Substance Misuse

Given the increased emphasis in recent years on using harm reduction strategies to slow the overdose crisis, the hurdle posed by state drug paraphernalia laws to freely allowing drug checking services or establishing syringe services programs is not inconspicuous. Accordingly, in 2022, LAPPA first undertook an extensive research project to determine how drug paraphernalia laws throughout the 50 states, District of Columbia, and all U.S. territories treat drug checking equipment (including fentanyl test strips and other items) and needles/syringes. This January 2024 version, which sets forth a summary of state and territory laws as of December 2023, is an update to the original report. ...

Through the use of medications for addiction treatment (MAT), an individual’s substance use, withdrawal symptoms, and the physiological and psychological cravings can be controlled, enabling the person to begin treatment while in a correctional facility and be released as a person in, or on his or her way to, recovery. Research shows that that the use of MAT for Opioid Use Disorder in correctional settings is a cost-effective and life-saving intervention....

In this document, the Legislative Analysis and Public Policy Association examines state-level legislative and administrative responses to the public health risk posed by expired and unused prescription medications. In the last several years, states, in coordination with the Federal Drug Enforcement Administration (DEA) have enacted legislation or promulgated administrative regulations to authorize drug take-back programs where expired or unused pharmaceuticals can be collected from the public by authorized persons and disposed of in a safe manner. Findings are presented by state for ease of comparison....

In this survey, the Legislative Analysis and Public Policy Association (LAPPA) examines the policy response at the state level to the spread of pill presses used to create counterfeit drugs. There is relatively little policy in this area compared to federal law, and most innovation is relatively recent.  Findings are presented jurisdiction by jurisdiction for easy comparison among states and between current state- and federal law....

In this fact sheet, LAPPA examines the features of the Snapchat app that can facilitate online drug transactions, the theory and progression of a major lawsuit against Snap brought by parents of overdose victims, and other recent legal and legislative actions taken against Snap for its alleged role in online drug sales....

Research indicates that there is often a reluctance among those witnessing an overdose to summon emergency assistance from law enforcement or other first responders out of fear of arrest for drug possession or other charges. In an effort to reduce this fear and to encourage overdose witnesses to seek help, state policymakers developed Good Samaritan laws specific to drug overdoses. The purpose of these laws is to prioritize the overdose victim’s safety over arresting drug users by granting limited protection from criminal liability to persons seeking medical assistance and, in most cases, to the overdose victim. This document (1) provides a singular resource for each jurisdiction's laws; (2) allows for a comparison of these laws between jurisdictions; and (3) identifies and highlights interesting provisions. ...

The Office of National Drug Control Policy (ONDCP) is an agency of the Executive Office of the President and is charged with leading and coordinating “the nation’s drug policy so that it improves the health and lives of the American people." This document provides statutory, regulatory. and legislative information about the nineteen states that have followed ONDCP’s example and created either a state-level office of drug control policy or an advisory commission separate from the state agency charged with oversight of controlled substances that is dedicated to addressing alcohol and drug abuse issues in the state....

This fact sheet provides updated information (as of April 2025) on the issue of drug diversion in health care settings. Drug diversion is defined as any criminal act or deviation that removes a prescription drug from its intended path from the manufacturer to the patient, and while the act of diversion can occur in a variety of settings and be committed by anyone, it is particularly likely to occur in healthcare settings by healthcare workers due to the ease in which they can access prescription drugs. Drug diversion in health care is a serious issue that can result in patient harm, financial loss to the healthcare entity, and civil and criminal litigation based on the perpetrator’s actions....