By Abby Goodnough, June 27, 2021
Overdoses have surged during the pandemic. Now, for the first time, Congress has appropriated funds specifically for programs that distribute clean syringes and other supplies meant to protect users.
GREENSBORO, N.C. — The thin young man quietly took in the room as he waited for the free supplies meant to help him avoid dying: sterile water and cookers to dissolve illicit drugs; clean syringes; alcohol wipes to prevent infection; and naloxone, a medicine that can reverse overdoses. A sign on the wall — “We stand for loving drug users just the way they are” — felt like an embrace.
It was the first day the drop-in center in a residential neighborhood here had opened its doors since the coronavirus forced them shut in the spring of 2020. “I’m so glad you all are open again,” the man, whose first name is Jordan, told a volunteer who handed him a full paper bag while heavy metal music riffed over a speaker in the background. He asked for extra naloxone for friends in his rural county, an hour away, where he said it had been scarce throughout the pandemic.
Overdose deaths rose by nearly 30 percent over the 12-month period that ended in November, to more than 90,000, according to preliminary federal data released this month — suggesting 2020 blew past recent records for such deaths. The staggering increase during the pandemic has many contributing factors, including widespread job loss and eviction; diminished access to addiction treatment and medical care; and an illegal drug supply that became even more dangerous after the country essentially shut down.
But the forced isolation for people struggling with addiction and other mental health issues may be one of the biggest. Now, with the nation reopening, the Biden administration is throwing support behind the contentious approach that the center here takes, known as harm reduction. Instead of helping drug users achieve abstinence, the chief goal is to reduce their risk of dying or acquiring infectious diseases like H.I.V. by giving them sterile equipment, tools to check their drugs for fentanyl and other lethal substances, or even just a safe space to nap.
Such programs have long come under attack for enabling drug use, but President Biden has made expanding harm-reduction efforts one of his drug policy priorities — the first president to do so. The American Rescue Act includes $30 million specifically for evidence-based harm reduction services, the first time Congress has appropriated funds specifically for that purpose. The funding, while modest, is a victory for the programs, both symbolically and practically, as they often run on shoestring budgets.
“It’s an enormous signal, recognizing that not everybody who uses drugs is ready for treatment,” said Daliah Heller, director of drug use initiatives at Vital Strategies, a global public health organization. “Harm reduction programs say, ‘OK, you’re using drugs. How can we help you stay safe and healthy and alive first and foremost?’”