Advocacy Project for Harm Reduction and Drug Education Funding
Drugs have been a part of US culture for many years, and not always in a good way. Addiction, abuse, dependence, illegal use, and prescriptions are now at record highs, and so are deaths. These problems surrounding drug-use are damaging not only people’s health but have created a large social and demographic problem in inner-cities especially.
Currently, the US is trying to end the massive expansion of drugs. One recent development is the opioid crisis which has resulted in the death of 175 people every day. This has affected public health and social and economic welfare. Overall, the US has been involved in this fight to end the expansion of drug use but maybe we aren’t going about it in the most effective way.
It is important that we find a solution to this drug epidemic. One clear solution is to spread acceptance of the drug Naloxone, also known as Narcan. Brian Resnick, a science journalist, says in his article titled, “This Drug Won’t Stop the Heroin Epidemic. But it Can Help”:
Narcan is the good twin to heroin’s bad. Its similar chemical shape allows it to push heroin out of the opiate receptors in the brain. But unlike heroin, it does not activate those same pathways. It shuts them down. After a paramedic sprays it into the nose…the effect is an immediate reversal of overdose symptoms. Often, this occurs with startling speed.
The government’s influence in the distribution of Narcan, a drug that reverses the effects of overdoses, is effective in limiting the number of overdoses and increasing the number of lives saved. Narcan can be given to newborn babies whose mothers took opioid painkillers during their term. It is safe to give Narcan because it does not suppress the breathing of the newborn. Suboxone, developed from Narcan, can be used in the treatment of addicts in remission (Ian). There has been a rise in heroin overdoses by 45%, so Narcan has taken a step to reduce that (Resnick). Radley Balko, again, Washington Post journalist on the drug war and criminal justice, reported that “It isn’t possible to administer Narcan in lethal doses…16 organizations trained 20,950 people in how to give Narcan to an overdosing drug user. The trainees have successfully reversed 2,642 overdoses.” Experts say that Narcan is effective and is saving many lives. The distribution of Narcan kits to be kept in the hands of the public has worried some as far as Good Samaritan laws. Senator Edward Markey, D-Mass., introduced legislation to fit the use of Narcan under Good Samaritan protections to those who administer the drug, meaning that those who administer the drug to those seeking medical attention are granted immunity from criminal prosecution (Resnick). Also, people who overdose and are treated with Narcan are commonly offered social service help and guidance. These professionals discuss treatment plans and the next steps for rehabilitation, overall trying to eradicate drug use. Narcan use in the public and the government’s policies supporting it has highlighted that the government is not enabling drug use in the US and is instead trying to eradicate it.
In addition, the increase of state-funded treatment centers provides patients with medical detox, post-treatment counseling, and other important support systems that make long-term recovery attainable. In addition to government rehabilitation programs, there has been an increase in education as a tool for prevention and needle exchange programs. In an article titled, “Addicted to Rehab,” “In 2008, Congress passed the Mental Health Parity and Addiction Equity Act, and in 2010, President Barack Obama’s Affordable Care Act became law. Both opened the floodgates of insurance money for addiction treatment” (Vogel). According to United Nations on Drugs and Crime in their article, “Drug Use Negatively Impacts Health, Productivity, and Crime,” they report that “In 2010, 7.9 million people in the United States alone needed treatment for problems related to illicit drug use, only 2.2 million received it.” Many experts point to this as a groundwork for treatment centers, and since 2010, the federal government has reached the agreement that sober houses violate the Americans with Disabilities Act and the Fair Housing Act, in order to protect people in recovery (Vogel). Sober houses are houses that recovering addicts can live in with other recovering addicts to help each other. The state governments have made steps to decrease the number of teenage users by encouraging schools to implement drug prevention education programs. Two specific programs that are being used in schools are called, Life Skills and Project ALERT. Both view drug prevention as a public health program instead of a criminal justice program on the war on illicit drugs (Drug Policy Research Center). Economists believe that drug prevention programs at a young age are cost-effective. The Alliance, Drug Policy wrote the article, “Needle Exchange Programs Slow the Spread of AIDS and Other Diseases.” which states that:
Increasing the availability of sterile syringes through needle exchange programs, pharmacies, and other outlets reduce unsafe injection practices such as needle sharing, curtails transmission of HIV/AIDS and hepatitis, increases safe disposal of used syringes, and helps injecting drug users obtain drug information, treatment, detoxification, social services, and primary health care. Injection drug use has accounted, both directly and indirectly, for more than one-third (36%) of AIDS cases in the United States since the epidemic began.
The government has been involved in the regulation of rehabilitation and treatment centers, including sober houses. They have also promoted in needle exchange programs and drug prevention programs in schools. Experts look to the government’s change in policies to prevent drug use throughout the US.
One expert who specializes in harm reduction is Kristen Marshall who is the Drug Overdose Prevention and Education (DOPE) Project Manager in San Francisco. The DOPE project is a part of a Harm Reduction Coalition and is a non-profit agency. She oversees overdose prevention, education, and ensures that people who use drugs carry Narcan, can recognize the signs of an overdose, and respond accordingly. Kristen Marshall also ran a syringe access and overdose prevention program in San Francisco. She also believes that the government is not effective enough at solving the drug crisis and that the government’s focus shifts from criminalization to harm reduction. Kristen Marshall believes the government is not enabling drug use but is not utilizing proven solutions rooted in harm reduction. She explains that the government has not enabled drug use but has done much harm by the state and federal policies that are in place. Instead, she sees the government taking a path of criminalization, ensuring that people who use drugs are punished – arrested, put in jail, put in prison, or fined. She states:
The government – and most people – approach drug use as something that is inherently bad, amoral, and criminal, and that addiction is a moral failing, is happening because the person using drugs is a bad, weak, or otherwise “lower” person because of it. If our government approached drug use, not as the result of the very real impact that trauma, mental illness, poverty, and massive policy failure have on communities, that if we were able to offer people the services and resources they needed as opposed to criminalizing them for even daring to ask for help while using drugs, we’d be in a completely different place with this current opiate crisis.
