During President Biden’s State of the Union this past February, he endorsed harm reduction as one strategy to reduce the epidemic of drug overdoses. What harm reduction means on the ground can vary from state to state, city to city. The goal of harm reduction is to provide drug users with tools, enabling them to use drugs safely. Harm reduction doesn’t seek, in the short run, to end drug use. Rather these programs work to reduce deaths due to overdoses.
Harm reduction which can include needle exchange, fentanyl strip testing, and the use of the overdose reversal drug, naloxone, can be controversial. Critics often see these programs as encouraging drug use. Many conservatives feel abstinence, just saying no, is a better approach. In general, the country’s drug control policy for many years has focused on military style interdiction and punitive measures for drug addicts.
A critical component of any harm reduction program is needle exchange. The CDC states that new users of needle exchange services are “five times as likely to enter drug treatment as those who don’t use the programs.” Needle exchange also reduces infections including HIV and hepatitis.
Despite the science behind harm reduction programs, the country remains ambivalent about it. Many states prevent the use of fentanyl test strips, another critical part of most programs. The laws consider the strips to be drug paraphernalia. According to the New York Times, “While the Centers for Disease Control and Prevention encourages the use of syringe exchange programs, … federal funds typically cannot be used to purchase syringes for drug use.”
Because of this ambivalence, most harm reduction programs run on a shoestring budget and face legal peril every day. There needs to be concerted advocacy for harm reduction funding and a push to make needle exchange fully legal. These actions would save lives.