Corey Davis

President Trump and members of his administration have justified recent deadly assaults on civilians abroad by claiming that the boats they were in were carrying illicit drugs and that the alleged drug smuggling “constitutes an armed attack on the United States.” We have effective prevention, treatment, and harm reduction interventions that reduce overdose and other harms. The U.S. should embrace and fund those initiatives at home, not engage in inhumane, unjust, and ineffective attacks abroad.

All 50 states and the District of Columbia have modified their laws to increase access to naloxone, the standard first-line treatment for opioid overdose. While these laws have been successful in increasing access to this lifesaving medication, few explicitly address the legality of distributing and administering naloxone that is past its expiration date. This fact sheet discusses whether Idaho laws forbid the prescription, dispensing, distribution, possession, or administration of expired naloxone and whether medical professionals and others who take such actions might be held liable.

In late July, the Trump Administration issued an Executive Order, “Ending Crime and Disorder on America’s Streets,” that threatens to further criminalize unhoused people, people who use drugs (PWUD), and other marginalized groups. While the order raised fears that all harm reduction activities would lose federal funding, SAMHSA has since clarified that lifesaving tools like naloxone, drug-checking supplies, and sharps disposal kits remain eligible for support. Still, the administration’s stance reinforces a dangerous narrative: separating “acceptable” overdose interventions from the core principles of harm reduction, which affirm the dignity and humanity of PWUD.

Infections among people who use drugs related to lack of access to new syringes and subsequent syringe sharing among people who inject drugs have increased dramatically. Increasing access to sterile syringes through syringe services programs (SSPs) is an extremely effective strategy for reducing the spread of bloodborne disease among people who use drugs, their partners, and their families. This factsheet discusses the legality of SSPs in Maryland.

This resource summarizes the characteristics of naloxone access and Good Samaritan laws in 50 states and the District of Columbia.

Drug overdose continues to claim the lives of tens of thousands of people in the U.S. every year. Opioids, both prescription painkillers and street drugs such as heroin and illicitly manufactured fentanyl, are responsible for the majority of these deaths. In response, states have passed legislation to increase access to the opioid overdose reversal medication naloxone, including provisions that allow for the distribution of naloxone through pharmacies. Some states have gone further and now require that naloxone be prescribed or offered to some patients. This fact sheet describes those requirements and links to the relevant laws.

Overdose Good Samaritan laws can offer immunity from legal prosecution to those who seek emergency help for someone overdosing and are associated with an approximate 15 percent reduction in overdose deaths. This resource provides information on Good Samaritan laws in each of the states where they exist.

Contaminants including fentanyl and fentanyl analogs are now present in the illicit drug supply throughout the U.S. Because no safe supply of most illicitly used drugs is available, helping people determine what is in the drugs they obtain can be an impactful harm reduction intervention. The easiest and most inexpensive way to accomplish this is often through use of fentanyl test strips and xylazine test strips. This resource outlines the legality of drug checking equipment in 50 states and the District of Columbia.

The major opioid settlement agreements generally do not address “supplantation,” the practice of using settlement funds to support an existing initiative rather than starting or investing in new initiatives.  Some states have enacted laws, rules, or guidelines that restrict or prohibit such supplantation. This fact sheet provides a description and brief analysis of how various states are addressing this issue.

Overdose Good Samaritan laws, which generally provide limited protections from arrest or prosecution for drug-related crimes, have been passed in most states. The limited protection these laws offer is often insufficient. A recently passed law in Maine that provides immunity from all but a small number of crimes, while not perfect, is a step towards improving the effectiveness of these laws.

This fact sheet provides information on Pennsylvania's Act 139, which provides limited immunity to overdose victims and bystanders that seek medical help, and increases accesss to naloxone, a drug that can reverse the effects of an opioid overdose.

This survey of state laws outlines how the legal landscape in each state may affect access to harm reduction services and supplies.