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Texas is one of the harder states in this list. Syringes and fentanyl test strips are both still classified as drug paraphernalia under state law, and there is no statewide authorization for syringe service programs. San Antonio has one anyway: Corazon Ministries runs a weekly needle exchange on the city's West Side, operating in the same legal gray area a Bexar County-run program tried and failed to occupy back in 2008, when the state attorney general opinioned that county workers distributing needles could still be prosecuted. In 2025, a bill to authorize syringe programs in six more counties (Dallas, El Paso, Harris, Nueces, Travis, and Webb) passed the Texas House 77 to 65 but died in the Senate without a hearing; its sponsor plans to reintroduce it in 2027.
Texas's 911 Good Samaritan law is also one of the weakest in the country: it does not apply to callers with a felony record, does not apply if the caller has already called 911 for an overdose in the past 18 months, and does not apply if police are already on scene. Naloxone fares better. Prescribers can issue it by standing order to anyone at risk or in a position to help, and pharmacists can request their own standing order from the Texas Pharmacy Association after a one-hour training.
The state's main coordinating body is the Texas Targeted Opioid Response (TTOR), run by Health and Human Services since 2017. On the ground, the Texas Harm Reduction Alliance operates a drop-in center and street outreach in Austin.
Last reviewed September 2026 by Penny Beach, PRS.
The Texas Department of State Health Services (DSHS) directs residents to a CDC-produced instructional video on naloxone administration as part of its Texas Overdose Data to Action program resources.
These are general steps. Always follow the instructions included with your specific naloxone product.
Recently added agencies in Texas
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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.
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