Nationwide laws prohibiting the possession of drug paraphernalia are not just ineffective, they’re anti-public health.

Addressing the needs of people using drugs must include fully repealing paraphernalia laws, said Amy Lieberman, senior staff attorney with the Harm Reduction Legal Project, during the APHA 2024 session “Laws Affecting People Who Use Drugs throughout the Lifespan.”

In the late 1970s, the Drug Enforcement Administration created the Model Drug Paraphernalia Act. Over 50 years later, most state paraphernalia laws that are still in existence were based on that model law.

These laws prohibit the possession, distribution and sale of items traditionally associated with drug use, such as bongs and rolling papers. But it also includes items that can reduce harms related to drug use.

“It’s very obvious they were targeting hippies and their marijuana, not services or programs that help people who use drugs,” Lieberman said. Some items made illegal under paraphernalia laws could save lives, she said. 

Fentanyl test strips, which detect the substance in drugs, are illegal under the Model Drug Paraphernalia Act. Fentanyl overdose was responsible for an estimated 75,000 deaths last year, according to the Centers for Disease Control and Prevention. 

Additionally, access to clean syringes for people who use drugs can prevent transmission of diseases such as HIV, hepatis C and other bloodborne pathogens.

Removing barriers to drug use supplies is good for public health. Lieberman highlights several advantages, including reduced stigma that prevents individuals from seeking help, decreased syringe litter, lower transmission of bloodborne pathogens, and improved access to treatment and knowledge of safer drug practices.

Services such as syringe services programs are positive but insufficient, Lieberman said. SSP laws often require local authorization and usually permit only certain injecting supplies, not smoking, which can be a harm reduction method over injecting.

Fully repealing paraphernalia is the only way to address the needs of people who use drugs and reduce harm, disease, overdose and over-incarceration, according to Lieberman.

Alaska is the only state that has adopted any paraphernalia law. In August 2023, Minnesota repealed nearly all paraphernalia-related provisions. 

Lieberman said health officials can help by supporting the removal of state drug paraphernalia laws, fully funding harm reduction programs and working with programs to support linkages to care and to increase reach.

Photo by Meeko Media, courtesy iStockphoto.