Leading federal health agency seeks to promote studies on the effectiveness of various harm reduction policies, including decriminalization and safe consumption sites, as part of a campaign to tackle the epidemic overdose.
While the Biden administration has yet to take a position on policy proposals to allow safe consumption facilities, the National Institutes of Health (NIH) on Wednesday released a pair of Requests for Nominations (RFA) for an effort which will provide funding for efforts to investigate how this and other harm reduction policies could help address the drug crisis.
Specifically, the NIH wishes to establish a Harm Reduction Network that aims to “improve our understanding of the effectiveness, implementation and impact of existing and new harm reduction practices in dealing with the crisis. opioid prevalence and substance use disorders more broadly ”.
HEAL Initiative: Harm Reduction Policies, Practices and Delivery Methods for People with Substance Use Disorders (Optional R01 Clinical Trial) https://t.co/59VOnbTVmj
– NIH Funding (@NIHFunding) December 29, 2021
A parallel RFA calls for a focal point within the network to provide ‘logistical and coordination support’, ‘data harmonization and sharing supports’ and ‘research and clinical practice resources’ .
Applications are accepted for projects that involve “(1) developing and testing new harm reduction strategies; (2) examine how to effectively implement new and existing harm reduction strategies; (3) expand the frameworks and delivery models through which harm reduction strategies are deployed; and (4) examine the impact of new harm reduction policies implemented at national and local levels.
“Harm reduction services aim to prevent or minimize the adverse effects associated with substance use, such as fatal and non-fatal overdoses and the transmission of infectious diseases,” said the advisory. “Examples of established harm reduction approaches include naloxone, fentanyl test strips (FTS), safer smoking equipment and sterile syringes, as well as human immunodeficiency virus (HIV) testing. and hepatitis C virus. “
Opinions from the NIH and its constituent agencies such as the National Institute on Drug Abuse (NIDA) indicate that ’emerging’ harm reduction policies’ include the decriminalization of various drugs, and the diversion and diversion efforts led by the United Nations. police and the prosecutor, and the authorization of safe consumption sites. . “
They also note that the White House’s Office of National Drug Control Policy (ONDCP) prioritizes harm reduction policy as a means of overdose prevention.
HEAL Initiative: Harm Reduction Policies, Practices and Delivery for People with Substance Use Disorders: Focal Point (R24 clinical trial optional) https://t.co/KPWFRhszv9
– NIH Funding (@NIHFunding) December 29, 2021
NIDA Director Nora Volkow has repeatedly expressed concerns about the damage caused by the criminalization of drug possession and specifically called racial disparities in law enforcement a major problem, including in an interview. with Marijuana Moment and in several editorials.
When it comes to safe consumption sites, Volkow said earlier this year that she was willing to continue exploring “how these support systems as a community can help people, for example, to engage in treatment, how they can prevent them from getting HIV. and how they can prevent them from overdosing and dying.
New York City launched the first sanctioned safe consumption site late last month, and advocates have questioned how the federal government would respond given its role in blocking a Philadelphia nonprofit , Safehouse, for launching its own harm reduction center.
New York City officials say the sites – where people can use currently illegal drugs in a medically supervised environment where they have access to treatment resources – have already saved dozens of lives.
This is only part of the NIH harm reduction research initiative, however. Here is a description of the research topics he wishes to explore:
Research to develop and test new approaches and / or frameworks for harm reduction service delivery, including strategies that involve sectors outside the health system and strategies that do not depend on face-to-face interaction to face
Research that seeks to understand individual and system-level barriers to the provision of effective, scalable, and sustainable harm reduction services, such as individuals forgetting or refusing to wear naloxone or fentanyl test strips, hand shortages -working, funding limitations and stigmatizing attitudes towards individuals with SUD.
Research to develop and / or test strategies to overcome identified barriers to effective, scalable and sustainable harm reduction services,
Research on strategies to ensure that people from vulnerable, under-researched and / or hard-to-reach populations have access to and benefit from harm reduction services.
Research on the implications of emerging harm reduction policies, including their effectiveness in reducing unwanted effects and barriers / facilitators to successful implementation in real settings
Research on harm reduction strategies for people using methamphetamine and other stimulants
Nine candidates will be selected to conduct the studies under the five-year program. It approves up to $ 6.75 million for FY2022 projects.
The new notice also talks about applications for marijuana research, stressing that such studies are “necessary to measure and report results using a standard delta-9-THC unit in all applicable research on subjects. human “.
“The aim is to increase comparability between research studies on cannabis. A standard delta-9-THC unit is defined as any formulation of cannabis plant material or extract that contains 5 milligrams of delta-9-THC, ”he says. “A rationale must be provided for human research that does not suggest using the standard unit.”
When it comes to safe consumption sites, activists in several cities have attempted to establish these centers in recent years.
In October, the Supreme Court dismissed a request to hear a case on the legality of establishing the facility in Philadelphia, but the case is still in a lower court and lawyers anxiously await a response from DOJ for show where the agency decides to stay. on the issue under the Biden administration.
By mutual agreement between federal officials and Safehouse, the administration’s deadline for submitting its position was extended to March 7. It had previously been extended until November 5 of this year. Defenders see this as a positive sign.
White House drug czar Rahul Gupta recently said exploring “all options” to reduce overdose deaths, and this could include allowing safe consumption sites for illegal substances if the evidence confirms their effectiveness.
The ONDCP director previously said he couldn’t speak to harm reduction centers due to the ongoing Safehouse litigation, but seemed more open to the possibility in the recent interview with CNN.
US Department of Health and Human Services (HHS) Secretary Xavier Bacerra also recently signaled that the Biden administration will not budge to block the facility’s secure injection sites, stressing that “we are literally trying to give users a lifeline.
But a spokesperson for the department later returned to the remarks, saying “HHS does not have a position on supervised consumption sites” and “the issue is the subject of ongoing litigation.” In any event, it would be up to the DOJ to decide whether to prosecute facility operators under the Controlled Substances Act.
Bacerra was among eight senior law enforcement officials in the state who filed an amicus brief in support of Safehouse’s safe injection site plan when he was California attorney general.
The Biden administration has generally promoted the concept of harm reduction as part of its drug policy, but it has not formally weighed in on safe consumption sites in particular.
Defenders put the current situation in no uncertain terms. They say harm reduction centers could mean the difference between life and death for countless Americans who currently use illegal drugs.
Early data from New York City indicates the facilities could prevent many more deaths than the Department of Health had predicted. Its feasibility study found that safe consumption sites could save up to 130 lives per year.
The legal complication of these harm reduction sites is primarily related to a so-called “federal crack law” which criminalizes the use of a place for the manufacture, distribution or consumption of controlled substances.
A coalition of 80 current and former prosecutors and law enforcement officials, including one who is Biden’s choice for the US attorney for Massachusetts, previously filed a brief urging the Supreme Court to take up the consumer case. safe from Safehouse.
As New York City is the first to open harm reduction centers, the governor of Rhode Island signed a landmark bill in July to establish a safe consumption site pilot program.
Massachusetts lawmakers proposed similar legislation last year, but it ultimately did not come into law.
A similar harm reduction bill in California, sponsored by Senator Scott Wiener (D), was approved by the state Senate in April, but other measures have been delayed until 2022.
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Photo courtesy of Jernej Furman.