This article by Jamie Bridge describes some of the issues and problems facing needle exchange services and staff in the UK. An audit of needle exchanges in the UK showed the extent of the "postcode lottery" that exists in terms of service coverage and quality. The article (from Druglink magazine - the bi-monthly publication from DrugScope in the UK) describes what needs to be done in order to take needle exchange into the next era and rise to the challenges of rising HIV and hepatitis C prevalence amongst the country's injecting drug users.