The organizations listed in the NASEN Directory represent a highly selected subset of SSPs operating in the North America. The NASEN Directory is not, nor has it ever claimed to be, a comprehensive listing of all SSPs operating in the United States. In that way, we can see what sorts of inferences can and, importantly, cannot be made using data derived from this source. In particular, it is crucial for those who may seek to analyze directory information to understand what the NASEN Directory represents, and what it does not. In response to the many inquiries we have received about the directory-and the many misconceptions of what the directory represents that have fueled those inquiries-Dave Purchase Project would like to clarify the procedures through which the directory has been generated and maintained, as well as changes to those procedures over time. Recently, more public attention has been given to the NASEN Directory. The NASEN Directory, started in 1992, is the oldest and most comprehensive list of SEPs in the United States. NASEN also maintains an online directory of syringe services programs (SSPs) in the United States, U.S. Today, Dave Purchase Project (named for its founder) continues to operate the Tacoma Needle Exchange as well as the North American Syringe Exchange Network (NASEN), a program that supports operational SSPs through loan assistance, fiscal sponsorship, program start-up kits, and lower-cost harm reduction supplies through the NASEN Buyers Club. In 1988, Dave Purchase, began distributing syringes in his hometown of Tacoma, Washington, paving the way for the first legally operating SSP in the United States.
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