The number of states with at least some laws that authorize or remove one or more legal barriers to syringe distribution from syringe services programs (SSPs) increased from 22 states to 42 between January 1, 2010, and June 1, 2024, according to new research published in the Journal of Law, Medicine, and Ethics by researchers at the Center for Public Health Law Research at Temple University Beasley School of Law and epidemiologists at Drexel University’s Dornsife School of Public Health.   

As of June 1, 2024, nine states did not have any legal mechanism enabling SSP operations in any way (Alabama, Iowa, Kansas, Mississippi, Missouri, Nebraska, Pennsylvania, South Dakota, and Wyoming), according to the study. 

The research provides rich details about the contents of state SSP laws, measuring key features of state-level laws authorizing and regulating SSP operations, as well as laws regulating possession and distribution of drug paraphernalia, across the 50 states and the District of Columbia, capturing laws in effect as of January 1, 2010, through June 1, 2024.  

Of the 33 states that explicitly authorized SSPs as of June 1, 2024, 24 states had enacted at least one law that allowed for the possession of syringes obtained from SSPs — most commonly, exempting SSP participants from prohibitions against drug paraphernalia possession. And 25 states had amended their drug paraphernalia laws to allow the distribution of syringes from SSPs. While state law has tended to become more conducive to this public health intervention, challenges remain. 

“While there is a solid research base that supports SSPs’ role in reducing disease transmission by providing access to sterile syringes and to valuable support services like naloxone distribution, testing for blood-borne infections, referrals to counseling and/or drug abuse treatment, and syringe disposal, we know less about how these laws impact SSP operations, injection risk behaviors, and health outcomes,” said Lauren Langan, JD, a legal program manager at the Center for Public Health Law Research and a lead researcher on the project. “These data provide an essential foundation for further research to support lawmakers, public health practitioners, and others in their work in the future.” 

The data were created using policy surveillance, a scientific legal mapping tool to create high quality legal data. 

The article, “Longitudinal Description of State Laws Governing Syringe Services Programs and Syringe Possession and Distribution, 2010-2024,” is now available at the Journal of Law, Medicine, and Ethics. The study data are available at LawAtlas.org.