Clean fentanyl test strips and needles, a target of the federal substance use subsidy program


WASHINGTON – Harm reduction strategies, including syringe service programs and the use of fentanyl test strips, will be eligible for federal grants under a $ 30 million, 3-year program announced Wednesday by the Biden administration.

“One hundred thousand overdoses over a 12-month period – it’s just heartbreaking,” said Rahul Gupta, MD, director of the White House’s Office of National Drug Control Policy, in a phone call with journalists. “We are losing an American every 5 minutes to this epidemic, driven in large part by the illicitly manufactured fentanyl. This is an unacceptable situation and requires an unprecedented and urgent response. We must use all the tools at our disposal; this includes our production strategies, which have long been underestimated at the federal level. “

“I want to define what harm reduction means for the federal government,” he continued. “It means putting life at the center. It means creating conditions where it becomes easier to save a life than it is to let it perish. It means focusing on policies based on science, evidence and data. Why the Biden-Harris Administration’s New Evil Reduction strategy includes expanding access to naloxone, drug test strips and syringe service programs. “

In addition to the harm reduction grants – which will be awarded at a rate of $ 10 million per year for 3 years – the administration has also issued model legislation for states wishing to initiate or refine their syringe service programs. , formerly known as needle exchange programs. “High-quality syringe service programs can prevent the spread of disease, save lives, and connect people to other health services, including treatment for substance use disorders,” Gupta said. . “They have a proven track record of improving public safety and reducing costs. However, their availability is limited in many areas. “

The model law “provides states with a framework to ensure that syringe service programs are available wherever needed,” he added. “He does things like giving advice to authorize the establishment of comprehensive syringe service programs in states … He helps advise law enforcement authorities on how to reduce needle stick injuries.” and other first responders; [suggests] data collection and reporting requirements; provides recommendations on immunity from arrest, charge and criminal prosecution; and provides training materials as well as funding strategies for syringe service programs. “

Health and Human Services Secretary Xavier Becerra said the grants and the model law were part of the administration’s four-pronged strategy on substance use, which includes primary prevention, harm reduction , evidence-based treatment and recovery support as his four priorities. The ad “builds on SAMHSA work [the Substance Abuse and Mental Health Services Administration] already done on harm reduction, including allowing federal grants to be used to purchase fentanyl test strips, and considering how to make naloxone widely available, including over the counter, ”he said .

“Overcoming addiction is not easy, and it rarely happens overnight,” Becerra added. “And where we can’t stop someone from using these substances, we should at least try to make sure that we prevent serious consequences like death. they fight their addiction, not by silencing them, stigmatizing them or pushing them into the shadows. “

The harm reduction grants will be available to providers of treatment for traditional and non-traditional substance use disorders, including primary care practices, said Miriam Delphin-Rittmon, PhD of SAMHSA. MedPage today during a question-and-answer session during the briefing. “This grant is open to state and local providers, primary care providers, community nonprofit organizations, and behavioral health providers,” she said. “We know that people who may be dealing with substances connect with a range of different organizations, and we want to create multiple service entries and multiple entries to access harm reduction support.”

The Biden administration sees recovery from addiction as happening along a continuum, said Delphin-Rittmon, assistant secretary for mental health and addiction at SAMHSA. “Returning to drug use is often part of the recovery process and therefore harm reduction does not view abstinence as the only positive outcome. “

Ask by MedPage today to learn more, she continued, “We know everyone’s journey to recovery is different, and for some people abstinence has absolutely worked for them. For others, abstinence doesn’t work for them, and that’s where harm reduction absolutely comes in. it helps some people who can continue to use. This gives them the tools and resources to test for substances so that they can stay alive and ultimately be engaged in services and support.

One of the issues officials did not directly address during the call was the use of supervised injection sites – places where people with drug addiction can go to use street drugs under medical supervision; the sites also offer links to drug treatment services. New York City opened two of these sites last week, but the opening of a potential safe injection site in Philadelphia was blocked by a court challenge.

Asked about the sites, Becerra said he could not comment directly due to “pending litigation,” likely referring to the fact that the federal government is among those included in the Philadelphia case. He added, however, that “the administration is also seeking ways to support research on the clinical effectiveness of emerging harm reduction practices; we want to be able to see this in real contexts… I hope I can give more details in the future. “

Racial equity is also at the center of these grants, Gupta said. “If you look at the numbers, there is a disproportionate environmental impact of the pandemic that we are seeing on communities of color” when it comes to substance use. “So it’s also important that we move forward, we also focus on making sure that we don’t widen, but don’t narrow, the racial equity gap.”

  • Joyce Frieden oversees the coverage of MedPage Today in Washington, including articles about Congress, the White House, the Supreme Court, health professional associations and federal agencies. She has 35 years of experience in health policy. To follow


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