Harm Reduction Resources in Orange County

What is harm reduction?

In general, the purpose of harm reduction is to decrease the likelihood of risky behavior. Almost everyone engages in risky behavior and employs harm reduction methods, too – we drive cars and wear seatbelts, we ride bikes and wear helmets, we take long walks in the woods and wear supportive shoes and bug spray, we go to the beach and wear sunscreen, for example.

In the context of substance use, harm reduction methods involve accepting that abstaining from drug use is not going to be a step that everyone is ready or willing to take, now or possibly ever, and taking steps to make them safer. Harm reduction seeks to prevent damage and disease, and increase public health overall by pinpointing risk and mitigating that risk.

Some harm reduction methods include safe syringe programs where substance users can get sterile safe needles to reduce the spread of disease in the community, naloxone distribution and training for overdose prevention, medication assisted treatment (methadone and buprenorphine), distribution of test strips to check for unwanted substances, and outreach to substance users to educate them about these programs and make connections to treatment if desired.

Harm reduction methods keep the community as a whole safer. Safe syringe programs reduce the number of contaminated needles in the community in general by making sterile needles widely available and making disposal of used needles safe and easy.

Harm reduction seeks to “meet people where they are”, provide the tools that they need to be safe and keep the community safe in the moment, and to build relationships in order to be available to help support as needed in the future.

Harm Reduction in General

NC Harm Reduction Coalition:

North Carolina Harm Reduction Coalition (NCHRC) is a statewide grassroots organization dedicated to the implementation of harm reduction interventions, public health strategies, drug policy transformation, and justice reform in North Carolina and throughout the American South.

NCHRC engages in grassroots advocacy, resource and policy development, coalition building, and direct services for people impacted by drug use, incarceration, sex work, overdose, gender, HIV and hepatitis. NCHRC also provides resources and support to the law enforcement, public health and provider communities.


Naloxone Saves:

A harm reduction resource for North Carolina. Includes information on how to get Naloxone, treatment options, harm reductions methods, and information for pharmacists.


Human Rights Watch Advocacy Brief (2011): 

We Know What to Do: Harm Reduction and Human Rights in North Carolina. This was written before syringe exchange programs were legalized, so some information is outdated but it’s a very good overview on harm reduction methods and the impact that syringe exchange programs have.


NCDHHS Syringe and Naloxone Access

Information from North Carolina Department of Health and Human Services about their harm reduction work – including information on the NC Safer Syringe Initiative and information on how to access Naloxone.


National Harm Reduction Coalition

The National Harm Reduction Coalition site includes detailed information on what harm reduction is, principles of harm reduction, training materials, and resources.


Where to get Naloxone in Orange County:

If you or a person you spend time with is an opioid user, it can be useful to have a Naloxone (name band Narcan) kit available to reverse an opioid overdose. Naloxone works by blocking the opioid receptors and reversing the overdose. Narcan kits are available in a nasal spray (most common) or injectable and come with instructions and training.

Orange County Harm Reduction Resources Flyer

Orange County Health Department

Offers free Naloxone kits and training by appointment at 2 locations:  Call (919) 245-2400 for an appointment.      

  • Whitted Human Services Center, 300 West Tryon Street, Hillsborough, NC 27278 Tuesday 9:30-6:30, Friday 8:00 to 12:00.
  • Southern Human Services Center, 2501 Homestead Road, Chapel Hill, NC 27516 Monday 8:00-5:00, Wednesday 10:00-5:00, Thursday 8:00-5:00.
  • https://www.orangecountync.gov/1780/Overdose-Prevention

Orange County Emergency Services    

If you are over 18 you can request a Narcan kit from any active Orange County ambulance.

Orange County Detention Center

There is a vending machine in the lobby of the Orange County Detention Center that dispenses free Narcan to the community. The vending machine is located in the lobby of the Orange County Detention Center at 1200 US-70 West, Hillsborough NC (across from the DMV) and is available to the public 24 hours/day.

This vending machine also dispenses free Fentanyl and Xylazine test strips to check for their presence in substances.

Orange County Southern Human Services Center

There is a vending machine at the Orange County Southern human Services Center that dispenses free Narcan to the community. The vending machine is located in the lobby of the Orange County Southern Human Services Center at 2501 Homestead Road, Chapel Hill, NC 27516 and is available to the public during regular business hours.

This vending machine also dispenses free Fentanyl and Xylazine test strips to check for their presence in substances.

The North Carolina Harm Reduction Coalition

The NCHRC offers Naloxone for the following groups of people: active IV drug users, people on medication-assisted treatment, people who are formerly incarcerated with a history of opiate use, people engaged in sex work or people who identify as transgender. If you fit these criteria and would like access to a kit, please contact Loftin Wilson at loftin@nchrc.org.

Lantern Project – Orange County Criminal Justice Resource Department

The CJRD Lantern Project distributes Naloxone kits to justice involved individuals in Orange County. If you are a program participant, ask your social worker for a kit. If you are not a participant, contact us for information.

Local Pharmacies: You can purchase Narcan without a prescription at several local pharmacies.

