Harm Reduction: Is it saving lives, or helping enable addicts?

Los Angeles County’s Homeless Outreach & Mobile Engagement (HOME) program uses street psychiatry to get psychiatric medication to people experiencing homelessness in an effort to get them a step closer to housing. The HOME team has 223 full-time staff members and served 1,919 people last year, 22% of whom ended the year housed.

The Olympia Bupe Clinic's walk-in model for treating opioid addiction allows patients to receive medication-assisted treatment with buprenorphine on their first visit without barriers or extensive wait times. This low-barrier approach eliminates the hurdles people often face when seeking treatment. The Clinic also hires staff with lived experience with addiction to build trust and community with patients.

Studies show that people who received at least one dose of naloxone following an opioid overdose are 11 times more likely to survive. In response, state policies and community-level programs and organizations are working to make naloxone accessible to those who need it. Today, naloxone can be found in grocery stores, gas stations, provided at events like concerts and community spaces like libraries.

Agencies like the SHARE Center are beginning to hire peer support specialists, who are individuals who have lived experience of recovery from mental health conditions and substance use disorders. Peer support specialists provide non-clinical, strengths-based support and build trusting relationships with those in need of care. Since the COVID-19 pandemic, demand for peer support specialists has grown exponentially and reports show that working with a peer support specialist can improve health outcomes and quality of life among other benefits.

Great Circle Recovery is the first tribally run opioid treatment clinic in the state and is opening up its second location. Approximately 250 people visit the clinic on a daily basis to access medications that help those suffering from addiction. The centers also provide access to counselors, case management and other medical services to support patients on their recovery journey.

Primary care practioners are prescribing buprenorphine to patients struggling with opioid substance use disorder, providing a support for medication-assisted recovery. Practices use a team-based approach and grant funding to provide this support and overcome the challenges of limited staff capacity and insufficient reimbursement.

In order to tackle opioid addiction, the state of Virginia found a way to make drug treatment accessible to people with medicaid by boosting “reimbursement rates to addiction treatment providers.” Historically, drug treatment hasn’t been covered by health insurance. Virginia is changing that. Already, “the percent of Medicaid members with an opioid use disorder who received treatment went up by 29 percent from April to December 2017 compared to the same period the previous year.”

Health engagement hubs like Washington state’s Buprenorphine Pathways connect people with prescriptions for methadone and buprenorphine to help treat addiction. In addition to medication and a syringe-exchange program, the hub also connects patients to social services, taking a more holistic approach to addiction treatment.

Several states are changing their drug paraphernalia laws, making it legal to possess fentanyl test strips which allow those who use drugs to test them for fentanyl. Fentanyl test strips are a means of harm reduction that allows the person to make informed decisions about their drug use in an effort to reduce fatal drug overdoses.

The G.R.O.W. syringe service program (SSPs) helps people who use drugs and those who need injection supplies for gender-affirming hormone therapy get access to clean syringes and safely dispose of needles. Community-based programs like G.R.O.W. also offer first-aid kits, at-home HIV tests, Narcan and personal care items. There are currently 13 SSPs registered in the state. In 2023, G.R.O.W. alone distributed more than 44,400 syringes and collected about 37,700.