By Corey Davis, Ashleigh Dennis, and Amy Lieberman at the Network for Public Health Law’s Harm Reduction Legal Project

State laws can both increase and reduce harms related to drugs and drug use. All U.S. states continue to rely primarily on a punitive approach to people who use certain drugs, criminalizing not only the possession, distribution, and use of those drugs but also the possession and distribution of devices used to consume them and check them for adulterants such as fentanyl. Consistent access to new injection and inhalation supplies is critical to prevent the transmission of HIV, viral hepatitis, and other communicable diseases among people who use drugs, and to prevent subsequent infection of sexual partners, children, and others. Drug checking equipment can help inform people who use drugs about the content of those drugs, leading them to make more informed decisions about their drug use. Laws that criminalize the possession and distribution of these objects lead to increases in preventable injuries and deaths. Similarly, state laws governing prescription medications make it difficult for community groups, harm reduction organizations, and similar entities to distribute naloxone, and a variety of laws designed to punish people who use drugs discourage those who are experiencing or witnessing an overdose to call for help. Most states have passed laws designed to mitigate some of the impact of criminalization. There is great variation in the presence and specifics of these laws, which can create confusion among both people who use drugs and people and organizations working to ensure that they have the supplies they need to protect themselves and others. This document is designed to reduce this information gap and help individuals and organizations better understand how the legal landscape in their state may impact access to harm reduction services and supplies and emergency medical assistance in an overdose. Specifically, this document includes detailed information regarding laws related to the possession and distribution of injection and smoking equipment, drug checking equipment, naloxone access, statewide naloxone standing orders, and overdose Good Samaritan overdose protections in all 50 states and the District of Columbia. For each state, each argether with a hyperlink that will take the reader to the text of the law. All iea of law is briefly explained in plain language. The relevant citation is also listed, tion is current as of August 1, 2023. 

Research Triangle Park, NC: RTI International, 2024. 101p.