der the rubric of public health law. Philadelphia, Cleveland, Los Angeles, San Francisco and six other counties or cities in California conduct syringe exchange based on their public health powers under state and local law…” Despite they are not legal under state drug laws, the needle exchange programs have been accepted and voted on in accordance with experts, where “…legal advisors in 13 cities and counties have found it equally reasonable to conclude that syringe exchange, conducted under public health auspices, is authorized under public health law and not prohibited by drug law…” In spite of the fact that except Swiss, these programs are not fully protected under the law, and users consuming drugs can be arrested and prosecuted, they are put in place by the local governments so as to try and reduce this harm. .
An important part of the needle exchange programs is to make sure that they not only prove some type of success, but also that they are not linked to other vices. In order to evaluate this, many different experts have tried to measure and chart the effectiveness of the program. Unfortunately, this is an extremely difficult task, as users can contract diseases not only from sharing needles, but from other activities. Literature says that there is a very positive effect of the needle exchange programs. For instance, according to Gibsona, “…of the 42 studies reviewed here, 28 found positive effects associated with use of syringe exchange, two found negative associations, and 14 found either no association or a mix of positive and negative effects…” Gibsona’s study shows that the programs help keep the users safe from blood borne diseases. But then, there is the question of whether or not the Needle Exchange Programs lead to any other vices. Usually, drug use can be linked to other vices such as prostitution and gambling, but because these programs are made to keep users in a clean and usually supervised environment, this would be more unlikely. Drugs are not consumed in a place where other vices may occur, or there is some type of temptation to commit other criminal acts. Instead, these institutions implementing the programs are reputable and not linked to other types of criminal activities. 
However, when we examine the needle exchange program, there are not only benefits but also drawbacks. According to some researchers, the biggest drawback is the fact that some people feel it is wrong and should not exist. The needle exchange programs can be under fire by some in certain communities. They feel that by allowing this may imply
 Csete, J., & Grob, P. J. (2012). Switzerland, HIV and the power of pragmatism: lessons for drug policy development. International Journal of Drug Policy, 23(1), 82-86.
 US Centers for Disease Control. (2005, July). Syringe Exchange Programs. Morbidity and Mortality Weekly Report, 54, 673.
 Susser, M., & & Staff. (1995, January). Harm Reduction- A Framework for Incorporating Science into Drug Policy. American Journal Of Public Health, 85(1).
 Burns, S., JD., Finucane, D., JD., Gallagher, H., JD., & Grace, J., JD. (1996, August). The Legal Strategies Used in Operating Syringe Exchange Programs in the United States. Health Law and Ethics, 86.
 Gibsona, D. R., Flynna, N. M., & Perales, D. (2001, Fall). Effectiveness of syringe exchange programs in reducing HIV risk behavior and HIV seroconversion among injecting drug users. AIDS 2001, 15:1329±1341.