Lethal Injections: The Law, Science and Politics of Syringe Access for Injection Drug Users

Abstract:     
Ensuring that injection drug users who cannot or will not stop injecting have access to sterile syringes is an important part of a comprehensive approach to reducing the transmission of viral and bacterial infections associated with injection drug use. Despite its public health value, however, syringe access has been politically controversial in the United States. The primary policy questions have been the legality of over-the-counter sales of syringes to IDUs, the legality of syringe possession by IDUs, and the authority of public health officials or private sector providers to initiate access interventions. This Article updates and significantly expands upon prior legal analyses of syringe access. The main focus is the body of law that regulates syringe sale, purchase, possession and disposal in the context of injection drug use in the United States, the District of Columbia, the Virgin Islands and Puerto Rico, including drug paraphernalia laws; syringe prescription laws and regulations; pharmacy regulations and miscellaneous syringe laws; needle exchange laws and regulations; and drug possession laws. To place the law in context, the paper summarizes and critically assesses the public health research on the health effects of syringe access rules and the collateral effects of policies enhancing syringe access for IDUs; examines the public opinion poll results, and discuss the ethics and politics of syringe access reform. It concludes with key recommendations for public policy.

Number of Pages in PDF File: 73

Accepted Paper Series