Newly released data synthesizes trends in state laws to increase access to naloxone and sterile syringes. The data, published to the Prescription Drug Abuse Policy System by the Temple University Center for Public Health Law Research, supports the need to accelerate states’ adoption of harm reduction strategies, including providing access to sterile syringes, support services, and the overdose reversal drug naloxone, to prevent opioid overdose death and the transmission of blood-borne diseases in the United States.   

Amidst an intensifying overdose crisis that claimed over 100,000 lives last year, researchers at the Temple University Center for Public Health Law Research captured more than 20 years of naloxone access laws and two years of laws governing syringe service programs across all 50 states. According to the research, all states now have naloxone access laws, and a significant majority (38 states and the District of Columbia) have laws that permit the operation of syringe service programs.   

“Law should reflect the changing needs of communities as well as the best existing evidence on what works to improve health, wellbeing, and equity,” said Elizabeth Platt, JD/MA, the director of the Center’s Policy Research Technology Program and the lead researcher on this project. “Harm reduction researchers have demonstrated that providing access to clean syringes, supportive services and naloxone saves lives. It’s encouraging to see states moving toward laws that support that goal — however slowly — but there is still room to grow.”  

To that end, the new data shows:  

• The number of states to provide prescriptive authority for naloxone increased from seven states and DC on July 1, 2017, to 12 as of January 1, 2022. This includes Colorado, Hawaii, Minnesota, Oklahoma, Vermont. Colorado, Minnesota, and Vermont made this change after March 2020 amid the COVID-19 pandemic.
• Overall, states increased provider immunity for dispensing naloxone to a layperson: 39 states and DC provide dispensers with immunity from criminal prosecution; 45 states and DC provide immunity from civil liability; and 38 states provide immunity from professional sanctions.
• In July 2021, West Virginia became the 33rd state with a law explicitly authorizing syringe service programs.
• Beginning July 1, 2020, Virginia became the 34th jurisdiction to allow for the possession of syringes by SSP participants. West Virginia and Virginia now exempt syringe service programs participants from prohibitions on syringe possession.
• In states that require SSPs to provide additional services beyond providing syringes, naloxone services were required in eight states and disposal services were required in 17 states as of August 1, 2021. 

The policy surveillance was conducted with funding from Vital Strategies, to continue to build the knowledge base for the ongoing work to stem the impact of the overdose crisis in the United States.     

“Access to naloxone and syringe services programs are critical strategies to reduce overdose and promote the health of people who use drugs,” said Kate Boulton, JD, MPH, Senior Legal Technical Advisor at Vital Strategies. “While this research demonstrates modest progress in state laws on these issues, we urgently need all states to embrace harm reduction strategies to prevent overdose and saves lives.”   

The longitudinal datasets now capture naloxone access laws from January 1, 2001, through January 1, 2022, and syringe service programs from August 1, 2019, to August 1, 2021, in all 50 states and the District of Columbia.   

The naloxone dataset was updated with support from the Opioid Research Workgroup from the University of Florida College of Pharmacy.   

Access these and other drug policy datasets at PDAPS.org.