Harm reduction and safe drug use policies are getting renewed attention as the Biden Administration embraces them to combat rising overdose deaths.
In an exclusive interview with National Public Radio (NPR), Secretary of Health and Human Services (HHS) Xavier Becerra said the administration is “willing to go places where our opinions and our tendencies have not allowed us to go [before]” due to the pandemic and spread of fentanyl throughout the country, which we cannot ignore.
According to data from the Center for Disease Control (CDC), overdose deaths have been steadily climbing across the country since June 2019. At the time, the CDC recorded more than 67,000 overdose deaths on a 12-month period, which missed the agency’s projections by approximately 1,700.
The most recent data as of October 3 shows that the total number of deaths linked to drug overdoses has climbed to nearly 100,000 on a 12-month basis.
States like Louisiana, Kentucky, West Virginia, and Vermont have been hit the hardest. According to the data, each of these states reported at least a 55% increase in overdose death since last year.
Against this backdrop, Becerra said that his agency is turning to methods that were once thought of as taboo, such as clean needle exchange programs, safe consumption sites, and providing drug testing strips to users to combat the overdose crisis.
“We are literally trying to give users a lifeline,” Becerra told NPR.
What is Harm Reduction?
According to the National Harm Reduction Center (NHRC), harm reduction is both a set of practical principles that address the individual harms of drug use and a social justice movement built on respect for human rights.
Harm reduction also encompasses a range of strategies, including:
- Supervised injection sites (SIS)— facilities where medical professionals can monitor people who use drugs and intervene in overdose cases
- Teaching drug abstinence
- Addressing the conditions of drug use as well as the use itself
“Because harm reduction demands that interventions and policies designed to serve people who use drugs reflect specific individual and community needs, there is no universal definition of or formula for implementing harm reduction,” the NHRC says on its website.
Research shows that these programs are needed now more than ever. According to a Substance Abuse and Mental Health Services Administration paper, more people were reported using drugs during the pandemic.
Meanwhile, the Drug Enforcement Administration recently said it is seizing more fentanyl than ever before. Most of it is coming from bootleg prescription medications.
How Does Harm Reduction Impact People Experiencing Homelessness?
Harm reduction programs provide individual-level care for people experiencing homelessness and can also help address one symptom of homelessness: substance abuse.
Addictive disorders can often cause someone to experience homelessness because they can rupture family relationships. People who struggle to pay their bills may also turn to substances to forget their troubles and can develop addictions in the process.
While housing remains the primary solution to homelessness, research from Canada’s Center for Addiction Research (CAR) shows that intertwining Housing First and harm reduction policies is integral to a systems-level response to ending homelessness.
Housing First policies are designed to provide housing with no strings attached. This means an individual is not required to go through a drug treatment program to keep their home. This allows service workers to address each person at the individual level rather than treating just one symptom of homelessness.
Similarly, harm reduction policies focus on reducing the harms of substance abuse at the individual level. This includes providing safe injection sites and treatment options while also reducing the stigmas surrounding substance use.
When combined, both Housing First and harm reduction policies have been shown to reduce the cost of providing housing and services to people experiencing housing, CAR said.
Plan of Action
According to a statement issued by the White House earlier this year, the Biden Administration is adopting several harm reduction policies into its drug policy priorities. Some of the policies include:
- Expanding access to evidence-based treatment;
- Advancing racial equity issues in our approach to drug policy;
- Enhancing evidence-based harm reduction efforts;
- Supporting evidence-based prevention efforts to reduce youth substance use;
- Reducing the supply of illicit substances;
- Advancing recovery-ready workplaces and expanding the addiction workforce; and
- Expanding access to recovery support services.
To begin adopting these harm reduction policies at the agency level, HHS is requesting additional funding for drug treatment programs, racial equity initiatives, and reducing stigma in its 2022 budget.
Becerra wouldn’t say how quickly he believed the policies would make a dent in the trajectory of overdose deaths. He added that it will be “tough” to get state and local buy-in in some areas.
For example, grassroots organizations in states like North Carolina, Pennsylvania, and West Virginia are all working to shut down the harm reduction programs that the federal government is now advocating for.
“If we want to keep people alive, we’ve got to try everything the evidence says might work,” Becerra said.
NPR asked Becerra if he supported safe injection sites like the ones proposed in New York and Pennsylvania. Becerra gave an answer that left open the possibility before an HHS spokesperson replied that the agency “does not have a position” on the sites. However, it “supports various forms of harm reduction for people who use drugs.”
How You Can Help
Incorporating harm reduction principles into homelessness response systems has proven to be an effective way of providing the person-centered care that many people experiencing homelessness need. And states around the country are taking notice.
Governor Eric Holcomb of Indiana recently announced a $1.7 million investment in harm reduction strategies. At the same time, Morgantown, West Virginia’s city council, has voiced support for the city’s syringe service program amid public pushback.
That’s why we need you to contact your representatives in Congress and tell them to vote for this bill. We need a national strategy to address both the opioid and homelessness epidemics. This bill is an excellent start toward that end.
Contact your lawmakers and tell them you support investing in harm reduction policies to address homelessness. If implemented appropriately, these policies can help people stay housed and keep themselves on a path for future success.