With drug overdose deaths surging, policymakers and lawmakers increasingly recognize the value of harm reduction strategies in saving lives. Syringe services programs (SSPs), formerly called needle exchange programs, are a time-tested strategy and, in May of this year, Arizona became the latest state to enact legislation that legalizes them.

Federal law permits states to have SSPs, yet many states still prohibit them. States that permit SSPs vary greatly in the regulation and restriction as well as the number of SSPs they allow to operate. Every state except Alaska has drug paraphernalia laws that criminalize the possession, sale, or distribution of supplies used to make, test, or ingest illegal drugs. These laws define in detail the items that constitute “paraphernalia.” State laws ranging from those that permit patients to purchase syringes for medical use to those that permit harm reduction organizations to operate SSPs are all exceptions to their paraphernalia laws. Corey Davis, et al argue that paraphernalia laws are major obstructions to harm reduction efforts and should be abolished.

On December 7 the Substance Abuse and Mental Health Services Administration announced the start of a $30 million grant program to aid state and community-based harm reduction programs, including syringe services programs. At the same time, the White House Office of Drug Control Policy released model legislation to assist state lawmakers seeking to permit and promote SSPs in ways that don’t restrict their efficacy.

These developments occurred within days of New York City announcing it was opening two Safe Consumption Sites in defiance of the federal law prohibiting them. The federal government is currently in litigation that seeks to block a similar effort in Philadelphia.

These are encouraging signs that policymakers may be finally realizing we will never have a drug-free society, and that much of the harm resulting from drug use is a direct result of drug prohibition.