The Needle and Syringe Exchange Programme (NSEP) in Malaysia is a fully Government-supported programme carried out multi-sectorally to reduce the spread of HIV/AIDS among drug users. However, NSEP contravenes the Malaysia Dangerous Drugs Act for which the enforcement is under the purview of the Royal Malaysia Police (RMP). This article attempts to highlight the challenges faced by the RMP in supporting the NSEP. Five police officers from the Narcotics Crimes Investigation Department were selected for in-depth interviews. Results show police officers had seized the NSEP’s objective, philosophy and intervention. However, they were not informed on how exactly the NSEP operates in the field. The findings also showed disagreement between law enforcement terms of reference and the NSEP strategies. Much effort is needed to integrate the NSEP into law and the stakeholders’ have to deliberate continually and provide accurate information on the NSEP implementation at all levels. It is also hoped to increase multi-sectoral participation based on punitive prohibition for drug offence in Malaysia.