Harm reduction in the context of the opioid crisis is focused on preventing overdose and infectious disease transmission by working with people who use drugs without moral judgment. Far too often, the public health imperative of harm reduction is blocked by federal policy, state laws, and other structural barriers anchored in the “war on drugs” that reduce the effectiveness of harm reduction efforts. To maximize the potential of harm reduction requires a whole-of-government approach, involving coordination across levels of government.
People who need opioid use (OUD) treatment in the United States are often not receiving it—at least two million people with OUD are experiencing a treatment gap that prevents or hampers their ability to receive life-saving care and support. This reality reflects structural, policy, and legal misalignments common to the entire US health care system, but that are especially present for behavioral health needs like substance use, and are exacerbated by other challenges related to stigma, lack of employment, and fragmented or nonexistent care coordination.
COVID-19 called for quick, decisive action by public health authorities to support communities and prevent infections. Since the pandemic began, legislators around the country have been acting to change the way authorities may respond to future public health emergencies — expanding or limiting officials’ authority to act in an emergency, changing who has authority to act, and the actions they may have the authority to take.
Hilary Wething, PhD, is an Assistant Professor of public policy at Penn State University. Her research area examines the relationship between economic volatility and labor market policy, household decision-making, and social safety-net programs
An estimated 65 percent of the United States prison population has an active substance use disorder (SUD). Providing comprehensive substance use treatment to incarcerated individuals has been shown to reduce both drug use and crime upon release. Treatment is a critical intervention to prevent opioid overdose deaths, which the CDC estimates increased by 15.4 percent, from 70,029 in 2020 to approximately 80,816 in 2021. Medications like methadone, buprenorphine, and naltrexone are an important part of a comprehensive approach to addressing opioid use disorder (OUD).
