Policy Approaches to Preventing Drug Overdose

About drug overdose

A drug is any substance that can change how a person's body and mind work. Drug overdose is injury to the body that happens when a drug is taken in excessive amounts. An overdose can be fatal or nonfatal. Opioids, particularly illicitly manufactured fentanyl, are currently the main driver of drug overdose deaths.

The drug overdose epidemic continues to evolve and is becoming more complex through an increasing range of drugs, such as synthetic opioids (for example, illicitly manufactured fentanyls) and stimulants, and the use of more than one substance at a time (called polysubstance use).

Policy approaches

CDC has compiled evidence-based strategies to prevent opioid overdose. One of the strategies is Syringe Services Programs (SSPs), a harm reduction approach that can help prevent overdoses by providing services and interventions for reducing overdose, enhancing health and wellbeing, and improving public health and public safety.

State policies vary in whether they:

• Allow SSPs to operate
• Require SSPs to facilitate access to substance use disorder treatment services
• Require SSPs to facilitate access to naloxone (a life-saving medication that can reverse an overdose from opioids)

What studies show

• People who use SSPs show high readiness to reduce or stop their drug use.1
• SSP participants are 5 times more likely to enter drug treatment and 3.5 times more likely to cease injecting compared to those who don't utilize these programs.2
• Nearly 30 years of research has shown that comprehensive SSPs are safe, effective, and cost saving, do not increase illegal drug use or crime, and play an important role in reducing the transmission of viral hepatitis, HIV, and other infections.34

SSPs save lives by lowering the likelihood of deaths from overdoses.

Policy landscape

The Office of National Drug Control Policy, a component of the Executive Office of the President, funded the Legislative Analysis and Public Policy Association (LAPPA) to conduct a summary of state SSP laws. The data below are sourced from that summary, which is current to June 2022, with some adjustments based on direct CDC review of the policies.

• Some states have enacted laws that prohibit the operation of SSPs. Other states (41 and Washington DC) either explicitly authorize SSPs, have laws intended to remove legal barriers to SSP operation, or de facto enable SSPs by the absence of any relevant prohibitions.
• Some states do recognize life-saving services offered by SSPs, including linkage to care and naloxone access.
• Substance use disorder treatment services must be promoted by SSPs through direct provision or referral in 26 states and Washington DC.
• Naloxone services must be promoted by SSPs through direct provision or referral in 12 states.

Hover over a state to see if SSPs can operate legally there, if it must increase access to substance use disorder treatment, and if it must increase access to naloxone.

Disclaimers

The findings and conclusions in this product are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.

This resource is intended to communicate succinctly and clearly about very complex policies. It is current to June 2022. For comprehensive picture of a given state's legal landscape, refer directly to current state law.

Development of this product was supported by Cooperative Agreement CDC-OT18-1802: Strengthening Public Health Systems and Services through National Partnerships to Improve and Protect the Nation's Health