She explains that Narcan is an amazing tool for the drug crisis and the government needs to take a public health initiative to enable all people to carry Narcan. Kristen Marshall says, “Narcan is 100 percent safe, and it works, every time, as long as its administered on time (meaning before the person dies). That means that every single opiate overdose death, technically, is preventable. So, the 64,000 people who died last year from opiate overdoses? They would all still be alive if our society and government deemed their lives worthy enough to save.” Saving overdose victims allows people to continue to make the choices they need to or want to, and maybe that’s to continue using, and maybe that’s to stop. “Dead people can’t change; drug use is NOT a death sentence,” according to Kirsten Marshall. But she explains that “Narcan can’t always be given to overdose victims in time due to fear of criminal action. Kirsten Marshall understands the immense nature of this problem and suggests a simple solution. She offers the opinion of turning away from criminalization and to focus on “harm reduction,” which means, “[…] meeting people where they’re at, not judging them, and not forcing them to change in ways their either don’t want or aren’t ready for.” She believes that the safest, cheapest way to help people in this crisis is to have syringe access services everywhere for people who use drugs. The reality is, people who engage with needle exchanges and harm reduction programs are five times more likely to seek treatment than people who don’t, according to Kirsten Marshall. It’s because people who use drugs are so judged, so stigmatized, and so afraid of going to prison, they almost never engage with any services, not even with their doctors. Overall, Kirsten Marshall believes that government policies are not enabling drug use and she sees the effort and funding towards criminalization, but she thinks the focus should be on harm reduction programs and not necessarily rehabilitation facilities. Harm reduction programs include the distribution of Narcan, she asserts, are vital to saving the US from this growing epidemic.
Kirsten Marshall concurs with The Alliance, Drug Policy in their article, “Needle Exchange Programs Slow the Spread of AIDS and Other Diseases” on the topic of harm reduction. Kirsten Marshall works with many needle exchange programs to provide free, clean needles to drug users. The article explains that the increase in needle exchange programs “increases safe disposal of used syringes, helps injecting drug users obtain drug information, [gives] treatment and social service.” Kirsten Marshall advocates for this exact idea. She says, “People who engage with needle exchanges and harm reduction programs are five times more likely to seek treatment than people who don’t.”
Overall, I believe that the current policies mainly focus on criminalization, which has proven to be effective in some capacities; however, I agree with Kirsten Marshall when she argues for a public health initiative and harm reduction policies. Kirsten Marshall argues, “The government approaches drug use as something […] criminal. If our government […] were able to offer people the services and resources they needed as opposed to criminalizing them for even asking for help while using drugs, we’d be in a completely different place.” I believe that a public health initiative proves to be very successful. With respect to the subtopic about rehabilitation and funding, the federal government has “increased state-funded treatment centers [,which] provides patients with medical detox, post-treatment counseling, and other important support systems that make long-term recovery attainable,” according to Mike Vogel. While looking at prevention efforts, I found that the federal government has focused on using education as a tool for prevention and needle-exchange programs.
In order to make advancements to solve the drug epidemic, I have assessed current policies, problems, and government action in order to outline a plan of action. I believe that this plan is not to discredit the effectiveness of the current course of action but instead build upon it and adjust based on new findings. I propose a holistic approach with a preference for rehabilitation and harm reduction while having criminalization as a Plan B to solving the drug epidemic. I suggest that we increase funding for public health initiatives such as needle-exchange programs, drug prevention education programs in schools, and more Office of National Drug Control Policy commercials. Needle-exchange programs have proven to be very effective because “a person [on average] will relapse seven times before they are even on that path to getting sober,” according to Kristen Marshall. Harm reduction programs which appear on the outside to enable a drug user’s habit, is actually what is keeping them alive long enough to make the decision if they want to change. Life skills and Project ALERT are two examples of effective drug prevention programs in schools. According to Provini, “both programs are centered around helping students develop their social settings, which provides them with tools to avoid drug use.” The increased amount of funding for these programs or others that are similar will result in education to students and a helping hand to current addicts.
Next, I believe we should focus on the distribution of Narcan to all law enforcement officers to save a person’s life from an overdose. Senator Edward Markey suggested legislation for Narcan to be placed under the Good Samaritan Law, which could be a great edition to fighting the drug epidemic by reducing overdoses.
The drug epidemic seems to be interwoven in other social problems such as the view of mental illness, socioeconomic conditions, and health care as a whole. I believe if we implement these changes with help from everyone, it will result in a lower amount of drug users and deaths related to drug use. I differ from government values of criminalization as being the most effective way to reduce the amount of drug use; a plan of rehabilitation and harm reduction will result in a system of better drug education, fewer overdoses, and helping those within the US to combat addiction.
The takeaways from this project involve reducing the stigma behind drug use in order to allow more treatment with compassion as opposed to criminalization. Harm reduction always people chances to change their behavior and seek help when they are ready. By providing clean needles, it reduces other health problems. In your community, you can carry Narcan in order to help someone in an overdose. In addition, you are able to call emergency services to help someone in the event of an overdose and not be criminally charged. I advocate for a more humane way of treating drug addiction and you can all take steps to destigmatize drug use, advocate for clean needles at local community centers and shelters, and carry Narcan in order to help people in emergency situations.
