Legality of drug checking equipment in the United States: A systematic legal analysis

Background: Fentanyl and fentanyl analogs are increasingly prevalent in the nation's illicit drug supply. While fentanyl-related deaths were previously confined largely to states east of the Mississippi, they are now increasing rapidly throughout much of the United States. Contaminants other than fentanyl are also present in illicitly obtained drugs. Using drug checking equipment to determine the contaminants that may be present in these drugs is a promising avenue for reducing overdose-related harm. Methods: Systematic legal review in which three trained legal researchers collected, reviewed, and coded all US state laws that specify whether the possession and distribution of drug checking equipment is generally legal, whether is it legal in the context of syringe services programs, and, where possession or distribution of drug checking equipment is not clearly legal, the potential penalties for violation. Results: We find that it is clearly legal to possess some or all drug checking equipment in 22 states, and clearly legal to distribute it to adults in 19 states. In 14 states where distribution of drug checking equipment is not clearly legal generally, it is legal when that equipment is obtained from a syringe services program. Potential penalties for violations range from small civil fines to multi-year jail sentences. Conclusions: There are currently great variations between states regarding the legality of drug checking equipment. Clarifying, modifying, or repealing drug paraphernalia laws would likely improve access to these promising technologies, potentially reducing overdose deaths.

Automated summary

Fentanyl and its analogs are increasingly prevalent in the illicit drug supply in the US, and drug checking equipment can potentially reduce overdose-related harm. However, the legality of possessing and distributing drug checking equipment varies greatly among states. Clarifying or modifying related laws may improve access to these devices and help reduce overdose deaths.