TY - JOUR
T1 - The legal environment impeding access to sterile syringes and needles
T2 - The conflict between law enforcement and public health
AU - Gostin, Lawrence O.
PY - 1998/7/1
Y1 - 1998/7/1
N2 - This article examines the legal environment for programs to prevent transmission of HIV and other blood-borne diseases among injection drug users (IDUs). Cost-effective public health programs often have questionable legal authority, and health professionals, community activists, and IDUs may be subject to arrest and prosecution. Legal impediments to the sale and distribution of syringes exist in every state: 47 states have drug paraphernalia statutes, 8 states have syringe prescription statutes, and 23 states have pharmacy regulations or practice guidelines. The Mail Order Drug Paraphernalia Act permits federal enforcement against individuals who knowingly sell or distribute syringes to IDUs. Congress has prohibited the use of federal funds for syringe exchange programs (SEPs). Legal restrictions on access to sterile syringes present formidable obstacles to public health prevention. These restrictions render it much more difficult for pharmacists to sell syringes over the counter or for physicians to prescribe syringes, create a chilling effect on IDUs seeking to comply with medical advice and protect themselves and their partners from disease, and place significant obstacles on the lawful establishment and operation of SEPs. Public health authorities have only sometimes creatively circumvented legal restrictions through judicial declarations of lawfulness, municipal declarations of a 'state of emergency,' and by use of the 'necessity' defense. I recommend repeal of syringe prescription statutes and reform of drug paraphernalia statutes and pharmacy regulations.
AB - This article examines the legal environment for programs to prevent transmission of HIV and other blood-borne diseases among injection drug users (IDUs). Cost-effective public health programs often have questionable legal authority, and health professionals, community activists, and IDUs may be subject to arrest and prosecution. Legal impediments to the sale and distribution of syringes exist in every state: 47 states have drug paraphernalia statutes, 8 states have syringe prescription statutes, and 23 states have pharmacy regulations or practice guidelines. The Mail Order Drug Paraphernalia Act permits federal enforcement against individuals who knowingly sell or distribute syringes to IDUs. Congress has prohibited the use of federal funds for syringe exchange programs (SEPs). Legal restrictions on access to sterile syringes present formidable obstacles to public health prevention. These restrictions render it much more difficult for pharmacists to sell syringes over the counter or for physicians to prescribe syringes, create a chilling effect on IDUs seeking to comply with medical advice and protect themselves and their partners from disease, and place significant obstacles on the lawful establishment and operation of SEPs. Public health authorities have only sometimes creatively circumvented legal restrictions through judicial declarations of lawfulness, municipal declarations of a 'state of emergency,' and by use of the 'necessity' defense. I recommend repeal of syringe prescription statutes and reform of drug paraphernalia statutes and pharmacy regulations.
KW - Drugs
KW - HIV
KW - Injection drug users
KW - Laws
KW - Needles
KW - Syringes
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U2 - 10.1097/00042560-199802001-00012
DO - 10.1097/00042560-199802001-00012
M3 - Article
C2 - 9663626
AN - SCOPUS:0032125163
SN - 1077-9450
VL - 18
SP - S60-S70
JO - Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology
JF - Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology
IS - SUPPL.
ER -