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Syringe Exchange Programs C.R. S. §25-1-520
Syringe Exchange Programs C.R. S. §25-1-520 states that an agency, including a local public health agency, may request approval from its board of health to establish a syringe exchange program operated by the agency or by a nonprofit organization with which the agency contracts.
This law was amended on July 13, 2020, to authorize a nonprofit organization with experience providing syringe services or a health facility licensed or certified by the state to operate a syringe exchange program without prior board of health approval. If an entity does not possess the qualifications mentioned above, it is still required to acquire board of health approval before to initiating a new syringe exchange program.
Once established, the agency is required to report to the state department specifying the nonprofit organization’s or health facility's annual number of syringe access episodes i and the number of used syringes collected by the facility.
Syringe Service Program Protections
Participants, volunteers, and staff are exempt from the provisions of paraphernalia laws, C.R.S. §18-18-425 to 18-18-430, when they are associated with an approved syringe exchange program created pursuant to this law (see Drug Paraphernalia Law Exemption, C.R.S. §18-18-430.5 below).
The passage of HB 24-1037, during the 2024 legislative session included the following amendments to 25-1-520
- 25-1-520 (2.3) authorizes a syringe access program operating pursuant to this section to purchase and distribute other supplies and tools intended to reduce health risks associated with the use of drugs, including, but not limited to smoking materials.
- 25-1-520 (4.5) authorizes a syringe access program operating pursuant to this section to acquire and use supplies or devices intended for testing controlled substances or controlled substance analogs for adulterants.
Drug Paraphernalia Law Exemption, C.R.S. §18-18-430.5
The Drug Paraphernalia Law Exemption, C.R.S. §18-18-430.5 states that participants, volunteers, and staff are exempt from the provisions of paraphernalia laws, C.R.S. §18-18-425 to 18-18-430, when they are associated with an approved syringe exchange program created pursuant to C.R. S. §25-1-520.
Due to a 2020 amendment, a pharmacist or pharmacy technician who sells non-prescription syringes is also exempt pursuant to section 12-280-123 (4).
Drug paraphernalia does not include testing equipment used to identify or analyze the strength, effectiveness, or purity of controlled substances.
Needle-stick Prevention C.R.S., §18-18-428
Needle-stick Prevention C.R.S., §18-18-428 was signed into law on April 3, 2015, this law allows for an exception to arrest and filing charges for the crime of possession of syringes for the purposes of drug use if the person, before being searched by a law enforcement officer, informs the officer that they have a needle, syringe, or other sharp objects on their person or in their vehicle or home that is subject to a search.
This exemption additionally applies if a person informs an emergency service provider or other first responder, either voluntarily or in response to a service provider's question, of that fact prior to assessment or treatment.
The exception to arrest and filing charges also applies to the crime of possession of a controlled substance as it relates to any residual controlled substance that may be found in a used needle, syringe, or other sharp object.
Penalties associated with paraphernalia possession as listed in C.R.S. §18-18-428 do not apply to the possession of drug paraphernalia that a person received from an approved syringe exchange program created pursuant to section 25-1-520 or a program carried out by a harm reduction organization, as defined in section 12-30-110 (7), while participating in the program.
Persons Furnishing a Non-Laboratory Synthetic Opiate Detection Test or a Non-Laboratory Additive Detection Test, C.R.S. §13-21-108.8
Persons Furnishing a Non-Laboratory Synthetic Opiate Detection Test or a Non-Laboratory Additive Detection Test, C.R.S. §13-21-108.8, effective August 7, 2024, person or entity, excluding the manufacturer, who acts in good faith to furnish a non-laboratory synthetic opiate detection test (e.g., fentanyl test strip) or a non-laboratory additive detection test, including an expired detection test, to another person is not liable for any civil liability if the test is stolen, defective, or produces an inaccurate result.
911 Good Samaritan Law, C.R.S. §18-1-711
The 911 Good Samaritan Law states that a person is immune from criminal prosecution for an offense associated with an overdose event when the person:
- reports, in good faith, an emergency drug or alcohol overdose event to a law enforcement officer, to the 911 system, or to a medical provider, or if the person aids or seeks aid for the person experiencing the overdose;
- remains at the scene of the event until a law enforcement officer or an emergency medical responder arrives, or if the person remains at the facilities of the medical provider until a law enforcement officer arrives;
- Identifies themselves and cooperates with the responding party.
