As the opioid epidemic continues to take its toll in the United States, some Republican legislators are championing harm reduction approaches like needle exchanges and addiction treatment—in what advocates say is an about-face on an issue many conservative politicians once opposed, Kaiser Health News reports.

Over the past few years, at least four red state legislatures have considered bills to allow needle exchanges, which provide sterile syringes to injection drug users, thereby helping to reduce new cases of hepatitis C virus (HCV), HIV and other infections. Two Republican-led states, Georgia and Idaho legalized them this year. And Florida, Missouri, Iowa and Arizona have all introduced bills this legislative session that would allow needle exchanges.

For years, research has shown the benefit of needle exchanges, but with the opioid epidemic in full force, harm reduction advocates say lawmakers are finally listening. This latest support is big news, say harm reduction advocates, because Republicans have in the past characterized such programs as enabling drug use and illegal activity.

But public health evidence of the effectiveness of needle exchanges’ is stacking up, as have the number of states allowing the programs. Currently, 28 states and the District of Columbia legally allow needle exchanges.

Another tipping point for many Republicans was the 2015 HIV outbreak in rural Scott County, Indiana, where more than 180 people out of just 24,000 residents were newly diagnosed with the virus. Vice President Mike Pence, then the governor of Indiana, initially opposed needle exchanges. But two months after the outbreak was detected, Pence allowed a limited syringe exchange in the county.

However, despite the movement among some Republicans to accept needle exchanges as common practice, 13 states still have laws banning them. All of those states have Republican governors and Republican-majority legislators, except Kansas, which has a Democratic governor.

To learn more about the Republican response to the opioid epidemic, click here.