Since the 1990s, the Texas Legislature has considered bills to legalize syringe exchange programs (SEPs) as a means of reducing the transmission of blood-borne diseases among people who inject drugs, yet the measures have failed to reach passage by the full legislature. With a new SEP bill under consideration in the current legislative session, Drug Policy Program director Bill Martin summarizes the scientific and fiscal evidence supporting the efficacy of syringe exchange programs and outlines a framework for public policies to deal with this aspect of drug use and abuse.