The Expanded Syringe Access Program (ESAP) in New York State (NYS) made syringes available to injection drug users without prescriptions through pharmacies and health care providers on January 1, 2001. This program was intended to provide illicit drug users with clean syringes so as to reduce transmission of blood-borne diseases, including HIV and Hepatitis C. The legislation that established ESAP mandated evaluation of the new policy's impact on trends in drug treatment and crime using existing indicators. This study, part of a larger evaluation, examined ESAP's impact on criminal activity and substance abuse. Findings strongly suggest that implementation of ESAP did not increase heroin use, drug injection, or criminal activity. Policy implications are discussed and recommendations for increasing syringe access are made. References (Published Abstract)