In five years, harm-reduction organizations distributed hundreds of thousands of sterile needles and syringes to drug users across Oklahoma, potentially saving lives and significantly reducing viral infection rates.
The state law protecting the organizations from criminal prosecution sunsets July 1, effectively grinding the work to a halt.
The organizations that run sterile syringe exchange and distribution programs are preparing to enter a new legal grey area. Some workers said they’ll continue despite the legal risk. Others said they won’t distribute needles or syringes anymore but will instead refocus efforts on distributing Narcan, a legal drug that reverses opioid overdoses.
Proponents of harm reduction said without the full breadth of syringe programs, people will die.
The Oklahoma State Department of Health estimated the organizations distributed 1.25 million syringes between 2022 and 2025, reaching more than 8,800 people in an attempt to minimize the negative results from drug use, such as increased risk of Hepatitis C, HIV infection and
overdose deaths. Harm reduction organizations said sustained contact with people who use drugs, such as weekly exchanges of syringes, leads to higher chances of rehabilitation than arrests and imprisonment.
One organization, the Oklahoma Harm Reduction Alliance, distributed an average of 35,000 syringes per year since the law passed in 2021. To date, the group estimated they’ve prevented about 300 overdoses.
“That’s 300 families that we got saved together,” said Tyler Read, who's been working with the alliance since 2021. “We kept them from that tragedy.”
The alliance typically meets on Thursdays at 10 a.m. in a small office in Tulsa, a quarter of a mile off of Highway 64, to place sterile syringes in discrete packaging. They average 150 to 200 kits, totaling 300 to 400 syringes, per shift. The team met for one last syringe packaging push on June 25, six days out from the law’s expiration.
The physical space is tiny and crowded with boxes of syringes, drug testing strips and naloxone. Its walls are adorned with posters celebrating Pride month and photos of artists who overdosed. A portrait of Mac Miller, a popular rapper who died from an accidental overdose in 2022, sits above two tangerines being used as props for an intramuscular naloxone demonstration.
Since 2021, the alliance has distributed sterile syringes to all 77 counties in the state and maintained a physical presence in seven counties, hosting tabling events and operating monthly clinics, as well as four 24-hour syringe takeback kiosks.
It’s not uncommon for the children of volunteers to join, especially during the summer when school is out. It’s a middle schooler-friendly environment, Executive Director Josh Ellard said.
Laurel Taylor, secretary for the alliance, first got involved with the group while pursuing a related Ph.D. She’s stayed involved because the matter is personal; her ex-husband used drugs before his death. Their son, Isaac, sometimes tags along to the kit-making shifts.
“He understands that this is about saving lives, having made these overdose reversal kits,” Taylor said.
Her son understands that the kits can save people much like his father.
Funding is perpetually an issue because syringes can not be purchased with state grants. But it makes injection safer, Ellard said, and so it’s worth it.
Injection drugs are an inherently dangerous practice. People who participate in intravenous, intramuscular or subcutaneous substance use are at higher risk of overdose or addiction than their counterparts who consume drugs nasally or by smoking. Sharing needles turns the risks into a larger public health crisis. The intravenous spread of Hepatitis C is especially of concern: In 2023, Oklahoma recorded the highest Hepatitis C death rate in the nation.
A 2024 Center for Disease Control and Prevention report found that 19% of people who inject drugs, some 3.6 million people a year, according to the most recent estimates of researchers, share needles.
Sterile syringe programs are associated with a 50% decrease in HIV and Hepatitis C contraction among people who inject drugs, a 2024 CDC study reported.
Discarded, used needles present a threat to anybody who comes into contact with them, including law enforcement. A 2009 study authored by researchers from the University of North Carolina at Chapel Hill and Yale University found that one in three officers experienced a needle-stick injury at some point in their careers.
Protecting law enforcement officers motivated Carol Bush, along with Sen. John Montgomery, to file the bill in 2021, when she was a state representative. The two hoped the focus on public safety would bridge the partisan divide that often limits the success of harm reduction proposals.
The bill also hinged on the idea that syringe service programs could establish entry points for addiction treatment.
