In the vast majority of U.S. states, possession and distribution of needles to inject illicit drugs is a crime. In the past, proponents have tried to combat the criminalization of needles by pushing states to enact needle exchange laws. These laws generally provide an exception to the general prohibition, which allows the distribution and possession of syringes in certain limited situations, such as when a person is on their way to or from the exchange site or can prove that a particular syringe originated from the exchange. Thirty-two states had explicitly approved PHC as of 1 August 2019 and a total of 39 states had taken at least 1 action to address legal concerns regarding PHC. Since 2014, the number of states explicitly allowing PHC has nearly doubled, and the new states included many rural, southern, or Midwestern states that had limited access to PHC and were at high risk of HIV and HCV epidemics. Both the trend and the number are encouraging, but neither sufficient nor consistent with legal action in other areas of drug health. Notably, in the 5 years that began on May 15, 2012, 45 states and the District of Columbia passed laws allowing the unscientific administration of naloxone, the standard antidote for opioid overdoses.50 Twelve states still do not have a clear statewide legal basis for PHC. Legal commentators have long pointed out that the quickest and clearest way to eliminate legal concerns from PHC public health work is to completely deregulate needles so that there is no criminal law governing their possession or distribution.51 The law has long been recognized as a factor in the availability of PHC, although the relationship is complex.23-28 PHC is not expressly prohibited by U.S. federal and state law; rather, they were considered illegal by some individuals because of laws governing the distribution and possession of paraphernalia or syringes prior to the development of HSPs.29 Utensil laws passed by most states in the 1970s were intended to shut down businesses knowingly targeting illicit drug users.
The laws generally prohibited the possession and distribution of items of any kind knowing that they would be used for the preparation, packaging or use of illegal drugs, and included syringes in a list of items that could be drug paraphernalia. While the clear wording of these statutes can be interpreted to cover HSPs, the fact that they are not intended to restrict HSPs or regulate legitimate health services has created considerable doubt as to their applicability.23 HSPs have operated in many places despite paraphernalia laws, while the few court decisions examining the legality of HSPs under drug paraphernalia legislation have reached contradictory conclusions.30, 31 Needle prescribing laws and various pharmaceutical regulations related to pharmacy purchases have also facilitated access to syringes,32-34 but are excluded from this study, with the exception of certain state laws governing the distribution and possession of syringes instead of utensil laws. Prevention of HIV and viral hepatitis due to injection drug use is a public health priority.1 The long-term decline in new HIV infection rates among people who inject drugs (IDU) has stagnated as infection rates have increased in “hot spots” where high use of non-medical prescription opioids coincides with economic vulnerability. changes in drug markets and lack of access to medications to treat opioid use disorder.2-4 The number of new cases of hepatitis B virus (HBV) is stable. But the number of new cases of hepatitis C virus (HCV), largely attributable to injection drug use, increased 3.5-fold, from 850 in 2010 to 2967 in 2016.5 Needle and syringe service programs (HSPs), which provide IDUs with sterile injection equipment and needle disposal services, can directly provide IDUs with services such as vaccination, treatment of substance use disorders, screening for infectious diseases and overdose prevention. PHC is safe, effective and cost-effective in reducing HIV and HCV transmission.6,7 Studies show that PHC does not increase crime rates or stimulate drug use, nor does it encourage new or young drug users.8-10 PHC can significantly reduce the number of needles discarded inappropriately.11 PHC can also play an important role in preventing overdoses. and the wider use of pre-exposure prophylaxis (PrEP) 12, 13 Legal researchers have developed a cross-sectional dataset that measures key features of needle possession and distribution laws and regulations in the 50 U.S. states and the District of Columbia in effect on August 1, 2019. We compared these data with previously collected data on legislation as of August 1, 2014. Always contact your city government or waste carrier for local needle and syringe disposal requirements. Never put loose syringes directly in the trash. Many states have conditionally allowed possession of syringes, with approval depending on the source of the syringe or even the willingness of the owner to notify police of the possession.
For example, the Ohio determination only applies to possession within 1,000 feet of the SSP and only if the participant can demonstrate active participation. Conditional laws create confusion about the legality of a particular syringe; This ambiguity may be protective if users and law enforcement assume that needles are protected, but it can be detrimental if the law creates a real or perceived burden of proof for the owner. The easiest way to build confidence in the legality of needle possession and support pharmacy sales as well as PHC is to lift any legal ban. Protection from prosecution based on drug residues in used needles is also important because it reduces legal barriers to proper disposal and because drug users may need to use their own needle more than once to avoid sharing. In several cases, police responded to an amendment to the Needle Possession Act by intensifying residue-based enforcement.38,39,48,49 Residue legislation exists in response to increased enforcement of the Drug Residues Act and serves as a protection from prosecution for drug residues left in used syringes. Overall, the law continues to fail to provide clear and comprehensive protection to IDUs who seek to maintain their own health and that of others by properly obtaining, using and disposing of sterile syringes. We are now in 2021 and we have been in an epidemic for over 20 years that shows no signs of abating. The days when it was acceptable to adopt a harm reduction approach for people who inject drugs are long gone. States should legalize the distribution and possession of needles and prohibit communities from criminalizing these activities. They should then fund needle access programs and ensure that they actively reach the most vulnerable.
Learn about safe needle and syringe disposal options by visiting the Minnesota Pollution Control Agency. In the past, state laws have created barriers that make it harder for people who inject drugs (IDUs) to access sterile needles by criminalizing the distribution and possession of these needles. People who inject drugs are more likely to share needles in states with restrictive laws, which can lead to the spread of blood-borne diseases such as HIV/AIDS. Needle distribution guidelines affect how easy or difficult people can access sterile syringes. As awareness of this public health issue has grown, many states have changed their laws to remove barriers to access. This is a longitudinal dataset that captures changes to needle and syringe distribution legislation from July 1, 2012 to July 1, 2017. A California Supreme Court decision in the 1970s ruled that residues were not the basis for a conviction for possession of controlled substances. In addition, syringes in a sharp container are not utensils – the exception for personal possession of a PHC also applies to syringes from a pharmacy, doctor or authorized supplier.