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 →
North Dakota has five syringe service programs, each tied to a local public health unit. A 2021 law, House Bill 1163, broadly defined "supplies" to include needles, syringes, prep equipment, wound care items, test strips, and naloxone, and specifically excluded all of it from the paraphernalia definition when it comes from or is returned to one of these programs. Outside that context, though, the picture is different: North Dakota is one of just five states where drug-checking equipment in general remains arguably illegal to possess, since paraphernalia law still technically covers testing equipment on its own. Naloxone is available through pharmacist prescriptive authority, and North Dakota's Good Samaritan law encourages friends, family, and bystanders to call 911 during an overdose without fear of prosecution.
All five of North Dakota's syringe service programs receive State Opioid Response funding, which they use specifically to purchase fentanyl and xylazine test strips and to connect participants to testing and treatment. Twenty-seven local public health units and three of the state's federally recognized tribes carry out opioid response activities with that same SOR funding, and North Dakota State University's School of Pharmacy runs the ONE (Opioid and Naloxone Education) Program, training pharmacies statewide to screen for opioid risk.
Because test strip legality depends on whether it came through a registered program, getting supplies through one of the five official syringe service programs, not just any pharmacy, is the safer path in North Dakota specifically.
Last reviewed September 2026 by Penny Beach, PRS.
Recently added agencies in North Dakota
Showing 8 recently added agencies in North Dakota out of 11 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.