Partisan politics derails efforts to improve public health through harm reduction
WASHINGTON, D.C. – Saving lives should be a winning political proposition regardless of one’s party affiliation. Yet, when it comes to policies like “harm reduction,” politicians are often intellectually inconsistent. Many seem to cherry pick the harm-reduction issues they deem politically palatable. This is true for both camps, from progressives who support banning e-cigarettes to conservatives who back the prohibition of syringe-exchange programs.
Described most simply, harm reduction meets people where they are when it comes to a variety of risky behaviors. More technically, it refers to any strategy that reduces the risk associated with a behavior. Harm reduction is in the news more than many people realize.
While attempts to ban e-cigarettes typically gets the most coverage, many states have taken up other harm-reduction policies. New Jersey recently cleared legal barriers for sterile syringe-exchange programs and Maryland just instituted a new law mandating better access to medication that reverses opioid overdoses. Policies like this are controversial, but these interventions improve health and ultimately save lives.
Despite this benefit, politicians from both parties often seize upon harmful behaviors – such as smoking or injection drug use – to stoke outrage or withhold their support for time-tested harm-reduction measures over concern for the political repercussions.
In a recent example, U.S. Sens. Tom Cotton, R-Arkansas, and Ted Cruz, R-Texas, amplified a debunked article that claimed federal funding earmarked for harm reduction could be used to buy and distribute “crack pipes.” That led Sens. Joe Manchin, D-West Virginia, and Marco Rubio, R-Florida, to introduce legislation banning the use of federal funds for select paraphernalia. The Biden administration attempted to clarify by stating that pipes were never part of the “safe smoking kits” in question.
In this example, both sides failed to support the full spectrum of harm-reduction strategies adequately. Distributing safe smoking kits, which often include rubber mouthpieces instead of pipes, can reduce harm by preventing mouth and lip sores that can lead to infections. Both sides also failed to mention that there is precedent for this proposal. Thirty-nine states allow syringe service programs – where drug users can exchange used needles for clean ones – because they reduce the transmission of HIV, Hepatitis C and other infectious diseases.
Progressives generally are more comfortable with harm reduction, yet they are not exempt from this phenomenon. By vetoing a bill to pilot overdose prevention centers in several cities, California Gov. Gavin Newsom recently showed that the left can also buckle under political pressure based on false narratives about harm-reduction efficacy. Despite saying in 2018 that he was “very, very open” to a pilot program, his actions in 2022 – when he’s up for re-election and possibly planning a presidential run – suggests that he sees them as a political liability.
Other examples of playing politics with harm reduction abound. From fear-mongering about rainbow fentanyl in Halloween candy to opposing the idea that reduced-risk nicotine products can help adults kick their smoking habits, harm reduction routinely gets caught up in partisan politics.
Politicians on both sides fail to realize that much of the controversy around harm reduction can be abated with better messaging. Harm reduction is another pillar of public health, and a much-needed bridge between prevention and treatment of health harms. Almost every politician wants to be hardline on prevention, and most claim to support treatment, but they forget that harm can be mitigated in a variety of practical ways.
For example, although no amount of combustible cigarette smoke is safe, people who smoke more frequently and for many years have a higher risk of lung cancer. Transitioning smokers to a non-combustible nicotine product that helps them quit smoking could be a solution to both reduce harm and improve their health. Harm reduction accepts the reality that this nation is composed of adult smokers, individuals who inject drugs and sexually active people. For those who cannot abstain or are not ready for treatment, harm reduction is a suitable alternative.
Partisanship should have no place in crafting harm reduction policy. Neither party wants to see more preventable deaths. Perhaps if both sides focused on that commonality, supporting harm reduction policy could move from controversial to commonplace. People’s lives depend on it.
