Nebraska is a state so big that it takes at least six hours to drive across it from east to west. But its two million residents have zero syringe service programs (SSP), leaving people who inject drugs without access to safe equipment. Possession or distribution of syringes is criminalized as a misdemeanor under the state’s drug “paraphernalia” laws. But Nebraska’s lawmakers now seem set to change that, with a bill to authorize syringe services—if cities or counties allow them.

On January 26, the Nebraska legislature voted 37-2 to advance Bill 307. It would exempt pharmacies and public health agencies from “paraphernalia” laws if they distribute syringes for the purpose of preventing transmission of blood-borne diseases like HIV or hepatitis C.

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“Syringe exchanges is an open window to bring people into other services,” Abadie said. “Once you start providing access to clean syringes, you [offer] wound care for ulcers, and from that care [you get] primary care referrals, mental health treatment, HIV prevention, hep C treatment, testing—that’s a lot of services and care provided once you establish contact with a population through a syringe exchange.”