Dear Chair Chukwuocha and Members of the Committee:

My name is Jeffrey A. Singer. I am a Senior Fellow in Health Policy Studies at the Cato Institute. I am also a medical doctor specializing in general surgery and have been practicing that specialty in Phoenix, Arizona, for over 40 years. The Cato Institute is a 501(c)(3) non-partisan, non-profit, tax-exempt educational foundation dedicated to the principles of individual liberty, limited government, free markets, and peace. Cato scholars conduct independent research on a wide range of policy issues. To maintain its independence, the Cato Institute accepts no government funding. Cato receives approximately 80 percent of its funding through tax-deductible contributions from individuals. The remainder of its support comes from foundations, corporations, and the sale of books and other publications. The Cato Institute does not take positions on legislation.

I write to share my thoughts on SB 249, which this committee will consider.

Senate Bill 249 recognizes a simple reality: criminalizing the possession of syringes, fentanyl test strips, and other drug-use equipment does not prevent substance use, but it can increase the associated risks.1 The bill authorizes harm-reduction programs to provide sterile equipment, naloxone, disease screening, and other services, while removing criminal penalties for possession of paraphernalia intended for personal use. It leaves prohibitions on drug trafficking intact but reduces barriers that discourage people from using tools that can lower their risk of overdose and infectious disease. Alaska has never had a statewide drug paraphernalia law, and Minnesota became the first state to repeal such a law in 2023, reflecting a growing view among policymakers and public health officials that public health objectives are often better served by harm reduction than by criminal penalties for possession of drug-use equipment.

One example is fentanyl test strips. These inexpensive tools allow people to detect the presence of fentanyl and several fentanyl analogs in drugs such as oxycodone, heroin, and cocaine. Research suggests the strips are highly accurate, and studies indicate that people who discover fentanyl in a substance often modify their behavior by discarding the drug, using a smaller amount, or consuming it more slowly. Such changes can reduce the risk of accidental overdose. In 2021, the Delaware General Assembly recognized the potential public health value of fentanyl test strips when it enacted Senate Bill 76, exempting them from the state’s drug paraphernalia laws and permitting their distribution to the public. SB 249 extends the same harm-reduction logic to other tools and services intended to reduce overdose deaths and the spread of infectious disease.

The bill’s provisions on harm-reduction programs are also consistent with a large body of evidence on syringe services programs. For decades, researchers have found that these programs reduce the transmission of HIV, hepatitis C, and other blood-borne infectious diseases among people who inject drugs. Many programs distribute sterile syringes, fentanyl test strips, and naloxone; provide testing for infectious diseases; offer basic wound care; and connect participants with treatment and social services. Multiple federally funded studies and systematic reviews have found that syringe services programs reduce HIV transmission without increasing illicit drug use or crime.2 As a result, they are endorsed by the Centers for Disease Control and Prevention, the Substance Abuse and Mental Health Services Administration, the National Academies of Sciences, Engineering, and Medicine, the American Medical Association, the American Society of Addiction Medicine, and numerous other public health and medical organizations.

Support for harm-reduction programs has also grown among many law enforcement officials, who recognize their role in reducing the spread of infectious disease and accidental exposures to contaminated needles among first responders. While some programs receive government support, others rely entirely on voluntary private funding. Long-standing privately funded programs across the country demonstrate that harm-reduction services can emerge through civil society as well as through government initiatives. The evidence indicates that programs providing sterile equipment, naloxone, and drug-checking tools can reduce preventable disease and death while serving as an important point of contact for individuals who later seek treatment and recovery services.

Alaska provides an instructive example. It is the only state that has never enacted a statewide drug paraphernalia law. As a result, individuals can obtain syringes, fentanyl test strips, and other harm-reduction tools without fear of violating state paraphernalia laws, and private organizations can operate syringe services and other harm-reduction programs without those legal barriers. Minnesota became the first state to repeal a statewide drug paraphernalia law in 2023. These developments reflect a broader reassessment of whether criminal penalties for possession of drug-use equipment advance public health objectives or instead impede access to evidence-based harm-reduction strategies. SB 249 would place Delaware within this broader national discussion about the role of criminal penalties in public health policy.

Public policy cannot eliminate the risks associated with drugs obtained in illegal markets. Policymakers can, however, evaluate whether existing laws reduce those risks or inadvertently increase them. The evidence regarding fentanyl test strips, syringe services programs, naloxone distribution, and other harm-reduction measures provides useful context for that evaluation as the General Assembly considers SB 249.

Respectfully submitted,

Jeffrey A. Singer, MD, FACS
Senior Fellow, Department of Health Policy Studies
Cato Institute