. Levine declared the Virginia opioid addiction crisis a public health emergency.

Jurisdictions eligible to provide Comprehensive Harm Reduction (CHR) services in 2018 were determined using an enhanced selection method.   Previously, the selection of jurisdictions was based on case rates per 100,000 individuals for thirteen opioid indicators.   This method excluded some densely populated areas of the state, which have large case counts, but low case rates compared to less populated areas.  To provide services to those most affected by the opioid epidemic, VDH decided to use both case rates and case counts to determine jurisdictions eligible to provide CHR services.  The Secretary of Health and Human Services and the Secretary of Public Safety and Homeland Security approved the change in selection criteria. All agencies interested in providing CHR services must complete an application process (see links below).

Authorized CHR Sites in Virginia

  • Health Brigade
  • Lenowisco Health District
  • Mount Rogers Health District
    • Contact: Breanne Forbes-Hubbard, (276) 685-0412
  • Council of Community Services

For general information on opioid addiction:  

If you need assistance with substance use:  

For questions about HIV or hepatitis contact the Virginia Disease Prevention Hotline at (800) 533-4148 or  For information about CHR programs, contact Bruce Taylor at or (804) 864-8015.

For more information about Comprehensive Harm Reduction programming or syringe services, please contact Bruce Taylor, Drug User Health Coordinator, at

Last Updated: July 13, 2020.