Harm Reduction Program Grant: What you need to know (NCD)

Feb. 9. 2022, 1:40 p.m. ET: White House press secretary Jen Psaki said during the White House press briefing Wednesday that the Biden administration does not support federal funding, directly or indirectly, for crack pipes in HHS ‘safe smoking’ kits.

Psaki said that the Health and Human Services Agency never intended to require that crack pipes be included in safe smoking kits.

HHS put out this statement midday on Wednesday:

“HHS and ONDCP are focused on using our resources smartly to reduce harm and save lives. Accordingly, no federal funding will be used directly or through subsequent reimbursement of grantees to put pipes in safe smoking kits. The goal of harm reduction is to save lives. The Administration is focused on a comprehensive strategy to stop the spread of drugs and curb addiction, including prioritizing the use of proven harm reduction strategies like providing naloxone, fentanyl test strips, and clean syringes, as well as taking decisive actions to go after violent criminals who are trafficking illicit drugs like fentanyl across our borders and into our communities. We will continue working to address the addiction and overdose epidemic and ensure that our resources are used in the smartest and most efficient manner.”

A program administered through the Health and Human Services Agency that will fund syringe exchange programs, the opioid reversal drug naloxone and “safe smoking kits and supplies,” has drawn criticism from some who question the use of federal money to pay for drug use supplies.

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The Substance Abuse and Mental Health Services Agency, which is part of HHS, has allocated nearly $30 million to fund a Harm Reduction Program Grant. The grant will offer money to agencies around the country to fund programs that aim to provide “community-based overdose prevention programs, syringe services programs, and other harm reduction services.”

What has caught the attention of some on social media platforms and what some media organizations have reported on is a requirement within the grant that calls on organizations getting the money to provide “safe smoking kits.”

According to a health organization in British Columbia, Canada, a safe smoking kit would generally contain a glass stem (crack pipe), a meth pipe that has a bubble at the end, a plastic mouth piece (hose), pipe screens which the website describes as a “safer alternative to Brillo or steel wool, a wooden push stick, Vaseline, foil used when smoking heroin and alcohol swabs.

The kit is one of 20 requirements for recipients of the grant money. The grant’s full list of required plans, services and/or supplies includes:

· Assess organizational readiness and create a strategic action plan.

· Develop a sustainability plan for when the grant runs out.

· Develop policies and procedures to implement evidence-based trauma-informed practices.

· Distribute FDA-approved overdose reversal medication (Narcan) and deliver overdose prevention education to target certain populations.

· Establish a process for referral to treatment and recovery support services.

· Create a harm reduction advisory council.

· Designate staff members who will design and implement a harm reduction program.

· Purchase equipment and supplies to enhance the program. Those supplies should include:

· A harm reduction vending machine(s) (used to deliver clean needles, clean syringes and disposal containers for used needles).

· Safe sex kits, including PrEP resources and condoms

· Screening program for infectious diseases such as HIV, sexually transmitted infections and viral hepatitis

· Sharps disposal and medication disposal kits

· Substance test kits, including test strips for fentanyl and other synthetic drugs

· Syringes to prevent and control the spread of infectious diseases

· Vaccination services (hepatitis A, hepatitis B vaccination)

A notice of funding for the grant, called the “2022 Harm Reduction Program Grant,” was posted on Dec. 8, 2021. Monday was the deadline for applications for the grant.

The grant description states that priority would be given to applicants who serve communities that are historically underserved.

According to the document, applicants for the grant are required to write a two-page “behavioral disparity impact statement” that details the population which the grant applicant serves, including “racial, ethnic, sexual, and gender minority groups.”

Those groups of people are defined as “historically underserved,” using the definition in President Joe Biden’s first executive order, Executive Order 13985, signed on Jan. 20, 2021.

In E.O. 13985, Biden defined “underserved communities” as including:

“Black, Latino, and Indigenous and Native American persons, Asian Americans and Pacific Islanders and other persons of color; members of religious minorities; lesbian, gay, bisexual, transgender, and queer (LGBTQ+) persons; persons with disabilities; persons who live in rural areas; and persons otherwise adversely affected by persistent poverty or inequality.”

On Tuesday, Sen. Marsha Blackburn, R-Tennessee, wrote to the department of Health and Human Services, expressing “grave concerns” that the grant program could include subsidizing drug paraphernalia.

“Government-funded drug paraphernalia is a slap in the face to the communities and first responders fighting against drugs flowing into our country from a wide-open southern border,” Blackburn wrote in her letter. “If this is the president’s plan to address drug abuse, our nation is in serious trouble.”

A spokesperson for HHS defended the program saying it is an effective way to help those struggling with addiction.

“The Harm Reduction Grant offered by the Substance Abuse and Mental Health Services Administration (SAMHSA) and authorized by the American Rescue Plan is a grant program designed to help Americans who are struggling with substance use stay healthy and safe, prevent overdose death, and find pathways into evidence-based treatments.

“Like all programs that use federal funding, these grants must adhere to relevant federal, state and local laws or regulations.”

National Drug Control Policy Director Dr. Rahul Gupta also defended harm reduction services, saying they need to be expanded.

“The reality is, evidence-based harm reduction services are out of reach for far too many people,” Gupta said. “Building on the Biden-Harris Administration’s efforts to expand evidence-based prevention, treatment and recovery support services, this historic funding will help make harm reduction services more accessible, so we can meet people where they are and save lives.”

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