Put politics aside and apply harm reduction for all substances
Today, the R Street Institute released a new report that examines harm reduction public policy in all 50 states for tobacco, opioids, and cannabis. The author, R Street Resident Senior Fellow for Integrated Harm Reduction, Stacey McKenna—in consultation with R Street’s tobacco harm reduction expert, Jeffrey S. Smith—reviewed harm reduction-related policies across different states and their inconsistent application when it comes to different substances. Using this information, the report ranks states as “restrictive,” “moderate,” or “permissive” on harm reduction with regard to each substance.
“In 2023, approximately 450,000 Americans died from smoking or second-hand exposure to cigarettes, and more than 112,000 died from a drug overdose. Some believe that the most logical way to prevent these deaths is for people to simply quit using substances,” said McKenna. “However, history tells us that abstinence is not a realistic goal for everyone. After all, people have consumed psychoactive substances for about as long as we have been human.”
Harm reduction is a pragmatic approach that gives people the knowledge and resources to stay safer—even when they continue engaging in risky behaviors such as substance use. Importantly, this approach recognizes that those risks may stem from two places: the inherent nature of the substance and prohibition itself. Because of this, harm reduction policies promote access to tools and resources that can help reduce some of these risks and ensure safer, regulated products.
Despite the life-saving potential of these policies, states do not always take a consistent approach to harm reduction legislation. Some states that support one type of harm reduction may actively oppose another type. This lack of consistent policy is often influenced by political drivers.
This theory plays out in this report’s findings. In reviewing the legislative landscape of each state across different areas of harm reduction, the author quantitatively compared select harm reduction policies across all states and qualitatively examined those states deemed as “restrictive” on at least one substance. (Below from the study: Comparison of Harm Reduction Across Three Policy Areas in 19 States Deemed “Restrictive” in at Least One Harm Reduction Category.)
Among other findings, the qualitative examination revealed an important pattern: The five states that are most restrictive of reduced-risk nicotine products in tobacco harm reduction—California, Massachusetts, New Jersey, New York, and Rhode Island—are, for the most part, relatively “permissive” when it comes to opioid harm reduction and cannabis use.
In this comprehensive analysis, author Stacey McKenna makes the case for lawmakers to reflect on their inconsistencies, put political motivations aside, and support harm reduction across all behaviors. As she concludes, “[P]olicymakers who want to improve public health and well-being related to substance use would do well to look to the field of harm reduction.”