Oklahoma’s harm reduction law inches toward expiration

Written By: Kayla Branch

(OKLAHOMA) Volunteers for Shred the Stigma gather every other Saturday to build kits containing fentanyl testing strips and clean syringes.

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Harm reduction programs, like Shred the Stigma, work to connect people who use drugs with overdose reversal medication, resources for mental health care and substance use treatment, and education and equipment for safer drug use to prevent the spread of infectious diseases. 

Shred the Stigma, founded in 2021, relies on volunteer drivers to distribute the kits across the Oklahoma City metro area. So far, the group says drivers have traveled nearly 28,000 miles across the city to deliver kits, which it says have helped reverse over 2,100 overdoses. 

“For people who use drugs, a lot of times, we’re the only resource they’re engaging with because they trust us,” said Kriston Ahlefeld, a board member with Shred the Stigma. “We say the same things and make the same resources available, but they’re more likely to engage with us than they are other services.” 

Oklahoma lawmakers legalized harm reduction programs in 2021, allowing the groups to possess sterile syringes without fear of legal trouble, as well as access state and federal funding for operations. Since then, eight providers have registered with the Oklahoma State Department of Health. Most states have some type of legal harm reduction programming, including syringe programs.

But the future of Oklahoma’s program is uncertain, providers said. 

Oklahoma lawmakers have only authorized harm reduction programs until July 2026. Unless lawmakers extend the legal right to operate the programs in Oklahoma, providers have two choices: shut down or continue to operate but risk legal challenges and lose government funding. 

“We are very concerned,” said Alexa Bottoms, harm reduction manager at HOPE testing in Tulsa, the largest harm reduction provider in the state. 

If these programs are no longer legal, HOPE expects to see a “major increase” in overdose deaths and the spread of infectious diseases, Bottoms added.

Research has shown that harm reduction programs can help reduce disease and death, according to the U.S. Centers for Disease Control and Prevention. But the groups have battled perceptions that harm reduction programs, especially those that supply clean needles, enable drug use. 

For several years, Oklahoma has had the highest rate of Hepatitis C deaths in the country, according to the CDC. Oklahoma also has one of the highest rates of HIV infections. Both diseases can be spread through shared needles and can cost over $500,000 to treat during a person’s lifetime, according to the CDC.

The Oklahoma House of Representatives narrowly approved a bill this spring to extend the legal authority for harm reduction programs in the state to 2027, but the bill wasn’t heard on the Senate floor. 

“To get someone from a period of addiction to a path toward recovery takes time and concerted effort,” said Rep. Daniel Pae, R-Lawton, who authored the bill. “This is a practical solution to addressing addiction and the spread of infectious diseases.” 

In the years since harm reduction programs became legal, officials have tried to measure their impact with data. But it took about a year for permanent rules to be put in place, and there were concerns from providers about what kind of data would be collected and whether participants could be identified. 

The slow start to data collection may put programs at a disadvantage when working with lawmakers, who typically want to see a strong track record of success, Brittany Hayes, policy director with Healthy Minds Policy Initiative in Tulsa, told lawmakers at an interim study last fall. 

Still, just in 2023, four harm reduction providers statewide provided roughly 800 referrals for further treatment, 19,500 doses of overdose reversal drugs, 18,500 fentanyl test strips and 517,000 clean syringes, according to Healthy Minds data. 

Harm reduction programs mostly rely on private funding. State law prevents state or federal money from being used to purchase sterile syringes or pipes. So far in 2025, the State Department of Health has only provided about $11,000 in support funding. 

The Cherokee Nation started its own harm reduction program in 2022 with help from a federal grant. So far, the program has reversed 140 overdoses and collected 127,000 used syringes, according to a statement shared with The Frontier. 

“With the harm reduction law set to expire in July of next year, we urge the Oklahoma Legislature to extend it so these proven, culturally grounded services can continue saving lives,” said Principal Chief Chuck Hoskin Jr. in a statement. 

HOPE testing launched a vending machine stocked with safe injection kits, HIV self-tests and overdose reversal drugs in 2022 funded through a private grant.

As individuals came into HOPE’s offices to use the vending machine, they began using other services like Hepatitis C treatment and referrals for mental health treatment, Bottoms said.

“While folks are utilizing the machine primarily to get their harm reduction supplies, they’re receiving larger scale services by just getting to know us, building relationships with our staff and are more inclined to explore all of our options,” Bottoms said.

While some programs may be able to continue receiving private funding and operating despite legal threats, larger programs like HOPE that rely on federal funding and public partnerships will not, Bottoms said. 

While the Biden administration aimed to expand harm reduction programming, the Trump administration released an executive order in July that, in part, targets the programs, saying they “facilitate illegal drug use.” The order gives the Secretary of Health and Human Services the job of making sure that no grant funding is being spent on harm reduction programs.

A spokesperson for the State Department of Health said the agency could not speculate on how the executive order could impact harm reduction programs in the state. Pae said he was also still trying to understand the ramifications of the president’s order. 

“In the meantime, I would encourage programs to continue doing the work they are doing,” Pae said. 

The Frontier is a nonprofit newsroom that produces fearless journalism with impact in Oklahoma. Read more at www.readfrontier.org.