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As overdose crisis rages, we must prioritize saving lives with harm reduction

A sign calling attention to drug overdoses is posted to the door of a gas station on the White Earth reservation in Ogema, Minn.
Associated Press/David Goldman

As advocates and service providers working on the frontlines of the overdose crisis, we’ve seen firsthand the devastating toll and growth of the overdose epidemic. All around us, people are dying. Families and communities are struggling. Everyday we hear stories of loss and of loved ones and residents trying to find life-saving assistance. 

The scale of this public health crisis is staggering – Americans are now more likely to die of an overdose than in a car accident. Throughout the past decade, over 1 million people lost their lives, with 2021 taking more than 107,000 Americans in just 12 months. Existing racial inequities are being compounded, as Black Americans now suffer from higher opioid death rates than white Americans. These numbers will continue to grow with each passing year unless we change the way we deal with substance use, which is why we must focus on public health solutions. That means ending the stigma around substance use and instituting harm-reduction policies that are proven to save lives.

How does a crisis causing the deaths of so many people go unaddressed? In part, it’s because of the stigma our country places on people who use drugs. Rather than focusing on the human cost of overdose and on public health solutions, policies dealing with substance use often center on criminalization and punishment, perpetuating racial injustice by design. Because of targeted policing, Black people make up 24 percent of drug arrests, almost double their demographic percentage, and are three times more likely to be arrested for drugs than white people, despite using and selling drugs at the same rates. Additionally, legislators continue to push new laws that disproportionately harm Black, Latinx and Indigenous people by sending them to prison, reducing access to life-saving support.

Harm reduction is an evidence-based approach that prioritizes keeping people alive. From the distribution of life-saving medicines like naloxone, to syringe service programs that provide education while reducing the spread of infectious diseases, this strategy prevents deaths, protects those who use substances and provides them with options when they are ready to seek treatment.

Harm reduction is compassionate, recognizing the dignity and humanity of people who use drugs. But it is also grounded in evidence. Hundreds of studies over more than three decades show that syringe service programs reduce overdose deaths and infectious disease transmission rates. States that have expanded access to naloxone, a drug that reverses opiate overdoses, saw double-digit reductions in overdose deaths. For instance, Connecticut Harm Reduction Alliance engaged approximately 3,500 participants, distributed 4,200 Narcan doses, and reversed over 300 drug overdoses in 2021. 

In fact, new recipients of syringe service programs are five times more likely to enter drug treatment than those who don’t use the programs. They also save taxpayers millions of dollars in medical treatment costs. However, while the U.S. has increased funding for drug prevention and treatment, there has been little money directed toward evidence-based programs that work with — and save the lives of — people who use drugs.

Congress and the Biden administration need to do more to keep people alive by increasing access to effective, lifesaving interventions, such as harm reduction services. 

Traditionally, federal support has focused on access to drug prevention and treatment services. To expand support for harm reduction and related interventions, Congress and the administration should provide resources for syringe services programs and related harm reduction programs nationwide to help prevent drug overdose and provide access to critical health and support services. They should make naloxone readily available to the people who use drugs, their friends and family and to people in the communities most affected by the overdose crisis. They should communicate often with directly impacted people and their families, harm reduction providers, and community leaders in order to rapidly respond and implement the solutions required to turn the corner on this deadly crisis.  

Today, we are at a major inflection point. Most overdose deaths are preventable. But for too long, we have let fear stand in the way of evidence, compassion and common sense. Too many of our children, sisters, brothers, parents, neighbors and friends have been lost.

We can either resign ourselves to this incredible loss, or we can take action. Congress and the administration must come together, take a public-health approach to this crisis, and fund effective harm reduction programs.

Mark Jenkins is founder and executive director of the Connecticut Harm Reduction Alliance.

Kassandra Frederique is executive director of the Drug Policy Alliance.

Tags Drug overdose drug use Health care overdose Public health

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