State syringe and drug possession laws potentially influencing safe syringe disposal by injection drug users.

OBJECTIVE: To review state laws and judicial decisions for potential barriers to proper syringe disposal by injection drug users (IDUs). DESIGN: Using standard legal research methods, this study reviewed drug paraphernalia, syringe prescription, drug possession, and syringe exchange laws and relevant case decisions in 59 jurisdictions. MAIN OUTCOME MEASURES: Drug paraphernalia, syringe prescription, and drug possession laws. RESULTS: Drug paraphernalia laws prohibit all possession of syringes by IDUs in 31 jurisdictions. Syringe prescription laws prohibit possession in 7 jurisdictions. In 53 jurisdictions, IDUs may be subject to prosecution for the possession of drug residue in used syringes. Only two states (HI, RI) have no legal barriers to safe syringe disposal by IDUs. Sixteen jurisdictions that have tried to expand syringe access for IDUs by authorizing SEPs or by deregulating pharmacy sale of syringes continue to have criminal law provisions that could pose barriers to proper disposal. CONCLUSION: IDUs are a significant source of syringes disposed of outside the health care system. Involving IDUs in safe community sharps disposal programs is an important public health goal, but may be frustrated by legal barriers. Although this study looked only at law on the books, and not law as actually applied, ethnographic and survey research indicates that criminal laws do influence the syringe possession behavior of IDUs. The findings of this study suggest that syringe and drug possession laws could deter IDUs from participating in safe syringe disposal programs.