The legal strategies used in operating syringe exchange programs in the United States.

Abstract

OBJECTIVES. This study sought to identify the strategies used by syringe exchange programs to establish their legality. METHODS. Statutes, court decisions, published studies of exchange programs, and news stories were reviewed, and telephone interviews were conducted with syringe exchange personnel. RESULTS. Twenty-seven exchanges have been authorized by amendments to or judicial interpretations of state drug laws or by administrative action under such laws, or operate in a state that has no laws regulating needles. At least 13 programs operate under claims of legality based on local interpretations of state law, principally public health law. The remaining syringe exchanges operate without a claim of legality. CONCLUSIONS. The deployment of syringe exchanges has been hindered by concerns about their legal status. This study shows that the applicability of drug laws to syringe exchange is open to dispute, and that local public health authorities may under some circumstances rely on their own legal authority to fund or operate syringe exchange programs.

Selective risk taking among needle exchange participants: implications for supplemental interventions

“…[14][15][16] To reduce this risk, some effort has been expended to provide clean, sterile syringes to injection drug users by establishing needle exchange programs. [17][18][19][20] The programs generally stress the importance of using clean injection equipment. The current study used a network methodology to characterize disease risk behavior among a sample of injection drug users who visited a needle exchange program between February 1995 and February 1997.…”

Opioid Addiction in Rural North Carolina: A Criminal Justice and Public Health Issue

“…These experts view drug use as a public health, rather than a criminal justice problem (Haden, 2004;MacMaster, 2004). The harms reduction approach is viewed by some as unconventional, unethical, and in some cases, its legality has been questioned (Burris et al, 1996). One example of a popular harms reduction program is needle exchange.…”

“…Their study found that some of the programs (n=9) violated local laws and their participants risked being criminally prosecuted for violating drug paraphernalia laws. Moreover, several other programs (n=27) were either directly or indirectly authorized by state amendment or judicial interpretation of the law to be exempted from prosecution (Burris et al, 1996). They also found that the remaining programs (n=13) had not been challenged and reviewed by the courts, but claimed their legality on the basis of being found under state public health and drug laws.…”

The Legislative and Policy Gaps in the National HIV and AIDS, STI Policy, 2004-2014, Ghana

“…The main question that has pre-occupied the minds of public health officials in these nations was how to frame national interventions and response to HIV/AIDS. Amongst the earliest push back on the intervention policies raised in the late 80's was whether HIV should be tackled with the "broad statutory provisions established to control the spread of sexually transmitted and other communicable diseases" such as tuberculosis (Burris, Finucane, Gallagher, & Grace 1996;Burris, 1999). Alternatively stated, the issue was whether HIV/AIDS as a communicable disease should be approached from the human rights angle or was it a public health disease control issue?…”

“…The study found that high-risk individuals had limited awareness of the reporting and notification law, and few cited concern about named reporting as a reason for avoiding or delaying HIV testing. The law had no effect on testing levels, post-test counseling rates or individuals' willingness to allow use of their names where the identification is held confidential by the Department of Health" (Hodge, Pulver, Hogben, Bhattacharya, & Brown, 2008;Burris, Finucane, Gallagher, & Grace, 1996;Burris, 1999).…”