BOSTON (CN) — In dealing with the opioid crisis, the Biden administration is quietly embracing “harm reduction” — a controversial approach that could save thousands of lives but create a political firestorm because it appears to be giving up and accepting illegal drug use as normal.
Harm reduction is a blanket term for interventions that are designed not to stop people from using drugs but simply to reduce their negative effects, including supervised injection sites, syringe exchanges, safe smoking kits, fentanyl test strips and the widespread availability of Narcan, a drug that reverses overdoses.
Although it makes little effort to trumpet it, “the Biden administration has made harm reduction the centerpiece of its effort to address the opioid crisis,” said Andrew Kolodny, who chairs the psychiatry department at Maimonides Medical Center in New York City.
David Herzberg, a historian of drug policy at the University of Buffalo, said Biden is making “deep and fundamental changes to a bedrock element of American policing culture that has been around for over a century.
"It’s amazing. As a historian you almost never get to say that something is brand new. But this is new,” he said.
But it’s “a drastic change in position,” according to 14 Republican U.S. senators who complained about it in a letter to the president. Harm reduction is “radicalized, illegal, and dangerous,” they claimed, adding that “the grave consequences of enabling and normalizing the consumption of illicit drugs” include “an increase in crime, discarded needles, and social disorder in the surrounding neighborhoods.”
The government’s official drug strategy includes harm reduction as part of a multi-faceted approach that also emphasizes drug treatment and prosecution of trafficking. But this is the first time that the government has thrown its full weight behind treating drug abuse not just as a criminal or individual psychological problem but as a public health issue.
Biden isn’t talking about it much, however, because of the political danger that it sounds like encouraging or at least normalizing the use of heroin and similar drugs, which are still prohibited under federal law and can result in a year in prison for first-offense simple possession.
An example of political controversy occurred in February when the administration announced a $30 million grant for harm-reduction programs that included “safe smoking kits” designed to reduce the spread of HIV and hepatitis, which led the Washington Free Beacon to run an article headlined “Biden Admin to Fund Crack Pipe Distribution to Advance ‘Racial Equity.’”
Although the newspaper later admitted that there was no evidence that crack pipes would be included in the kits, a Republican National Committee official tweeted the story, Fox News host Tucker Carlson repeated it and Senators Marco Rubio and Joe Manchin introduced a bill to outlaw the practice anyway.
As a result of dust-ups like this, Biden is likely waiting until after the midterm elections to publicly further his agenda, Herzberg said.
This could include a highly controversial move by the Department of Justice to allow supervised injection sites where users can take illegal drugs under medical supervision to prevent overdoses.
Eight days before Biden took office, the DOJ won a lawsuit to stop such sites from opening in Philadelphia. But in February of this year it reversed course, announcing that it is “evaluating supervised consumption sites, including discussions with state and local regulators about appropriate guardrails for such sites, as part of an overall approach to harm reduction.”
Several such sites are now operating in New York City and the federal government has made no effort to stop them. Once the midterms are over, the DOJ will likely announce that it won’t interfere with any such sites in much the same way that it currently doesn’t interfere with states that have legalized marijuana, said Alex Kreit, director of the Center on Addiction Law & Policy at Northern Kentucky University.
