What is harm reduction, the drug treatment program criticized by Senator Ted Cruz?

Republican U.S. Senator Ted Cruz last month criticized President Joe Biden for allegedly funding the distribution of free crack pipes – a claim that federal officials have denied and called misleading.

Cruz was referring to the Biden administration’s $30 million grant program aimed at mitigating the fallout from the country’s opioid crisis and rising fentanyl overdoses. The program relies on what are called harm reduction policies, which call for minimizing the adverse health and economic effects of drug abuse until users can get treatment instead. than to criminalize addiction.

The senator’s comments focused on safe smoking kits, which typically contain alcohol swabs, lip balm and other protective materials intended to protect users from possible burns, blisters and infections. transmissible diseases such as HIV and Hepatitis C. Some harm reduction organizations include glass rods that can function as pipes in their safe smoking kits. But White House press secretary Jen Psaki denied that the federal program would fund the inclusion of tips and said the federal government does not support direct or indirect funding of such articles.

As conversations continue about harm reduction from opioids and fentanyl, here’s what you need to know about Cruz’s claims and harm reduction practices in Texas.

How were Cruz’s comments misleading?

In early February, Cruz sparked controversy when he tweeted “Biden crime policy: Crack pipes for all,” then later went on his podcast, “Verdict,” to further amplify the statement, which fact checkers say is false.

Cruz’s comments responded to a news article from a conservative publication that claimed the program providing funding for harm reduction policies under the Biden administration would distribute crack pipes as part of safe smoking kits. security.

His statements that Biden was handing out crack pipes — in conjunction with messages from other Republican senators — reverberated in conservative and right-wing news circles.

The fallout was significant enough that US Senator Joe Manchin, a moderate Democrat from West Virginia, joined Republican US Senator Marco Rubio of Florida in introducing legislation banning federal funds for the purchase of props like pipes and needles.

But federal officials have denied claims that the program is funding pipes. In a joint statement, Health and Human Services Secretary Xavier Becerra and National Drug Control Policy Director Rahul Gupta said their agencies were focused on “smart use of our resources.” to reduce the harm and death caused by drug use.

“As a result, no federal funding will be used directly or through subsequent reimbursement to recipients to put pipes into safe smoking kits,” they said.

A spokesperson for Cruz did not respond to requests for comment.

What is the risk reduction approach?

Harm reduction offers a scientific alternative of recognizing addiction as a disease, as opposed to traditional, unscientific approaches that have criminalized drug use.

In most cases, harm reduction does not seek to cure the addictions of those served. Instead, it works to ensure that people who use drugs stay alive and as healthy as possible until they can receive proper treatment.

Proponents understand that drug use carries significant risks, but also believe that people – especially those with addictions – need love and support.

“There are going to be people using drugs,” said Claire Zagorski, a harm reduction and drug policy researcher at the University of Texas at Austin’s College of Pharmacy. “I want to meet these people wherever they are.”

Zagorski said harm reduction is economically smart — people who overdose or injure themselves while using can end up with a hospital bill they can’t pay.

Marcia Ory, a professor of public health at Texas A&M University and chair of the school’s opioid task force, said the harm reduction approach accompanies a change in perception of addiction. Evidence shows that people who become addicted to drugs do not lack willpower, but rather experience bodily changes that make them want more drugs.

Ory, whose task force provides training in harm reduction and naloxone administration, said if criminalization is successful, fewer people will be addicted and fewer lives and families will be ruined.

“I hope that harm reduction strategies will become the norm, that they will be widespread, that the view of addiction will move away from a criminal perspective towards a medical perspective,” Ory said. “These strategies have been around for a while, and the problem is how to use them to the fullest, because that’s what’s going to save lives, families, communities.”

What do risk reduction practices look like?

Programs can distribute a range of products all aimed at reducing the harms of drug use. This can include safe injection kits with clean syringes and fentanyl test strips, which are a relatively inexpensive way to check for the deadly narcotic that is increasingly a contaminant in other drugs.

“Because fentanyl is becoming more prevalent — it’s deadly — that’s even more why some of these harm reduction strategies are so important,” Ory said. “The assumption is that if you have freely available drug paraphernalia it’s going to encourage drug abuse, that’s not a scientific fact.”

Items given out may also include naloxone, often known as Narcan, a drug that can treat an opioid overdose. In addition, many programs also distribute products for non-drug use, such as safe sex kits and general hygiene kits with soap and toothbrushes.

Are harm reduction policies used in Texas?

As the state grapples with the ongoing opioid epidemic and a rise in fentanyl deaths, public health experts say harm reduction strategies can both help people fight their drug addiction and stem the fallout from the crisis.

Narcan is a product that many harm reduction groups in Texas distribute and the state has also adopted. Recent deals between the state and pharmaceutical companies implicated in the opioid epidemic provide millions of Narcan dollars to the state.

But other strategies hit a snag in Texas: State law criminalizes the possession and distribution of drug paraphernalia, including fentanyl test strips. Clean syringes and tubing can also be considered as accessories.

During last year’s legislative session, a bill sponsored by State Rep. Jasmine Crockett, D-Dallas, sought to remove criminal penalties for possessing props. The bill was rejected by the committee but was never put to a vote by the Texas House.

Crockett, who is vying for a congressional seat in South Dallas, agrees that a harm reduction approach is the future for helping to combat drug problems, unlike the criminalization of drugs.

“You lock someone up with an addiction, you don’t help them at all,” Crockett said. “You just put them away, then you let them come back. Guess what? They still have an addiction. And they haven’t been given the tools and the resources. And sadly, they weren’t treated with the dignity that they really should be accorded.

These obstacles have prompted many harm reduction policy advocates to criticize Cruz for politicizing their work.

“It’s outrageous that someone like Ted Cruz would even comment on harm reduction tools when many of the evidence-based tools we need in the first place are illegal in the state,” said Paulette Soltani, director of the Texas Harm organization. Reduction Alliance, which protested outside Cruz’s Austin office in March. “It’s a political issue at the expense of the lives of Texans.”

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