Nebraska, one of the last states with no legally operating syringe service programs (SSP), will again confront proposed legislation that Governor Jim Pillen (R) and other opponents of harm reduction have been holding off for several years. LB165 was carried over from 2025 and entered into the current legislative session January 7. It’s sponsored by Senator Megan Hunt (I), who has been leading the legislative push to authorize SSP in Nebraska.
The bill would clear jurisdictions to authorize SSP at the local level if they chose to. It would also exempt SSP staff and participants from the state’s drug paraphernalia statute when they’re carrying syringes or other banned items to and from the program. Without such an exemption, paraphernalia violations are a Class II misdemeanor, which can be punished with up to six months’ jail time.
As the law stands currently, the only people authorized to distribute syringes in Nebraska are pharmacists. Nebraska also borders most of the other states without authorized SSP: Kansas, South Dakota, Wyoming.
HIV transmission in Nebraska has been increasing, and disproportionately affecting the state’s small population of Black men.
The Nebraska legislature passed a predecessor to the current bill in 2024. Despite widespread support it was vetoed by Pillen, who then dismantled legislators’ attempt to override the veto.
“Governor Pillen’s arguments against this bill were based on junk studies and fringe radical YouTube videos that go against volumes and volumes of peer-reviewed published research on how these programs have worked in other jurisdictions,” Hunt told colleagues during a January 2025 Judiciary Committee hearing.
Pillen has also leaned on Nebraska’s status as the state with the lowest overdose mortality rate, which it has achieved through shocking underreporting by the county attorneys who sign off on death certificates. Nebraska is the only state where cause of death is determined by prosecutors, rather than medical examiners or coroners, and a 2025 investigation found a pattern of not ordering autopsies unless there was a chance that the results could put someone in prison. Eleven counties hadn’t reported an overdose death in more than 20 years.
In 2025 Hunt brought back an updated version of the bill that explicitly restricted syringe services to adults, as Pillen had claimed that SSP “encourage” drug use by minors.
“This bill is airtight, it’s ready to go,” Hunt continued at the same 2025 committee hearing. “It simply gives the green light for city councils or village boards with the support of their constituents to figure out if and how they want to take this on. They can be as restrictive as they like, and they can pull the plug if the program isn’t working as intended.”
But rather than advancing, the bill was pushed to the 2026 session.
“[G]iven that it does not have the votes to advance from committee, there likely will not be any movement on it in 2026,” Hunt told Filter.
Pillen’s 2024 veto also leaned on other persistent yet entirely baseless myths, like the suggestion that “inadequate disposal of dirty needles [could leave] vulnerable populations like children at risk of contracting deadly diseases.”
There has never been a single confirmed case of HIV transmission from a publicly discarded needle. Once outside the human body, the virus dies almost immediately, which is why the extremely rare instances of needlestick transmission are among health care workers in hospital settings.
There have been perhaps three cases of hepatitis C transmission from accidental needlestick in community settings, none of them in the United States and none involving children. While hep C can eventually be fatal if left untreated, it takes years and often decades.
Hep C is also entirely curable with modern antiviral pills taken once a day for two or three month. The medication is almost always successful and rarely has any side effects, but can cost tens of thousands of dollars out of pocket. Nebraska was also one of the last states to impose abstinence as a prerequisite for Medicaid coverage of hep C treatment, finally waiving it in 2024.
Image via United States Department of Veterans Affairs
Correction, January 13: A previous version of this article stated that LB165 was reintroduced in January 2026; the bill is a carryover from 2025.