Table 2.

Additional legal requirements for operating a syringe services program (SSP) in the 50 US states and the District of Columbia, 2014 and 2019

Legal Requirement	August 1, 2014	August 1, 2019
Local government approval	Colorado, Massachusetts, New Jersey	California, Colorado, Florida, Indiana, Kentucky, Louisiana, Maryland, Massachusetts, New Jersey
Local law enforcement approval	California, Colorado	California, Colorado, Ohio
One-for-one exchangea	Connecticut, Delaware, Hawaii, Maryland, Maine, New Mexico	Delaware, Florida, Hawaii, Maine
No redistributionb	Delaware	Delaware, Florida

^aSSP participants are limited to 1 new syringe for each syringe returned.

^bSyringes distributed at an SSP may not legally be redistributed by the recipient.