Expanded Syringe Access Program (ESAP): Overview of the Law and Regulations

In 2000, the New York State Legislature changed the Public Health Law to authorize a demonstration program to expand access to sterile hypodermic needles and syringes. This is a public health measure to prevent blood borne diseases, most notably HIV/AIDS and hepatitis B and hepatitis C. ESAP became effective January 1, 2001 and as of the summer of 2009, became a permanent program.

What The Law Says

  • Licensed pharmacies, health care facilities, and health care practitioners can sell or furnish hypodermic needles or syringes to persons 18 years of age or older without a patient-specific prescription.
  • Persons who are age 18 years or older may legally obtain and possess hypodermic needles and syringes through ESAP- without a medical prescription.
  • For all hypodermic needles and syringes provided through ESAP are accompanied by a required safety insert explaining proper use, risk of blood borne diseases, proper disposal, dangers of injection drug use, how to access drug treatment as well as information about HIV/AIDS.
  • Pharmacies may advertise the availability of hypodermic needles or syringes without a prescription and they must keep them in a manner that makes them available only to pharmacy staff (i.e., not openly available to customers).
  • An independent evaluation conducted in consultation with the New York State AIDS Advisory Council, was submitted to the Governor and the Legislature on January 15, 2003. It assessed the impact of ESAP on needle and syringe sharing, substance abuse, pharmacy practice, criminal activity, accidental needle sticks among law enforcement, sanitation and other personnel, syringe disposal, and various methods of education on safe use and proper disposal.

The New York State Department of Health was responsible for developing regulations to implement ESAP.

What The Regulations Say

  • Under Chapter 433 of the Laws of 2021, Public Health Law (PHL) Section 3381 was amended eliminating the requirement for pharmacies, health care facilities and health care practitioners to register with the New York State Department of Health (NYSDOH) in order to dispense syringes without a prescription to persons 18 years of age and older.
  • Consistent with this amendment, NYSDOH no longer registers providers for participating in the Expanded Syringe Access Program (ESAP). These providers must continue to accompany syringe dispensing with the safety insert as required by PHL Section 3381.
  • Pharmacies, clinics, and health care practitioners that want to include the option to accept household sharps under ESAP will register for this program's component.
  • Providers that accept needles and syringes for disposal must comply with state and local laws regarding the disposal of regulated medical waste.
  • Article-28 facilities, like hospitals and nursing homes are required to accept household sharps.

What To Do If You Have Questions Concerning ESAP

Questions concerning ESAP can be directed as follows: