The $1.9 trillion American Rescue Plan signed into law last week contained a series of provisions that have excited Democrats and progressives. Enhanced unemployment payments of $300 per week will continue until September. Support for low-income families will help with heating and cooling costs. The legislation allocates billions of dollars to struggling public transit agencies and expands the child tax credit.
Buried beneath the billions allocated for big-ticket items, three paragraphs in the 242-page legislation have given harm reductionists cause for celebration. They allocate $30 million for a range of harm reduction services and spell out a seismic change for the federal government’s approach to harm reduction. It is the first time the federal government has ever provided funding for such services.
The legislation directs grants to be provided “to support States; local, Tribal and territorial governments; Tribal organizations; nonprofit community-based organizations; and primary and behavioral health organizations to support community-based overdose prevention programs, syringe services programs and other harm reduction services.”
Advocates “have been working for years, if not longer, to build political support and build political recognition of the value of harm reduction providers and the role that they play in preventing overdose death and responding to the overdose crisis,” said Grant Wilder Smith, the deputy director of national affairs for the Drug Policy Alliance*. He described the funding as a “breakthrough.”
“The money couldn’t come at a more critical time.”
Though the Substance Abuse and Mental Health Services Administration will have to more thoroughly detail the list of programs eligible to receive the funds, the legislation states that grants will be given to help control the spread of infectious diseases (like HIV and hepatitis C), distribute overdose reversal medications (like naloxone) and provide overdose education, among other uses.
“The money couldn’t come at a more critical time given what we know about the worsening overdose crisis during the pandemic and economic downturn,” Smith said. “Given what we know in terms of talking with providers around the country and hearing that they’ve lost revenue, lost staff during the pandemic and economic downturn. Many have seen cuts to their revenue sources.”
The COVID-19 pandemic has made the overdose crisis deadlier. Between June 2019 and May 2020, more than 81,000 people died from overdose, according to figures released in December by the Centers for Disease Control and Prevention. People are using more, and in isolation—and in the absence of robust harm reduction services like syringe service programs, they’re more likely to reuse supplies like syringes and stems, elevating risk of transmitting HIV and hepatitis C.
Weekly overdose visits to emergency departments also rose drastically in 2020. While the total number of ED visits dropped precipitously, weekly ED trips linked to overdose were as much as 45 percent higher than in 2019.
Breakdowns of overdose data by race have yielded concerning findings. Research on Philadelphia’s overdose deaths found that fatalities soared more than 50 percent among the city’s Black residents, while overdoses among white residents actually declined in certain months.
Even as activists celebrated the passage of unprecedented funding for harm reduction services, they continued to call for more substantial funding—enough to meet the scale of the crisis.
“We dare to hope that this first significant federal investment in harm reduction is a watershed moment,” Daliah Heller, the director of drug use initiatives at Vital Strategies, said in a press release celebrating the funds included in the American Rescue Plan. “[A] sign that our country is ready to reject the punitive, carceral approach to drug use that has led to tens of thousands of deaths each year, and adopt proven harm reduction strategies grounded in health and dignity.”
* DPA previously provided a restricted grant to The Influence Foundation, which operates Filter, to support a Drug War Journalism Diversity Fellowship.
Photograph via Pixabay