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 who can otherwise prescribe hypodermic needles or syringes may register with the New York State Department of Health to sell or furnish up to 10 hypodermic needles or syringes to persons 18 years of age or older.
  • Persons who are age 18 years or older may legally obtain and possess hypodermic needles and syringes through ESAP- without a medical prescription.
  • Pharmacies may not advertise 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).
  • Registered providers must cooperate in a program to assure safe disposal of used hypodermic needles or syringes.
  • Hypodermic needles and syringes provided through ESAP are accompanied by a 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.
  • 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

The regulations amended Part 80 of Title 10 (Health) NYCRR, pursuant to Section 3381 of the Public Health Law. A new section of Part 80, Section 80.137 established ESAP.

The regulations elaborated on the legislation as follows:

  • Eligible providers must register with the NYSDOH to sell, furnish, or accept for disposal hypodermic needles and/or syringes. Pharmacies, clinics, and health care practitioners that wish to accept household sharps under ESAP will have to register for this program component. Hospitals and nursing homes are already required to accept household sharps. Providers that accept needles and syringes for disposal must comply with state and local laws regarding the disposal of regulated medical waste.
  • Registration is limited to providers in good standing. It requires completion of a registration that includes: information regarding the provider; an attestation that the provider will abide by applicable laws and regulations; an explanation of how the provider will participate in safe disposal; and an authorized signature.
  • Registered providers must notify the NYSDOH of any changes to the registration information, including notification to withdraw from the program.
  • Registration information may be included in a resource directory or registry for use by consumers and providers.
  • Registration may be suspended for a period up to one year, upon the finding of a violation of Section 80.137 or when the provider is found to be no longer in good standing.
  • Individuals age 18 or older may legally obtain and possess hypodermic syringes and needles obtained pursuant to this regulation.

What To Do If You Have Questions Concerning ESAP

Questions concerning ESAP can be directed as follows:

  • ESAP Registration Process: Bureau of Narcotic Enforcement at (518) 402-0707.
  • Other Program Information: AIDS Institute at (212) 417-4770
  • By email also: ESAP@health.ny.gov