Connecting you with life-saving harm reduction resources including needle exchanges, naloxone distribution, HIV testing, and more.
Just want to understand harm reduction first? Start here →
Missouri's syringe service programs still operate in a legal gray area. A 2022 bill that would have exempted registered exchange programs from paraphernalia charges passed the House and cleared a Senate committee, but there is no clear public record confirming it was ultimately signed into law. In practice, programs in St. Louis and Kansas City have run for decades regardless, the same way programs did in other states before formal authorization caught up. Fentanyl test strips are on firmer ground: the Missouri Foundation for Health's recommended decriminalization took effect in 2023. Naloxone is available from any pharmacist under a statewide standing order at no or low cost, with more than 11,000 prescriptions a year dispensed that way. Missouri's Good Samaritan law is unusually broad, covering not just drug and paraphernalia possession but also probation and parole violations and underage alcohol offenses for someone who seeks help during an overdose.
MoNetwork runs a syringe service program, naloxone distribution, and family support out of St. Louis. The St. Louis Black Harm Reduction Coalition applies harm reduction specifically within Black communities in the city, and the state health department's Bureau of HIV, STD and Hepatitis provides Harm Reduction 101 training to local agencies and community organizations statewide.
Because the legal status of syringe programs here has not been fully settled, confirm directly with a local program like MoNetwork before assuming statewide protection.
Last reviewed September 2026 by Penny Beach, PRS.
Recently added agencies in Missouri
Showing 8 recently added agencies in Missouri out of 57 total — search a city above to narrow it down
Local listings for these cities. The number is how many locations are listed.
Find agencies that offer these critical services
Safe syringe exchange programs that reduce disease transmission and provide a connection to care.
No Cost or low-cost naloxone (Narcan) distribution to reverse opioid overdoses.
Confidential testing for HIV and Hepatitis C with connections to treatment.
Basic wound care services to prevent infections and complications.
Fentanyl test strips and drug checking services to reduce overdose risk.
Find harm reduction agencies in your state. See the national overview
Harm reduction is a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use. It is also a movement for social justice built on a belief in, and respect for, the rights of people who use drugs.
Help us build the most comprehensive directory of harm reduction services. Submit an agency to our database.