In the ’90s, harm reductionists like Dan Bigg liberated lifesaving naloxone from the medical establishment and put critical tools in drug users’ hands. Research later proved what we long knew: that supplying naloxone at the community level is an effective overdose intervention. It was one we would desperately need even more as fentanyl began spreading through the drug supply in the mid-2010s. 

Peer-led, community SSP remain the cornerstone of harm reduction. Yet as the number of authorized SSP has grown, the funding has not kept pace. 

Nearly two decades ago, the National AIDS Fund—what today is AIDS United—began the Syringe Access Fund to support SSP by bringing together a collaborative of large donors and dispersing the money across the community.

Over the years, harm reduction has become more and more professionalized. This has brought some benefits, but has also seen the movement quietly appropriated by people without lived experience of drug use or HIV, who tend to have more public-facing jobs and personas that invite people outside the movement to look to them as the experts because they find them more approachable.

We’ve seen our terminology taken up by legislators and pundits, but not always our philosophy.

Harm reduction today is gaining a tenuous hold on broad public support while battling unprecedented crises. We’re at the intersection of intense stigma and repression contrasted against federal recognition and funding. We’ve seen too many organizations in adjacent fields posture as harm reductionists without hiring people who use drugs, let alone advancing them to leadership positions. We’ve seen our terminology taken up by legislators and pundits, but not always our philosophy.

The Syringe Access Fund has now been rebranded as the Harm Reduction Futures Fund. Nothing about the focus or goals has changed, but the change in name reflects the real-world impact of perceptions of our language.

The word “syringe” continues to bear a stigma that makes potential partners in restrictive environments hesitant to work with us. We sought a new name because, candidly, in order to sufficiently support peer-led SSP we needed to be able to court more donors—being an “intermediary fund” means that it only grants as much money as it can raise. We also sought the new name because, over time, “syringe access” has become somewhat of a misnomer for what we do. 

Syringes are only a portion of what the Fund supports. The new name better reflects the breadth of what we have evolved to do and what we could resource with increased funding. Harm reduction is about access to much more than just syringes—smoking pipes, blood-borne disease testing, condoms, naloxone. 

I’ve been in this movement for 15 years and still struggle to find the right words to convey the power and scope of harm reduction. But I know that it includes not just surviving one day at a time, but building ourselves a future.

A future without preventable HIV, viral hepatitis and mass overdose, a future grounded in compassion, dignity and respect. That prioritizes services rooted in radical love and demands ongoing and righteous civil disobedience.

Photograph courtesy of Kastalia Medrano

The post Rebranded AIDS United Fund Looks to Harm Reduction’s Future appeared first on Filter.

The claim was based on $30 million in funding from the Substance Abuse and Mental Health Services Administration (SAMHSA), which allows organizations on the ground to decide which harm reduction interventions are needed for their community. 

Even though it’s not clear how much—if any—of this money would go toward safer smoking kits with pipes, conservatives still screamed, “$30 million for crack pipes?!” 

My response? Yeah, if only…

If only we lived in a world where policy was rooted in science and compassion. If only we lived in a world where the government saw 100,000 of its citizens dying in a year and invested in the interventions that are proven to save lives. If only we adopted a harm reduction approach to ending the overdose epidemic.

When faced with pushback rooted in conservative lies, the “key pillar” snapped.

To its credit, the Biden administration has tried more than any other. It rightfully added harm reduction as a key pillar in the national overdose response plan. And as part of that, SAMHSA created this grant program. This is a start, which we badly need to bring to scale.

But when faced with pushback rooted in conservative lies, the “key pillar” snapped.

.@SecBecerra and @DrGupta46 released a statement in response to misinformation about harm reduction grant program dollars. Read the statement: https://t.co/3TWgiuDgJu

— HHS.gov (@HHSGov) February 9, 2022

Ignoring science comes at a high cost. Every life lost is a tragedy, and there have been more than 100,000 tragedies in the last 12 months. We see Black and Indigenous men hit the hardest. The fact that these deaths were overwhelmingly preventable compounds the devastation. 

The evidence is unequivocal. Safer smoking kits—including pipes—save lives. The kits increase safety and reduce the risk of diseases and injuries. Providing them creates a window to build trust, establish relationships, and connect people to other services and education. The kits also offer alternatives to injection, a route of administration that increases risks of disease, overdose and death. And providing safe and sterile equipment to those of us who use drugs does not encourage the use of drugs. 

These are facts, not partisan issues. 

Those of us who use drugs are all too accustomed to this vitriol. Perhaps the Biden administration was unprepared.

But more than just the science, what gets to me most as someone who has worked in harm reduction for 15 years, is the lack of compassion. Every person, regardless of choices around substance use, deserves to be treated with respect and dignity. There is no compassion, no dignity and no respect in the hatred spewed by politicians with toxic Twitter accounts.

Those of us who have worked in harm reduction, and those of us who use or have used drugs, are all too accustomed to this vitriol. Perhaps the Biden administration, which only recently claimed harm reduction as a pillar of its overdose strategy, was unprepared. But if the administration plans to continue to adopt harm reduction—and I really hope it does—it will need to be ready next time to respond with firm arguments based in science and compassion. 

One way the government can prepare is to establish confidence in the evidence. Government can show this confidence with significant investment, by seeking out our expertise, and in the public language it uses.

Our lifesaving work in harm reduction has been underfunded for decades. Few private or public funders have been willing to face the reactionary backlash. And even fewer have been willing to show strong public support. 

Suppose the administration, faced with opposition, had signaled its support with a tweet that said, “Our goal with harm reduction is to save lives.” That’s it. Full stop. That’s the kind of political support the harm reduction community needs. 

Another way the government can be better prepared is by partnering with an intermediary funder, such as my organization, AIDS United. We have decades of grant-making experience, subject-matter expertise and deep relationships in communities. We can ensure funding gets into the hands of those who care profoundly about people who use drugs, their well-being and their human rights.

Without considerable investments we will see more HIV outbreaks, hepatitis C infections and overdose deaths. Black, Brown and Indigenous communities will bear the brunt.

Regardless of government support or the lack of it, the harm reduction community isn’t going away. We’ve been saving lives for decades, and will continue to do so. 

But let’s be clear: Without considerable investments and reduced criminalization we will see more HIV outbreaks, hepatitis C infections and overdose deaths. Black, Brown and Indigenous communities will bear the brunt—as always—intensifying needless disparities and suffering. 

And we’re tired, deeply so. From the early days of the HIV epidemic through the present overdose crisis, the isolation and grief are overwhelming. 

It’s beyond time to support harm reduction. Enough is enough.

Photograph of a protest in Ontario, Canada by Carlyn Zwarenstein

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