From 2001 to 2015, the number of opioid-related hospitalizations and emergency room visits in Missouri more than doubled, indicating that the use of injection drugs such as heroin and fentanyl has risen drastically.1 This development has put individuals who use injection drugs at increased risk of contracting blood borne infections, such as HIV or hepatitis C, through the use of contaminated needles. Surveillance of injection drug-related infectious disease is difficult, but the Centers for Disease Control and Prevention has designated Missouri as a state with significant risk of outbreaks of hepatitis C or HIV due to injection drug use. As such, they have issued a determination of need for needle exchange programs in the state.2 SB 64 would allow needle exchange programs to operate in Missouri. These programs must register with the Department of Health and Senior Services in order to avoid violating laws prohibiting the manufacture, distribution, delivery, or sale of drug paraphernalia. New exchanges would be prohibited from operating within 500 feet of a school building.2
