Legalized syringe exchange programs help thousands in Oklahoma

Harm reduction programs distribute sterile needles, overdose-reversing drugs, fentanyl test strips and other supplies across Oklahoma

By: - August 29, 2023 5:00 am
Pictured are nine boxes of Narcan, which can reverse opioid overdoses

Boxes of Narcan nasal spray sit on a table at a syringe disposal event hosted by Shred the Stigma, a harm reduction nonprofit based in Oklahoma City. Narcan is the most commonly known form of naloxone, an opioid overdose-reversing drug. (Photo by Carmen Forman/Oklahoma Voice)

OKLAHOMA CITY — Andrea Haddox has seen too many friends and loved ones overdose or get sick after sharing used needles.

Her own past battle with drugs is the driving force behind her nonprofit’s mission to distribute free supplies aimed at reducing harm — like sterile syringes, fentanyl test strips, opioid-reversing agents, condoms, emergency contraception and more — to Oklahomans in need.

“I do this work because of the people that I’ve lost,” she said. “We’ve lost volunteers. We’ve lost friends. We’ve lost family, and that’s always hard. But knowing that we’re doing something that makes a difference is really important.”

When Haddox’s organization, the Oklahoma Harm Reduction Alliance, distributes opioid overdose-reversing drugs such as naloxone, the packages include her contact information.

“Are you OK? What do you need? Can I support you in any way?” she will text when someone reaches out.

Up until two years ago, much of Haddox’s work was in a legal gray area. It wasn’t until 2021 that state legislators explicitly legalized syringe exchanges and harm reduction programs, a first in Oklahoma.

Syringe exchanges allow drug users to swap used hypodermic needles, which could spread disease if shared for intravenous drug use, for sterile ones without facing retribution.

Proponents say the decision has saved countless lives.

Since September 2022, more than 5,027 people have accessed harm reduction services through the state’s four registered programs, according to a spokesperson for the Oklahoma State Department of Health. By law, harm reduction programs are required to register with the health department.

Senate Bill 511, which legalized syringe exchanges, also opened the door for state agencies to partner with harm reduction programs, said Jason Hall, a program manager for the Oklahoma Department of Mental Health and Substance Abuse Services.

What is harm reduction?

Broadly speaking, harm reduction is mitigating the negative outcomes associated with risky behavior, Hall said.

A black vending machine dispenses free naloxone
A naloxone vending machine from the Oklahoma Department of Mental Health and Substance Abuse Services sits in the lobby of the Oklahoma Health Care Authority. Naloxone helps reverse opioid overdoses. (Photo by Carmen Forman/Oklahoma Voice)

That can include wearing a seatbelt while driving or putting on sunscreen before going outdoors. Or, it could be heading off negative outcomes associated with drug use, said Hall, who conducts opioid overdose prevention training.

The mental health department provides naloxone and fentanyl test strips to nonprofit organizations, who help deliver them across the state. No state funds can be used to purchase hypodermic needles, according to the new law.

The mental health department is also working to install 40 free harm reduction vending machines throughout Oklahoma. The first was placed in the Tulsa Day Center in June.

“We want Narcan and naloxone as readily available as first-aid kits,” Hall said.

Overdose deaths are on the rise in Oklahoma and illicitly manufactured fentanyl is increasingly being found in other drugs, he said. An estimated 707 Oklahomans died from unintentional opioid or fentanyl overdoses in 2021, nearly double the number of overdose deaths in 2020.

People who access harm reduction services are three to five times more likely to seek out addiction and recovery resources, Hall said.

While some syringe exchange programs were operating in Oklahoma before the Legislature legalized such initiatives, more have cropped up since the new law took effect.

In July 2022, Drew Cook founded Shred the Stigma, a nonprofit that serves residents in the Oklahoma City metropolitan area. In its first year, the nonprofit distributed 12,600 harm reduction kits and helped reverse 839 opioid overdoses by giving away free naloxone.

A former intravenous drug user who has been in recovery for more than a decade, Cook said he’s heard naysayers claim programs like his enable drug use. Cook argues Shred the Stigma and similar programs make drug use safer and connect people to recovery resources when they’re ready.

“When we started this service up, we were not worried about whether or not we got mass approval for what we’re doing,” he said. “We’re worried about positive health outcomes. We’re trying to help people find a better tomorrow.”

Pictured is a portrait of Drew Cook, the executive director of Shred the Stigma.
Drew Cook, executive director of Shred the Stigma, poses for a portrait at a syringe disposal event on Aug. 12, 2023. Shred the Stigma is a harm reduction nonprofit based in the Oklahoma City metropolitan area. (Photo by Carmen Forman/Oklahoma Voice)

Oklahoma is among the worst states in the nation for the number of deaths due to Hepatitis C, a bloodborne illness affecting the liver that can be transferred when people share needles. According to the Centers for Disease Control and Prevention, the state had the highest rate in 2021 — the most recent info available.

Oklahoma is also one of seven states with high rates of HIV in rural areas, according to the Oklahoma State Department of Health. HIV can also spread through unhygienic needle use.

Cook said he’s hopeful that the number of harm reduction programs across the state continues to grow. The law allows nonprofits, religious institutions, tribal governments and other government entities to operate such programs.

Harm reduction programs see ‘exponential’ growth

The Oklahoma Harm Reduction Alliance mails naloxone and fentanyl test strips to anybody who requests them, in addition to delivering such items to about a dozen bars in the Tulsa area.

The organization has also distributed 75,000 sterile syringes so far this year — up from 20,000 to 40,000 annually in previous years, Haddox said.

To order naloxone or seek addiction recovery resources, visit 

The nonprofit does periodic syringe take-back events and has permanent disposal containers in Tulsa and Sapulpa.

In 2018, Haddox helped found Stop Harm on Tulsa Streets, a local syringe services program. But Haddox kept envisioning a statewide harm reduction effort, so she branched out and founded the Oklahoma Harm Reduction Alliance a year later.

Haddox helped advocate for the legislation that legalized harm reduction programs. Since SB 511 became law, her nonprofit has been able to be more open about its work and expand its services.

“Our program has grown exponentially since we’ve been able to talk about it with people and let people know,” she said.

Oklahoma law allows harm reduction programs to operate until 2026. As that deadline draws near, lawmakers are expected to examine the impact of such programs as they contemplate whether they should remain legal for an extended period of time.


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Carmen Forman
Carmen Forman

Carmen covers state government, politics and health care from Oklahoma City. A Norman native, she previously worked in Arizona and Virginia before she began reporting on the Oklahoma Capitol.