The Biden administration‘s new strategy for addressing the crisis of drug abuse emphasizes controversial harm reduction strategies.
The administration’s effort to beat back the addiction crisis includes prioritizing harm reduction services, which are not meant to keep people from doing illicit drugs, such as heroin and cocaine, but rather to keep them safe and alive when they do. Harm reduction programs also steer users toward substance use treatment resources, which they otherwise would not be made aware of if they were using on their own.
“In other words, harm reduction is people-centered. It means helping people who use drugs access the services they need to stay alive. It means building trust with them so that when they wish to seek help, they know where to turn,” the administration said.
President Joe Biden’s blueprint outlines the need to expand the availability of naloxone, the lifesaving opioid overdose reversal drug, as well as fentanyl test strips that alert users to trace amounts of the deadly synthetic opioid in their drugs. The strategy also includes expanding syringe services programs, which give users access to and disposal of sterile syringes and injection equipment, as well as links to substance use disorder treatment.
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“We are changing how we help people when it comes to drug use by meeting them where they are with high-impact harm reduction services and removing barriers to effective treatment for addiction while addressing the underlying factors that lead to substance use disorder head-on,” said Dr. Rahul Gupta, director of the Office of National Drug Control Policy.
The administration’s newly released strategy is in alignment with Biden’s stated goals for dealing with the opioid crisis from before he gained office. Biden included the first-ever mention of harm reduction services in a State of the Union address earlier this year, telling Congress, “There is so much we can do. Increase funding for prevention, treatment, harm reduction, and recovery.”
The administration also established the first-ever Harm Reduction Grant Program in December through the Substance Abuse and Mental Health Services Administration with a budget of $30 million. The funding was allocated through the American Rescue Plan passed early in Biden’s presidency to counter the damage done by COVID-19, which includes significantly increased rates of fatal overdoses tied to opioids. Over 106,000 people died due to drug overdoses in the 12-month period ending in November 2021, according to the Centers for Disease Control and Prevention.
Applications for grant funding were due in early February, and many Republicans took issue with a specific service that SAMHSA grant money would cover: safe smoking kits, which typically contain alcohol swabs, lip balm, and other protective materials meant to protect users from burns, blisters, and transmittable infections such as HIV and hepatitis C. It was reported in a Washington Free Beacon article that the safe smoking kits would also include government-funded pipes for smoking crack cocaine or crystal methamphetamine. The outlet’s reporting caused an uproar, eliciting condemnation from Republican lawmakers, such as Texas Sen. Ted Cruz, Tennessee Sen. Marsha Blackburn, and North Carolina Sen. Thom Tillis, although the Biden administration denied it. HHS and the Office of National Drug Control Policy later issued a joint statement, saying, “No federal funding will be used directly or through subsequent reimbursement of grantees to put pipes in safe smoking kits. The goal of harm reduction is to save lives.”
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More generally, opponents of the harm reduction strategy maintain that it enables drug users to continue using rather than successfully convince them to enter a total abstinence program.
The harm reduction strategy has been found to reduce the rate of HIV/AIDS transmission among people who inject drugs without increasing rates of drug use. Harm reduction services have also provided people who use drugs with a gateway to addiction treatment programs that they may not have sought out otherwise. For instance, community-based syringe services programs that provide sterile supplies have been shown to reduce drug use, and people who take advantage of them are five times as likely to enter treatment and more likely to reduce or stop using injectable drugs.
