Implementing Harm Reduction Policy into the U.S. Healthcare System


Harm reduction philosophy is not a new concept in the U.S. healthcare system. Harm reduction programs offer practical, feasible effective, safe and cost-effective solutions to the U.S. drug problem. With several hundred operational needle and syringe exchange programs in place, the U.S. needs to adopt harm reduction policy at the national level. This would help catalyze the culturally changing approach towards drug mentality in all aspects from recreational drug use to addiction.

Illicit drugs, such as marijuana, opium, coca, and psychedelics have been used for thousands of years for both medical and spiritual purposes. The United States history with drugs is complicated and often linked to politics and misinformation. The United State’s War on Drugs started in the 1970s under Rickard Nixon. Under Nixon’s presidency federal drug control agencies gained power and legitimacy whiling pushing through strict drug control policy. The U.S. created a strict zero tolerance policies with society’s support – deeming the subject taboo and unethical, drugs as evil, and addicts as “bad” people. Today, this mentality is surrounded in controversy from drug-control policy and recreational drug use to treatment of addicts and rising healthcare costs. The traditional, outdated, and ineffective laws and mentality are creating more harm than good. As the number of illicit drug users in the U.S. increases, society needs to take a different approach towards the drug community.

Harm reduction is range of public health practices designed to reduce the negatives consequences associated with various human behaviors, both legal and illegal. The philosophy focuses on the prevention of harm and increased drug education, rather than the prevention of drug use itself. Many individuals do not understand that addiction is a biological disorder and that addicts have no control over their addictive tendencies. Harm reduction recognizes that addicts are sick individuals and deserve the same respect and access to medical resources as others in society. From this sense, Harm reduction is a social justice movement built on the belief that drug users have the same rights as others. Advocates claim harm reduction saves lives, reconnects marginalized drug addicts with the community, has financial benefits to healthcare costs, and is overall beneficial to society. Critiques, however, argue harm reduction practices encourage drug users, perpetuate a problem, and give the “green light” on illicit drug use. Yet, there is no evidence that harm reduction encourages drug use, increases drug use, or sends a larger signal to society.

Regardless of successful harm reductions programs in Europe and Australia since the early 1990s, operational programs are limited in North America. The only operational supervised injection site in North America is in Canada. INSITE is a legal, supervised injection site offering a safe environment to use illicit drugs and to connect with healthcare services. The facility allows drug users to shoot-up safely without fear of arrest and with on-site medical assistant. There is sufficient evidence that INSITE has public health benefits by lowering HIV and AIDS rates, but the model has not been widely adopted because it is still controversial and political.

The United States has several harm reduction programs, but outright lacks federal support. Despite President Obama and other politicians advocating for reforms – such as reducing the crack/powder sentencing disparity and ending the ban on federal funding for syringe access programs – a change has yet to happen in drug control funding and harm reduction implementation. By eliminating the federal funding ban on syringe and needle exchange program and diverting 10% of funding spent on drug reinforcement towards harm reduction programs, the United States government would save millions of dollars annually in the healthcare system. Though implementing these changes into American culture will be a tedious process, the timing is ideal with structural changes occurring in the healthcare system and the results being economically, emotionally, culturally beneficial for our society.

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