Access to clean needles, fentanyl test strips and opioid-reversing naloxone are key to the Biden administration’s plan to reduce opioid drug overdose deaths, which have reached a record high.

Thursday, the administration will formally send Congress a report outlining its harm-reduction plan. A White House fact sheet said that the “National Drug Control Strategy” comes at a “time when drug overdoses have taken a breathtaking toll, claiming 106,854 lives in the most recent 12-month period.”

The release calls it “a whole-of-government approach to beat the overdose epidemic.”

Nationally, an estimated 41.1 million people needed treatment for substance use disorders, but the National Survey of Drug Use and Health in 2020 found just 2.7 million actually received treatment.

Among challenges, it noted barriers to treatment, as well as underfunding and restrictions on use of harm-reduction tools like naloxone and clean syringes on the local level.

Among the plan’s key points:

  • Expand “high-impact harm reduction,” including naloxone (which when administered correctly and promptly reverses overdose), drug test strips and clean-needle distribution programs.
  • Improve access of those at highest risk of overdose to evidence-based treatment.
  • Improve the data collection and research on which drug policy is based.
  • Go after drug traffickers and their profits.

Plans to disrupt drug trafficking range from collaborating internationally and locally to take down drug operations, to breaking up money laundering and related financial operations so drug manufacturing and trafficking isn’t profitable.

The White House touted changes already made in combatting America’s drug challenges. Examples included nearly $4 billion provided in the American Rescue Plan to provide services for mental health and substance use disorders treatment, including $30 million for harm-reduction efforts. It also said the Drug Enforcement Agency lifted a decade-long moratorium on opioid treatment programs with a mobile component, expected to boost treatment in rural and underserved communities, including jails and prisons.

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“For far too many years, the overdose crisis has been unraveling the very social fabric of our nation and destroying American lives and livelihoods. Biden’s inaugural National Drug Control Strategy delivers on his Unity Agenda — a call to action to beat the overdose epidemic. It recognizes that this is not a red state issue or blue state issue. This is America’s issue,” Dr. Rahul Gupta, director of the White House Office of National Drug Control Policy, told reporters in a press briefing.

The Associated Press reported that changes in state policies and laws will be needed for the expanded harm reduction.

Robin Pollini, an associate professor at West Virginia University who studies injection drug use and harm reduction, told NPR that access to harm reduction services like clean needles varies greatly depending on where one lives. She said a ban on federal funding for syringes would be needed to expand the programs.

Deseret News has reported on a number of harm reduction efforts to combat the opioid epidemic, including in Canada, where officials decided the drug supply was so tainted and dangerous that the government opted to focus first on reducing deaths. Vancouver, for instance, was testing MySafe, an ATM-like machine that dispensed clean needles.

Dr. Brent Kious, an ethicist, psychiatrist and instructor at the University of Utah, told Deseret News that opioid-directed harm-reduction efforts are measured by outcomes for society, as well as for individuals. “It’s not just whether fewer addicts die, but also if they are less likely to buy and use illegal street drugs, if they avoid dirty needles that can spread HIV or hepatitis C, and if they commit fewer crimes to support their habit,” that article said.

Critics worry, though, that harm reduction efforts may instead signal tacit approval of drug use.