In 1995, an NGO working in the Spanish Bilbao prison, which has 250 male prisoners, initiated an NSP.  This model was preferred to dispensing machines because the NGO was already working in the prison and offered the possibility of providing health education information. All prisoners and staff received information on the programme, which was established in two discreet locations.

The service was available five hours per day. Prisoners received injection kits (similar to the ones available in pharmacies) containing a syringe, distilled water, disinfectant swipe, a condom and a hard container for carrying the used needles. The evaluation indicated that the prisoners trusted the system and no prisoner had lost any privilege due to their participation in the programme. Prison staff did not report any security problems. The programme allowed for referral to drug dependence treatment. While the programme was not run on a one-for-one exchange basis, the planning committee’s target was an 80% exchange rate, which was achieved.