Overview
Paraphernalia laws, which prohibit or restrict the possession or distribution of safer drug use supplies (such as syringes, pipes, and drug checking equipment) increase health harms and make communities less safe. While states have generally been moving in the direction of reforming paraphernalia laws in order to remove barriers to safer use supplies, our research shows that there is much work to be done.
As we’ve written many times previously, repealing or reforming paraphernalia laws should be a key harm reduction policy priority. These laws, which prohibit or restrict the possession or distribution of safer use supplies such as syringes, pipes, and drug checking equipment, increase health harms and make communities less safe.
Sharing of syringes and other injection equipment remains a leading cause of HIV infection, including several injection-related HIV outbreaks over the past decade. New hepatitis C cases, most of which are caused by syringe sharing, are near all-time highs. Endocarditis, osteomyelitis, and other skin and soft tissue infections related to injection drug use (IDU) have all dramatically increased over the past decade.
We recently conducted a systematic legal review of state laws that govern access to safer use supplies, as well as the penalties that can be imposed upon conviction. As the provision of new smoking equipment to people who use illicit drugs can reduce health harms, injection frequency, and sharing of smoking equipment, we examined laws that impact those supplies as well as those that impact syringes.
We found that the possession of syringes for IDU is permitted in 21 states, and the free distribution of syringes is permitted in 19 states. The possession of smoking supplies, meanwhile, is permitted in 15 states and the free distribution of such supplies is permitted in 14 states. In nine states (Arkansas, Massachusetts, Maine, Michigan, Minnesota, Oregon, Vermont, Washington, and West Virginia) the possession and free distribution of all injecting and smoking equipment is not prohibited. We found wide variations in the penalties that may be imposed for violations of paraphernalia laws, ranging from a small civil fine to multi-year sentences of incarceration.
Syringe services programs (SSPs) are permitted in 40 states. While they’re permitted to distribute syringes in all 40 states, those syringes are clearly legal to possess in only 33. SSPs are clearly permitted to distribute smoking supplies in only 19 states, although that equipment is legal to possess in only 17. Some states impose restrictions on SSP operation, such as where they can be located or the amount of supplies they can provide.
Largely due to the work of harm reduction advocates and public health allies, states have generally been moving in the direction of removing barriers to safer use supplies. In 2021, for example, Maine decriminalized the possession and distribution of both injecting and smoking equipment. In 2023, Oregon removed all “item[s] designed to prevent or reduce the potential harm associated with the use of controlled substances” from the definition of paraphernalia. That same year, Minnesota legalized the possession and free distribution of all drug use equipment, as well as the possession of residual amounts of drugs in that equipment. New Jersey in 2024 excluded “any materials or equipment used or intended for use in preventing, reducing, or mitigating the adverse effects associated with the personal use of” controlled substances from the definition of paraphernalia.
However, this research shows that there is much work to be done. Some states continue to completely prohibit the distribution and possession of syringes, and many continue to restrict access to safer smoking supplies despite smoking becoming an increasingly common method of drug use. We encourage you to read the full article and, as always, don’t hesitate to reach out for assistance.
This post was written by Corey Davis, J.D., M.S.P.H., Director, Harm Reduction, Network for Public Health Law.
The Network promotes public health and health equity through non-partisan educational resources and technical assistance. These materials provided are provided solely for educational purposes and do not constitute legal advice. The Network’s provision of these materials does not create an attorney-client relationship with you or any other person and is subject to the Network’s Disclaimer. Support for the Network is provided by the Robert Wood Johnson Foundation (RWJF). The views expressed in this post do not represent the views of (and should not be attributed to) RWJF.
