In the summer before my freshman year of high school, my aunt succumbed to complications stemming from her substance use disorder. Raised in a low-income family in Bourbonnais, Illinois, she faced barriers to accessing essential healthcare and addiction treatment.
Had harm reduction resources been available to her, the trajectory of her life might have taken a different course. This is not just about compassion; it is a proven strategy that can save lives in the United States, and I urge Connecticut policymakers to use every tool in their arsenal to reduce overdose deaths ahead of the next legislative session.
This landscape of tragedy and urgency has led me to feel uniquely poised to advocate for the crucial role of harm reduction, which is a public health approach that “emphasizes engaging directly with people who use drugs to prevent overdose,” among other things.
Many people who are addicted to drugs want to stop, but their brain tells them that they need to use in order to maintain their daily life. I studied neuroscience and conducted research into the neurobiology of addiction during college, and a key hallmark of addiction is the weakening of the circuits in the brain that would normally allow people to exercise self-control. This is not widespread knowledge and leads many onlookers to believe that people with an addiction should “just quit,” which contributes to the stigma associated with people who use drugs and their hesitancy to seek out help or even healthcare.
As such, harm reduction approaches like supervised injection sites are an important component in preventing overdose deaths. Supervised injection sites, also known as safe use sites, are places where people can use illicit drugs in the presence of trained staff who are ready to respond in the case of an overdose. Drug users typically bring their own drugs and are given clean needles and a safe space to consume them.
Utilized across parts of Europe, Canada, and Australia, these sites have been proven to reduce overdose deaths and increase access to addiction treatment and health services. At a safe use site in Canada called Insite, the facility has supervised more than 3.6 million injections since 2003. No one has ever died there.
I’ll admit, I was initially skeptical of harm reduction strategies, and understand that it might seem crazy to offer a space for people to use drugs. However, in addition to helping lower the rates of overdose deaths and increasing access to addiction treatment, there is no evidence that safe use sites are associated with an increase in crime in the areas they operate in.
Aaron Chalfin, an associate professor and graduate chair of criminology at the University of Pennsylvania, recently found that the presence of overdose prevention centers in two New York City neighborhoods did not lead to an increase in crimes or calls for emergency service in the areas surrounding these sites. In fact, they have been associated with less outdoor drug use.
Even Texas Gov. Greg Abbott, who was initially skeptical of harm reduction strategies, has expressed support for legalizing fentanyl testing strips, a key resource provided at safe use sites. Moreover, considering that people from low-income backgrounds already have higher mortality rates, safe use sites may be a vital stepping stone for people with less wealth to get access to addiction treatment and healthcare services.
I can guarantee that nearly everyone in this country knows somebody —or knows someone who knows someone— whose life has been impacted by addiction. As millions of people continue to suffer every year from the opioid epidemic that was catalyzed by the Sackler family and Purdue Pharma, why don’t we use every tool we have to try and prevent overdose deaths?
Harm reduction strategies can reduce deaths in the short term, but also long-term by allowing people who use drugs to gain initial control of their use and segue into treatment. While it is too late for my aunt, it’s not too late for us to prevent future deaths, and I implore policymakers to adopt harm reduction strategies in the United States.
Carson Ferrara is a graduate student in public health and substance use researcher at the Yale School of Public Health.