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A controversial approach to drug addiction, known as “harm reduction,” has received federal funding for the first time under the Biden administration, possibly signaling the beginning of a major change in federal drug policy.
Most approaches to drug addiction focus on getting people with addictions into treatment, while harm reduction entails keeping them safe while they are still using.
President Joe Biden’s American Rescue Plan Act, which passed Congress in March, contained $30 million for harm reduction programs, marking the first time federal funding had been provided for such programs. Biden’s fiscal year 2022 budget proposal includes money in the $10.7 billion Health and Human Services budget for harm reduction programs, although a precise figure was not available.
“It’s an enormous signal. To have [harm reduction] supported monetarily is ... a recognition of the crisis we are in the midst of and that we need a more holistic approach to drug use in this country,” said Daliah Heller, director of drug-use initiatives at Vital Strategies, a nonprofit organization that addresses public health problems.
Needle exchange programs, which give people who are addicted to drugs clean needles to avoid HIV or hepatitis C, are probably the best-known method of harm reduction. But the approach involves much more.
“The easiest way to think about it is as a public health strategy for reducing the potential health and social harms associated with drug use,” Heller said.
Organizations involved in harm reduction often provide Naloxone, a drug that can treat overdoses. They also offer other services, such as support group meetings, access to anti-craving medications such as methadone, and help with finding treatment.
“We work in a gray area,” said Louise Vincent, executive director of the North Carolina Survivors Union in Greensboro, a center that provides harm reduction services. Vicent said people often think drug users “are either completely well or completely sick. There is no place where you can go ... that you can say, 'I don’t want to give up drinking, but I do want to give up smoking crack' ... [At the Survivors Union] we listen to what people want.”
Vincent has previously struggled with drug addiction, which is common among people who work in harm reduction.
According to the Centers for Disease Control and Prevention, overdose deaths increased during the pandemic. From April to November 2020, overdose deaths jumped by nearly 62,000 compared to the same period in 2019, an increase of almost 10%.
The rise in deaths may be linked to an increase in drugs such as heroin being mixed with more dangerous drugs such as fentanyl, a synthetic opioid responsible for a major share of overdose deaths in the United States, according to the CDC.
“It’s important to understand that the illicit drug supply is adulterated,” Vincent said.
To combat this, harm reduction centers often provide test strips and machines to determine if a dose of heroin or other drug contains harmful additives.
A considerable amount of research has found needle exchange programs reduce the incidence of HIV and hepatitis C. Other studies have found they reduce healthcare costs and result in more people entering drug treatment.
But these programs have their critics, including those who claim they enable drug users. Needle exchange programs often face opposition from residents and politicians concerned they will lead to more drug addiction and crime.
“I know people who are alcoholics, and I don’t buy them a bottle of whiskey. And I know people who want to kill themselves, and I don't buy them a bullet for their gun,” Mike Jones, a county commissioner in Scott County, Indiana, told the Courier-Journal.
Jones and fellow commissioner Randy Julian voted in June to end a needle exchange program in Scott County.
In 2018, Charleston, West Virginia, shut down a similar program.
Danny Jones, the mayor of Charleston at the time, told the New York Times it was a “mini-mall for junkies and drug dealers.”
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Original Author: David Hogberg
Original Location: Biden funds controversial 'harm reduction' approach to drug treatment