 General info on naloxone access in NC from Naloxone Saves:


Alliance Health Naloxone Resource Guide

This guide is geared towards providers, but contains useful information: https://www.alliancehealthplan.org/providers/network/program-resources/medical-and-pharmaceuticals/naloxone-resource-guide/

NCDHHS Naloxone Distribution Toolkit

This toolkit is intended for local health departments, coalitions, and other community organizations and includes detailed information on law and policy for Naloxone distribution. https://www.ncdhhs.gov/media/8091/download

NCDHHS Naloxone FAQ:

Answers to frequently asked questions about Naloxone from NC DHHS https://www.ncdhhs.gov/media/8092/download

Where to Get Safe Syringes in Orange County?

The Orange County Health Department

offers a package of 20 free clean syringes for pickup and a disposal bins for used syringes. No appointment needed. Walk-ins welcomed Monday - Friday 8:30am -4:30 pm. Please note hours of operation can fluctuate, call in advance.    

Orange County Emergency Services             

If you are over 18 you can request a sterile syringe kit from any active Orange County ambulance. If you have syringes to dispose, they can be disposed of in the sharps container inside the ambulance.

Student Action Health Coalition (SHAC)

The SHAC team distributes harm reduction supplies including syringes, bandages, antibiotic ointment, masks, hand sanitizer, and Narcan at IFC in Carrboro on the First and Third Tuesday of every month. The also offer safe disposal of syringes.

IFC (Inter Faith Council)
110 W. Main Street
Carrboro, NC 27510


NC Harm Reduction Coalition (NCHRC)

Contact: Loftin Wilson; (919) 370-0671; loftin@nchrc.org

Mobile exchange on Wednesdays 1pm-6pm, call or text for locations.

Fixed-site exchange on Fridays, 3:00 – 6:00 pm at 1209 N. Elizabeth St in Durham, inside the office of Recovery Community of Durham

They offer the following services:

  • Sterile syringes and injection supplies
  • Safe syringe disposal and biohazard containers
  • Naloxone and overdose prevention training
  • Fentanyl tests for drug-checking
  • Safer sex supplies
  • Safer snorting and smoking supplies
  • Wound care and hygiene supplies
  • Peer support and linkage to care
  • Testing for HIV/HCV/HBV/syphilis
  • Masks and hand sanitizer

Starting Point Rural Harm Reduction Collective

  • Startingpointrhrc@gmail.com
  • Mobile delivery available 7 days a week. Call or Text (919)590-9512 for delivery
  • They offer safe syringes, and safe syringe disposal and deliver anywhere in Orange County, NC.

Safe Injection advice from NC Harm Reduction Coalition: 


NCDHHS North Carolina Safer Syringe Initiative

 information about safe syringe exchange programs in North Carolina: https://www.ncdhhs.gov/divisions/public-health/north-carolina-safer-syringe-initiative

Pharmacies that sell syringes without a prescription

  • Carrboro Family Pharmacy:  Carrboro Plaza, 104 NC-54 suite J, Carrboro, NC 27510, (919) 933-7629
  • Hillsborough Pharmacy & Nutrition: 110 Boone Square St, Hillsborough, NC 27278, (919) 245-1212
  • Tarheel Town Pharmacy: 370 E Main St Ste. 160, Carrboro, NC 27510, (919) 240-7827
  • Walgreens on Environ Way off 54: 1106 Environ Way, Chapel Hill, NC 27517, (919) 942-8738

Harm Reduction Laws

People may be afraid to administer naloxone due to concerns about liability if they make a mistake, or to ask for needed help due to concerns about legal implications of “outing” themselves to authorities as substance users. There are a few laws that address these concerns directly. Here are some resources that discuss laws related to harm reduction measures.

How to Recognize an Opioid Overdose 

How to Recognize an Overdose

Substance Test Strips 


As explained by the Centers for Disease Control and Prevention, there are two types of fentanyl: Phamaceutical fentanyl and illegally made fentanyl. Both are synthetic opioids but most recent cases of fentanyl-related overdoses are linked to illegally made fentanyl. See the CDC's page for more facts about this. 


Xylazine is a non-opioid-sedative or tranquilizer, not approved to be used in people, that has increasingly found its way into many drugs.  Xylazine poses many health risks and has been linked to overdose deaths, as well. Fentanyl mixed with xylazine has been declared an emerging threat by the White House’s Office of National Drug Control Policy. Read more about Xylazine at the CDC's page.

The Orange County Criminal Justice Resource Department has free fentanyl and xylazine test strips to check for their presence in drugs. These test strips are distributed through vending machines at the Orange County Detention Center and the Orange County Southern Human Services Center.

Orange County Detention Center

1200 US-70 West, Hillsborough NC (across from the DMV), available to the public 24 hours/day

Orange County Southern Human Services Center

2501 Homestead Road, Chapel Hill, NC 27516, available to the public during regular business hours.

More information on xylazine:

Xylazine in the drug supply

Xylazine wounds and overdose

Xylazine wound care

Drug Checking – A Promising Public Health Response to a Tainted Drug Supply

Rapid Response Xylazine Test Strip

What are some Opioid Use Disorder and Substance Use Disorder Resources in North Carolina?

You may find information on Opioid and Substance Use Disorder resources by county by visiting the Disability Rights North Carolina website here.

Additionally, you may become informed about you rights concerning Substance Use Disorders and Access to Healthcare Services by reviewing this document provided by Disability Rights North Carolina.