The Intersection of Harm Reduction and Zoning Law: A Growing Divide Between NIMBYs and Public Health Initiatives

Walking into Fayette County’s courthouse in eastern Indiana, one would expect to find the normal sights and sounds of a courthouse—attorneys preparing for trial, clerks assisting individuals, and judges in their chambers. However, the Fayette County courthouse offers something found in only nine of Indiana’s ninety-two counties: a syringe exchange program (“SEP”). Located in the courthouse’s basement, this program offers vital services to people fighting substance use disorder, such as clean needles, needle disposal, HIV and hepatitis C testing, naloxone to prevent overdose death, fentanyl test strips, immunizations and medical care, and referrals to drug treatment centers. Programs such as Fayette County’s SEP only became legal in Indiana in 2018, following the passage of Indiana House Bill 1438, which allows a county to create a SEP. Even with a legal path to the creation of SEPs, only nine counties in Indiana now operate such a program. Although considerable progress has been made in Indiana to reduce the harm of substance use disorder, there are still counties unwilling to provide individuals with these life-changing and lifesaving services.