The United States is facing an opioid epidemic. According to the National Institute of Health (NIH), in 2021, over 106,000 Americans died of drug overdoses. While the overprescription of painkillers and fentanyl’s popularization present new dangers on the drug landscape, substances like crack cocaine, cocaine and heroin continue to plague communities nationwide. As a result, state and federal governments have begun implementing harm reduction programs to reduce drug overdoses and mitigate the spread of diseases associated with drug use like HIV and Hepatitis.  

It’s easy to vilify harm reduction practices when there is a misconception about what harm reduction actually is. Contrary to popular belief, harm reduction programs do not endorse, encourage or enable drug use. Rather, they provide lifesaving resources to those who already struggle with substance abuse and cannot take on abstinence-based treatment yet. For example, harm reduction programs supply those who use drugs with the supplies necessary to make using them as safe as possible. Harm reduction programs distribute Naloxone (Narcan), an intranasal or injectable medication that can reverse opioid overdoses. The National Institute of Health estimates that states with laws increasing access to Nalaxone can see a more than fourteen percent decrease in opioid overdose deaths follow implementation. Programs also distribute fentanyl strips, so drug users can avoid consuming the highly dangerous drug, often laced into street drugs. Syringe Service Programs supply those who use substances via injection with alcohol swabs, tourniquets, sterile needles/syringes and containers/sites to safely dispose of them once used. According to the CDC, those who use Syringe Service Programs are five times more likely to start treatment and three times more likely to stop using drugs. Supervised consumption sites, also known as overdose prevention sites, are also a core harm reduction component. At these sites, drug users can use pre-obtained drugs under the supervision of nurses and other medical professionals to stop a potential overdose. 

What’s incredibly important to note is many harm reduction centers and groups act as a gateway point for drug users to receive long-term treatment, referring them to counseling, support groups, social services and rehabilitation programs, as well as prescribing medications like Methadone, which help drug users transition into recovery. Essentially harm reduction theory maintains that if someone is being harmed by their use of drugs and can’t participate in abstinence, that at least their risk for overdosing, contracting bloodborne infections & STDs, accidentally consuming fentanyl or polluting nearby public areas with hazardous drug paraphernalia can be dramatically reduced because they too are worthy of protection. Even in the face of legal challenges, harm reduction initiatives, often run by medical professionals, community activists and drug users in recovery, continue to operate in conservative strongholds.

Although harm reduction has proved successful in curbing the worst effects of drug use, the American right remains convinced these practices prevent drug users from “getting clean” because they enable their usage. Tucker Carlson has mocked President Biden’s attempt at implementing harm reduction by claiming Biden wants to provide Black cocaine users with Crack pipes because he doesn’t care about the opioid crisis affecting White Americans. Texas Governor Ted Cruz joined in on criticizing the 30 million dollar SAMHSA grant, which includes harm reduction policies, by tweeting, “Biden crime policy: Crack pipes for all.” Drug users don’t continue to use drugs, despite their incredibly harmful effects, because of the services and supplies harm reduction programs provide; they continue to use drugs because of the ways in which substances are addictive. Harm reduction programs exist because drug users who aren’t ready to enter abstinence-based treatment will continue to use them anyway. That doesn’t mean, however, that it isn’t worth trying to shield this vulnerable population from HIV, Hepatitis, skin wounds, STDs and overdose. Arguments that harm reduction enables drug use, when harm reduction keeps drug users safe and refers those ready to engage in abstinence to treatment, are invalid.

Republicans like Carlson and Cruz don’t represent the large number of Americans who, in my opinion, are likely pro-harm reduction. Still, their power as influencers of public opinion and lawmakers/legislators means their rhetoric is partially responsible for upholding the current legal precedents preventing harm reduction from being implemented equally across the country. Currently, state and local governments cannot use federal funds from the HHS to purchase syringes/needles, including Biden’s 2022-2025 SAMHSA grant, without proving their area is at an elevated risk for HIV or hepatitis outbreaks to the CDC. In 19 states, it is illegal to possess fentanyl testing strips because they are “drug paraphernalia”. Furthermore, the HHS does not support supervised injection sites. Such is why New York is the only state to operate these sites. Even California Governor Gavin Newsom (D) vetoed a bill allowing certain California cities and counties to operate such sites, claiming they would worsen California’s drug problems. 

If the public starts treating substance abuse like what it is: a complex issue that does not make an afflicted person deserving of punishment or social isolation, the GOP would not be able to incarcerate individuals struggling with addiction. Therefore, if we truly want to change addiction treatment, recognizing the important role harm reduction plays, we have to change how we think about our justice system and the place of drug addiction within it.