This analysis demonstrates the negative effects of legal restrictions on syringe services programs, suggesting changes to improve public health for drug users.
Drug overdose and drug-related harm are major sources of preventable injury and death in the United States. The criminalization and stigmatization of people who use drugs continues to inform law and policy that is ineffective at preventing this harm. While harm reduction interventions such as syringe services programs (SSP) have been widely adopted, the laws that govern these programs often impose restrictions that make SSP operation more difficult and less effective. For example, 23 state permit SSPs to operate only if they receive authorization from state or local government officials, and 5 states continue to adhere to some version of a "one for one" exchange model. This article presents data on these and other state laws that impede the work of SSPs. It also highlights ways the experience and expertise of people who use drugs can be integrated into the creation and implementation of SSP operational models. Removing barriers to these life-saving programs is critical to decreasing drug-related harm.
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Lieberman et al. (2026) studied this question.
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