Real Solutions

Harm reduction is finally getting the attention it deserves

July 8, 2021

If the opposite of addiction is connection, perhaps it is unsurprising that 2020 heralded yet another grim milestone—a 30 percent increase in overdose deaths. For those struggling with substance abuse and mental health issues prior to the pandemic, the experience of forced isolation proved too big a burden to bear alone. Syringe services programs, also known as syringe exchanges, are key providers of harm reduction supplies. During the pandemic, many of these vital organizations had to close or scale back their services. Syringe services programs provide much more than sterile syringes and supplies; they often provide wound care tools, food, fentanyl test strips, HIV and STI testing, and naloxone, the lifesaving drug that reverses opioid overdoses. This left many in need further from accessing resources that could save their lives; however, there is a glimmer of hope on the horizon in the form of dedicated federal funding to enhance the effectiveness of these interventions.

The American Rescue Plan and the president’s 2022 budget contains something revolutionary. Although the sums are comparatively small, these plans mark the first time that the federal government has allocated money specifically for harm reduction efforts. This is a step toward realizing the president’s drug policy priorities for his first year in office. Including harm reduction in the federal budget and his drug policy priorities is a bold and commendable action by President Joe Biden, as he is the first president to do so. Here at R Street, we have been promoting harm reduction since our beginnings, and we commend the administration for adopting a pro-harm reduction policy position.

The public health strategy for harm reduction operates on the principle that abstinence-only approaches do not work at the population level. The United States tested this theory with the prohibition of alcohol. Despite it being illegal, people continued to drink. And they drank despite the supply of alcohol becoming less safe. The war on drugs is yet another example of the failure of using prohibition as the sole intervention. As such, harm reduction meets individuals where they are and not an idealized vision of where they ought to be. Opponents of harm reduction programs argue they promote increased drug use and often propose legislation to curb their operations. From Indiana to North Carolina to West Virginia, policymakers are ignoring the evidence and the results are proving devastating, with the Centers for Disease Control and Prevention (CDC) triggering a health advisory warning for the detection of several HIV outbreaks among intravenous drug users.

While the president’s efforts are targeted toward reducing overdose deaths, there is an opportunity to apply harm reduction to a number of areas impacting public health—tobacco control, sexual health, illicit drug use and alcohol consumption are examples. That is why R Street recently expanded its scope of harm reduction public policy—a recognition of the value in addressing these topics simultaneously and not in silos where they risk monopolizing one another’s success. Our new Integrated Harm Reduction program is dedicated to promoting harm reduction—in all its forms—to policymakers and practitioners alike by providing expertise, convening thought leadership and advocating for meaningful public policy change. We hope that you’ll join us in this new endeavor.

Image credit: Mitch