A coalition of over 60 harm reduction organizations is calling for the Biden administration to increase federal funding to harm reduction services by $15 billion over the next four years.
“This 20 percent increase over current funding levels is necessary to reach those not now getting help,” the National Campaign for Harm Reduction Funding (NCHRF) wrote in a December 22 letter addressed to the Biden-Harris transition team and recently shared with Filter.
The current federal budget for addiction treatment and prevention stands at $18 billion per year. But that funding is not reaching the majority of people who use drugs—especially Black and Brown people, who have been disproportionately impacted by both the COVID-19 pandemic and the overdose crisis, the letter writers point out.
The campaign members call for an additional $3.7 billion per year to “meet people who use drugs where they are,” since federal funding has largely gone to abstinence-only treatments in the past.
NCHRF hopes that the additional funding would be used for a variety of services, including syringe programs, naloxone training and distribution, and harm reduction psychotherapy. The campaign also recently presented its demands in a meeting with a representative from the Biden transition team’s Agency Review Team for Health and Human Services.
NCHRF’s letter doesn’t specifically mention safe consumption sites (SCS), however, the legal status of which has not been definitively determined in the US. (Most recently, an appellate three-judge panel ruled that Safehouse, a would-be SCS in Philadelphia, would violate the federal “crack house statute.” However, that ruling is currently only binding in the Third Circuit states of Pennsylvania, New Jersey and Pennsylvania.)
Providing funding directly to non-governmental organizations would help speed up the process.
The group also recommends “funding at $250 million a year geographic-based cooperative grants to non-governmental organizations and public health agencies involved in addressing the needs of people who use substances who are not actively engaged in formal treatment.”
Providing funding directly to non-governmental organizations would help speed up the process of ensuring that harm reduction resources get to wherever they’re needed. It would also cut down on the amount of federal funding that gets squandered. For example, states had not withdrawn $1.4 billion of State Opioid Response grant funds from the federal government as of August 2020, according to a December 14 report by the Government Accountability Office.
NCHRF includes harm reduction organizations from all over the country, as well as advocacy organizations and groups of medical professionals.
One of the coalition’s strengths is its willingness to embrace organizations all across the “harm reduction-recovery continuum,” according to Dr. Andrew Tatarsky, the founder and director of the Center for Optimal Living and a harm reduction psychotherapy expert.
“Traditionally, there has been a really unfortunate split between traditional recovery communities and the harm reduction world,” Tatarsky told Filter. But now, he thinks “that traditional split is being healed” thanks to the “sea change” of traditional recovery organizations being more willing to embrace harm reduction principles. He pointed to Enzo Recovery and the Levenson Foundation, both signers of the campaign’s letter, as examples of such groups.
Tatarsky added that there’s a historical precedent for what NCHRF is demanding: In 1990, Congress enacted the Ryan White CARE Act, which created a specific program to fund the medical care of low-income people with HIV.
“There has not been an analogous effort around federal government support for harm reduction,” Tatarsky said.
The campaign views its demands of shifting towards a public health approach through a racial justice lens.
Three main reasons triggered the formation of NCHRF, according to Heather Haase, a NCHRF member.
First, the campaign members anticipated that the new Biden administration would be more responsive to the harm reduction community.
Second, while the COVID-19 pandemic “completely exacerbated the overdose crisis,” according to Haase, it also created new opportunities to address the crisis in the form of telehealth, as well as relaxed regulations around methadone and buprenorphine.
Third, the police killings of George Floyd and Breonna Taylor brought the importance of criminal justice reform to the forefront for NCHRF’s members. The campaign views its demands of shifting towards a public health approach (rather than a punitive one) through a racial justice lens. And it did not shy away from that stance during the meeting with a representative from the new administration’s HHS team.
“The ‘War on Drugs’ approach has been particularly harmful to Black and Brown communities,” Dr. Samuel K. Roberts, a professor at Columbia University’s Mailman School of Public Health, said during the meeting. “Making the shift to harm reduction is a scientific way to begin to repair the racial, political, economic and health inequalities experienced by these communities.”
Going forward, NCHRF plans to welcome even more organizations into its fold, and hopes to continue its advocacy efforts in the long term, “definitely long beyond the transition to the new administration,” Haase told Filter. Individuals will also be able to sign on to the letter at a later date, according to Tatarsky.
Current initiatives in the policy realm could advance the goals of the harm reduction movement as well, said Jennifer Flynn Walker, senior director of mobilization and advocacy at the Center for Popular Democracy, and one of the signers of the letter.
Flynn Walker mentioned the Comprehensive Addiction Resources Emergency (CARE) Act, introduced to Congress in 2019 by then-Rep. Elijah Cummings (D-Md.) and Sen. Elizabeth Warren (D-Mass.). Passing the CARE Act, which was inspired in part by the Ryan White CARE Act, would provide $100 million in federal funding over the next 10 years.
It would also ensure that there are programs “actually designed by drug users,” Flynn Walker told Filter, since the act would set up “localized planning councils” that would give people who use drugs a seat at the table to decide where money goes.
Flynn Walker also brought up Biden’s calling for 100,000 public health jobs in his coronavirus relief “American Rescue Plan.” She said it would be crucial to remind Biden that “we need to have as part of those public health jobs harm reduction outreach workers.”
Such a strategy would not only tackle the public health crisis of overdoses but address the coronavirus pandemic as well.
Harm reduction organizations “are the places where people can go with no judgment,” Flynn Walker said. “Those are also the places that are going to help with vaccine distribution because those are the people that can talk to people on the street about the importance of getting the vaccine.”
Correction, January 20, 2021: A previous version of this article misstated Heather Haase’s title.