“One thing that folks are really uncomfortable with hearing is that if somebody's engaging in substance use, particularly with injectable drugs, they're going to continue that regardless of the access that they have to a clean syringe or not,” said Brittany Hayes, senior vice president of policy at Healthy Minds Policy Initiative.
Under Senate Bill 511, harm-reduction organizations said they had better chances of establishing relationships with people using drugs and connecting them with treatment without the threat of criminal charges.
“What I think sometimes gets lost in these conversations is that harm-reduction is really about keeping people alive and healthy long enough to access treatment and care when they're ready,” said Jeff Burdge, director of development and communications for HOPE Tulsa, which distributed more than 419,000 sterile syringes through safer injection kids in 2025. “Every person who walks through our doors deserves that opportunity.”
Oklahoma was one of 37 states that allowed syringe service programs as of May, according to a report by the Legislative Analysis and Public Policy Association.
Bush said her initial plan was never to set a five-year limit on the bill, but she saw it as the only feasible way to get it through a politically divided, conservative legislature after it had failed the previous year. Bush said she and her conservative colleagues agreed to circle back after five years and figure out if the sterile syringe programs had helped lower Hepatitis C and HIV infections and reduce the number of law enforcement agents who’d been poked with needles on the job. Then, they could adjust the law based on what was working.
“I'm not sure that conversation ever happened,” said Bush, who didn’t seek re-election in 2022.
With Bush and Montgomery no longer serving in the legislature, Rep. Daniel Pae, R-Lawton, in 2025, proposed a renewal bill. He was cautiously optimistic.
And then, in July of 2025, President Donald Trump issued an executive order calling for heightened scrutiny of harm-reduction programs and ordering a crackdown on programs that couldn’t prove they had true positive effects.
Pae said the executive order put conservative colleagues who’d previously supported harm-reduction legislation in a difficult spot. And people wanted more data than the organizations could provide. Collecting and sharing data about illegal substance use is hard while maintaining anonymity and sensitivity.
In Indiana, a similar bill extending harm-reduction became law with a new requirement that people seeking sterile syringes must present an ID, a component that has faced widespread pushback.
Pae’s 2025 successor bill, HB 2012, initially sought to remove the July 1 sundown date altogether. The version that passed in the House established a one-year extension, but the bill was never heard on the Senate floor, effectively killing it.
Pae plans to introduce another extension bill in the next legislative session.
Until then, any organization that continues to distribute syringes faces potential legal consequences. In Oklahoma, possession or distribution of drug paraphernalia carries a maximum sentence of up to a year in jail and fines up to $10,000.
Michael Olson, policy counsel for Oklahomans for Criminal Justice Reform, said criminalizing the distribution of sterile syringes is a mistake.
“We're trying to solve this problem in a way that doesn't really make sense,” he said. “We're talking about a public health problem that requires a public health solution.”
Groups such as Oklahoma Harm Reduction Alliance know that sterile syringe exchange does not solve drug addiction. But advocates of harm reduction remain steady in their commitment to the communities they serve.
“We're doing a different kind of good,” Read, from the alliance, said. “It's not for everybody obviously. But it’s important to the people who it's important to. It's very important to them and they need us.”
Cherokee Nation Principal Chief Chuck Hoskin Jr. said sterile syringe programs boil down to a simple question: “Do we want to keep active users and those impacted by active users in the community, safer or less safe?” The state, he said, has chosen the latter.
The Cherokee Nation launched a harm reduction program in 2023 and has safely disposed of 160,000 dirty or used syringes, distributed at least 160,000 sterile syringes and handed out more than 20,000 doses of Narcan since.
The affected groups are determined to continue their work to the extent permitted by law. For Oklahoma Harm Reduction Alliance, the list of services they’ll continue to provide is long, including naloxone and Plan-B distribution and used syringe takeback and disposal. For the Cherokee Nation’s Harm Reduction Program, it means a continued concerted effort to get Narcan into the hands of people who use drugs and combat Hepatitis C infections.
“We'll continue to do a job to the extent the law allows us to,” Hoskin Jr. said. “Unfortunately, the law is going to result in more people sick or dying.”
Oklahoma Watch, at oklahomawatch.org, is a nonprofit, nonpartisan news organization that covers public-policy issues facing the state.
