The end of 2021 saw several aggressive new harm reduction initiatives coming out of the federal Office for National Drug Control Policy (ONDCP) and the Substance Abuse and Mental Health Services Administration (SAMHSA).
One was a model law for syringe services programs (SSPs). Although these are legal under federal law, SSPs can’t operate unless state laws allow them to. In December, the ONDCP released a model law for states to use to ensure that such programs are accessible, safe and effective, and save money.
SSPs reduce HIV, HPV and other diseases, as well as help drug users access addiction treatment, reducing costs overall. But in many areas, they can’t open, and some that can are hindered by outdated laws, according to the ONDCP. SSPs are also valuable for their ability to refer people to treatment.
“At a time when overdose deaths have reached an unprecedented number, we must meet people where they are and do everything we can to save lives,” said Rahul Gupta, M.D., ONDCP director. “This model law provides states with a framework to make sure syringe services programs are available wherever they are needed. High-quality syringe services programs can prevent the spread of disease, save lives and connect people to other health services, including treatment for substance use disorder.”
SSPs reduce opioid overdoses by:
- teaching participants overdose prevention, recognition and response;
- distributing naloxone to those most likely to benefit from it; and
- providing real-time information on drug market trends that can drive overdose.
The model law would:
- authorize the establishment of comprehensive SSPs within states;
- delineate the required components for SSPs operating within states, including that such programs directly provide, or offer referrals to, expanded services, including substance use disorder treatment;
- reduce needlestick injuries to law enforcement, emergency services personnel, sanitation workers and members of the community;
- provide data collection and reporting requirements for SSPs;
- provide immunity from criminal arrest, charge and prosecution for the possession, distribution or furnishing of hypodermic needles and syringes and other supplies;
- provide education and training materials for members of the community, including law enforcement and other first responders; and
- provide a mechanism for funding of SSPs.
The research and drafting of the model law was funded through the ONDCP’s Model Acts Program and authored by its cooperative agreement award recipient, the Legislative Analysis and Public Policy Association (LAPPA).
Other initiatives by the Biden administration in 2021:
The American Rescue Plan invested almost $4 billion to allow the Department of Health and Human Services’ (HHS) Substance Abuse and Mental Health Services Administration (SAMHSA) and the Health Resources and Services Administration to expand access to vital mental health and substance use disorder services. The funding also included $30 million in supports for harm-reduction services — a historic amount that will enhance interventions like SSPs.
HHS announced the new HHS Overdose Prevention Strategy, which focuses on expanding primary prevention, harm reduction, evidence-based treatment and recovery support services for all Americans.
The ONDCP released the model law for states to help expand access to naloxone, which saves lives by reversing opioid overdoses.
HHS released the Practice Guidelines for the Administration of Buprenorphine for Treating Opioid Use Disorder, which exempts eligible health care providers from federal certification requirements related to training, counseling and other ancillary services that are part of the process for obtaining a waiver to treat up to 30 patients with buprenorphine. This action expands access to evidence-based treatment by removing a critical barrier to buprenorphine prescribing.
The Drug Enforcement Administration lifted a decade-long barrier to opioid treatment programs that want to include a mobile component. This rule change will help provide treatment to rural and other underserved communities, including incarcerated individuals.
The CDC and SAMHSA announced that federal funding may now be used to purchase fentanyl test strips in an effort to help curb the dramatic spike in drug overdose deaths.
The CDC launched four complementary education campaigns that provide information about the prevalence and dangers of fentanyl, the risks and consequences of mixing drugs, the lifesaving power of naloxone and the importance of reducing stigma around drug use to support treatment and recovery.
The National Institutes of Health is supporting research to accelerate scientific solutions to the overdose crisis, including research on prevention of substance use and use disorders.
The ONDCP designated six new counties as part of its High Intensity Drug Trafficking Areas (HIDTA) program. These counties, located in California, Illinois, Kentucky and Pennsylvania, will receive support for regional law enforcement efforts to disrupt and dismantle drug trafficking organizations.
The ONDCP provided funding for the nationwide expansion of the HIDTA Overdose Response Strategy to all 50 states, Puerto Rico, the U.S. Virgin Islands and the District of Columbia. The strategy brings together drug intelligence officers and public health analysts at the local and regional levels to share information and develop evidence-based intervention and support services that reduce overdoses.
The ONDCP provided funding to support the establishment of state-level model legislation that advances efforts to expand access to harm-reduction services, as well as promote equity in access to treatment and drug enforcement efforts for underserved communities.
The ONDCP hosted more than 300 state, local and tribal leaders from all 50 states; Washington, D.C.; American Samoa; the Virgin Islands; Puerto Rico; and the Northern Mariana Islands for a virtual convening titled “Opioid Litigation Settlement: Using Evidence to Lead Action.” At the convening, government officials, researchers and experts discussed how state, local and tribal governments can use evidence and data to guide decisions about how funds from opioid litigation can be spent to address addiction and the overdose epidemic, while advancing equity.
The ONDCP announced $13.2 million in grants for 106 Drug-Free Communities Support Programs (managed by the CDC) across the country working to prevent youth substance use, including prescription drugs, marijuana, tobacco and alcohol. In June, the ONDCP announced $3.2 million for 65 communities nationwide for its Community-Based Coalition Enhancement Grants to Address Local Drug Crisis Program to reduce youth substance use.
The ONDCP announced the release of a model law for state legislatures that would help ensure opioid litigation settlement funds are directed to addressing addiction and the overdose epidemic in impacted communities and with public accountability.
For the model law, go to https://legislativeanalysis.org/model-syringe-services-program-act/.