The immunity described above also extends to the person who suffered the emergency drug or alcohol overdose event. There are limitations to immunity based upon possession and/or distribution of certain amounts of substances.
Third Party Naloxone, C.R.S. §18-1-712
The Third Party Naloxone, C.R.S. §18-1-712 law allows for a person other than a health care provider or health care facility who acts in good faith to administer naloxone to another person whom the person believes to be suffering an opiate-related drug overdose. The individual who administers naloxone shall be immune from criminal prosecution for such an act. Amended July 13, 2020 to extend immunity to individuals administering expired naloxone.
The C.R.S.13-21-108.7 legislative declaration encourages the administration and distribution of opioid antagonists, including expired opioid antagonists, by persons and entities, including law enforcement personnel, school district personnel, and health care providers, for the purpose of saving the lives of people who suffer opioid-related drug overdose events. Persons responding to an opioid overdose are encouraged to call for emergency services immediately.
Pursuant to C.R.S. 18-1-712.3, amended in 2024, the mere presence of a drug approved by the FDA for opioid overdose reversal, such as naloxone, is not indicative of a crime and shall not be used to support probable cause.
Prescribing or Dispensing Opiate Antagonists, C.R.S. §12-30-110
Prescribing or Dispensing Opiate Antagonists, C.R.S. §12-30-110 states that a prescriber may prescribe and dispense, directly or in accordance with standing orders and protocols, an opiate antagonist to any individuals or entities defined in the statute. Prescribers may also issue standing orders and protocols to entities outlined in the statute. Entities defined in 12-30-110 may furnish an opiate antagonist to a family member, friend, or other person who is in a position to assist an individual who is at risk of experiencing an opioid overdose.
A prescriber or entity described in the statute who dispenses an opioid antagonist is strongly encouraged to educate persons on the use of the opiate antagonist in the event of an overdose, including instruction concerning risk factors for overdose, recognizing an overdose, calling emergency medical services, rescue breathing, and administration of the opioid antagonist.
A prescriber prescribing or dispensing an opiate antagonist in accordance with this section, other than a pharmacist or other prescriber prescribing and dispensing from a prescription drug outlet or pharmacy, is not required to comply with laws relating to labeling, storage, or record-keeping for the opiate antagonist.
Naloxone Standing Orders, C.R.S. §12-36-117.7
Naloxone Standing Orders, C.R.S. §12-36-117.7, signed into law on April 3, 2015, this law concerns the ability to furnish a supply of emergency drugs for the purposes of treating individuals who may experience an opiate-related overdose event. This bill allows licensed prescribers to prescribe, and licensed dispensers to dispense, an opiate antagonist, either pursuant to a direct prescriber order or in accordance with standing orders and protocols.
Coverage for Opiate Antagonists Provided by a Hospital C.R.S., §10-16-154
Signed into law on July 13, 2020, Coverage for Opiate Antagonists Provided by a Hospital C.R.S., §10-16-154 requires health insurance carriers to reimburse a hospital if the facility provides a covered person with naloxone upon discharge.
Pharmacy Exemption to Prescription Requirement C.R.S., §12-280-123
Signed into law July 13, 2020, Pharmacy Exemption to Prescription Requirement C.R.S., §12-280-123 requires a pharmacist to notify an individual dispensed an opioid of potential risks and about the availability of opiate antagonists to reverse an overdose if:
- the individual is concurrently prescribed a drug(s) named in statute; or
- the opioid prescription is at or in excess of 90 morphine milligram equivalent
If an individual to whom an opioid is being dispensed chooses to accept the pharmacist’s offer for an opiate antagonist, the pharmacist shall counsel the individual on types of opiate antagonists and how to use opiate antagonists in the event of an overdose.
A pharmacist may prescribe and dispense an opiate antagonist in accordance with C.R.S. 12-30-110.
A pharmacist or pharmacy technician may sell a nonprescription syringe or needle to any person.
School Employee or Agent Administration of Opiate Antagonists C.R.S., §22-1-119.1
School Employee or Agent Administration of Opiate Antagonists C.R.S., §22-1-119.1 states that a school district board of education of a public school, the state charter school institute for an institute charter school, or the governing board of a nonpublic school may adopt and implement a policy whereby:
- A school may acquire and maintain a supply of opiate antagonists on school grounds or on a school bus operated by the aforementioned entities.
