merchants from profiting from the drug trade. It would seem that the underlying premise or rationale for the forceful involvement in drug control by governments is to protect the health and well-being of members of society by engaging police power to eliminate the drug trade and to free society from the negative health consequences and deviant behaviors that have been associated with drug abuse.

At the core of U.S. drug control policy is the belief that a scarcity of drugs and drug paraphernalia, coupled with harsh punishments for dealers and users, will cause a reduction in drug abuse and undesirable behaviors that are often tied to such drug abuse. (For a detailed treatment and analysis of the history of drug policy in the United States, the reader is referred to the following publications: Courtwright, 1982, 1992; Morgan, 1981; Musto, 1987, 1991; and Reuter, 1992.)

Legislative/Statutory Environment

Two categories of laws have been enacted that directly impact the availability of sterile syringes and other injection drug use paraphernalia: drug paraphernalia laws and prescription laws.

Drug paraphernalia laws prohibit the manufacture, sale, distribution, and possession of equipment and materials intended for use with narcotics (Gostin, 1993). Under these laws, over-the-counter sale of hypodermic syringes and needles is technically allowed. A valid medical prescription for the purchase of syringes or needles is not required. In 45 states and the District of Columbia (see Figure 5.1) such laws are in effect (Valleroy et al., in press). The most recent versions of these state and local laws (late 1970s and early 1980s) are based on the Model Drug Paraphernalia Act (art. 2), which was formulated by the Drug Enforcement Administration in 1979 as an amendment to the Uniform Controlled Substances Act (9 U.L.A., Part II, 1988). Under that model act, drug paraphernalia are broadly defined and specifically include hypodermic syringes, needles, and other objects used to inject controlled substances into the body.

In the midst of the AIDS epidemic, the federal government enacted a federal statute to further limit the sale, distribution, and possession of drug paraphernalia. In 1986, the federal government joined the regulation and control arena of drug paraphernalia by enacting the Mail Order Drug Paraphernalia Control Act (21 U.S.C. § 857, 1986) as section 1821-1823 of the Anti-Drug Paraphernalia Act (P.L. 99-570). This statute encompasses any activity involving drug paraphernalia (broadly defined) crossing interstate lines. The significance of this act is that it establishes federal jurisdiction over matters regulating drug paraphernalia that, until then, had been the territory of state and local governments.

Prescription laws are distinctly different from drug paraphernalia laws.

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