- An employee or agent of the school may, after receiving appropriate training, administer an opiate antagonist on school grounds or a school bus to assist an individual experiencing an opioid overdose event.
- Training must include risk factors for overdose, recognizing an overdose, calling emergency medical services, rescue breathing, and how to administer an opiate antagonist.
- An employee or agent of the school may supply opiate antagonists on school grounds or on a school bus to any individual, including a student. Students must receive school-sponsored training before receiving opiate antagonists from an employee or agent of a school.
An employee or agent of the school acting in accordance with policy adopted in accordance to this section is not subject to civil or criminal liability. School district boards of education, charter school institutes, and governing boards of nonpublic schools are encouraged to adopt and implement a policy for an employee or agent of the school to furnish an opiate antagonist on school grounds or on a school bus to any individual, including a student. Additional recommendations related to the development of the policy can be found in C.R.S. 22-1-119.1(4).
Drug Additive Detection Tests-C.R.S. 22-1-119.2
Drug Additive Detection Tests-C.R.S. 22-1-119.2 Allows a school district board of education, the state charter school institute, or the governing board of a nonpublic school to adopt a policy for a school to acquire and maintain a supply of non-laboratory synthetic opiate detection test (e.g.,fentanyl test strip) and non-laboratory additive detection tests. The policy may allow an employee or agent of the school to supply non-laboratory opioid or additive detection tests on school grounds to any individual.
A school, school district, or state charter school institute shall not prohibit a student from possessing or administering an opiate antagonist on school grounds, a school bus, or any school-sponsored event. A student must not be prohibited from possessing a non-laboratory opiate or additive detection test on school grounds, on a school bus, or at any school-sponsored event.
Opioid Treatment for a Person in Custody C.R.S., §17-1-113.4
Opioid Treatment for a Person in Custody C.R.S., §17-1-113.4 states that a correctional facility or private contract prison may make available opioid agonists and opioid antagonists to a person in custody with an opioid use disorder. The correctional facility or private contract prison is strongly encouraged to maintain the treatment of the person throughout the duration of the person’s incarceration, as medically necessary.
As funding and supplies allow, if a person in custody is treated for an opioid use disorder pursuant to this section, the correctional facility or private contract prison shall offer the person, upon release from the facility, at least two doses of an opioid reversal medication in a form approved by the federal drug administration and provide education to the person about the appropriate use of the medication.
Nothing in this section imposes civil or criminal liability on a state law enforcement agency or law enforcement officer when ordinary care is used in the administration or provision of an opioid reversal medication in cases when an individual appears to be experiencing an opioid overdose.
Continuity of Care for Persons Released from Jail, C.R.S., §17-26-140
Effective August 7, 2024, Continuity of Care for Persons Released from Jail, C.R.S., §17-26-140 states that if a person is treated for a substance use disorder at any time during the person’s incarceration, the county jail shall, at a minimum, conduct the following before releasing the person from the county jail’s custody:
- Provide post-release resources to the person;
- Provide a list of available substance use providers;
- Provide the individual with an opioid antagonist and education. If the person received or has been assessed to receive medication for addiction treatment while in jail, has a history of substance use, or requests opiate antagonists upon release
If the person received medication for addiction treatment while in jail, has a history of substance use, or requests opiate use-disorder medication, upon release from jail prescribe to the person medication for an opiate use disorder, provide education, and coordinate continued care for the person. Continued care includes scheduling an appointment with a substance use provider who can continue the person’s treatment and providing a prescription for a sufficient amount of the medication that the person was taking while in custody to sustain the person until the scheduled appointment.
A county jail shall not delay a person’s release from the county jail because the jail cannot timely comply with a requirement of this section.
Injuries To Be Reported - Penalty For Failure To Report - Immunity From Liability, C.R.S. §12-240-139
Amended by HB24-1037-Substance Disorders Harm Reduction, Injuries To Be Reported - Penalty For Failure To Report - Immunity From Liability, C.R.S. §12-240-139 states that licensees who attend to or treat injuries are not required to report injuries that they have reason to believe involve a criminal act associated with the possession of drugs or drug paraphernalia.