4 posts categorized "Substance Abuse"

To save lives, fund syringes

March 15, 2021

SyringesWhen COVID-19 struck, the United States was already facing a number of public health crises, with national rates of overdose, HIV, and viral hepatitis rising due to increases in substance use linked with a surge in prescription opioids.

The pandemic has converged with these crises, worsening health outcomes for people who use drugs — a crisis that is likely to persist unless we change our approach to drug use.

Take overdose deaths, which increased some 20 percent in the United States between June 2019 and June 2020, to more than 81,000, according to the Centers for Disease Control and Prevention. That's the most fatal overdoses ever recorded in a single year.

And while national figures for new HIV and viral hepatitis cases are not yet available, it's likely they are growing, too, given reported spikes in injection-drug use. (Both diseases can be transmitted via the sharing of injection supplies.) From 2014 to 2018, HIV diagnoses increased 9 percent among Americans who use drugs overall, while some 2.4 million Americans had been diagnosed with hepatitis C as of 2016.

Such grim statistics underscore the need for the U.S. to adopt evidence-based drug policies that can save lives and improve outcomes for people who use drugs. The willingness of the Biden administration to think differently about national drug policy and the changing views of Americans present a critical opportunity to do that.

For decades, policy makers and medical professionals have addressed substance use in two main ways: demand reduction and supply reduction. Both approaches treat substance use as an immoral behavior to be eschewed, instead of as a personal response to social factors or difficult life circumstances.

Neither strategy has significantly reduced substance use or its associated harms. Even though drug arrests jumped 171 percent between 1980 and 2016, the price of most illicit drugs fell, while attempts to dismantle the international drug trade have resulted in extreme violence.

Indeed, America's War on Drugs has tyrannized countless numbers of Black and brown families with racialized policies like mandatory minimum sentencing guidelines. Such policies have resulted in the overcriminalization of minor drug offenses, the mass incarceration of Black and brown people, and fractured communities across the nation.

Meanwhile, Americans are still using drugs.

It is long past time for the U.S. to embrace the principle of harm reduction, which has proven to lower rates of substance use around the world. Harm reduction recognizes the humanity of people who use drugs, acknowledging that people's relationships with substances usually change over time, and aims to minimize the negative consequences of substance use by fostering the inclusion of those who use drugs in an ecosystem of interventions and services.

The most effective harm-reduction interventions are syringe-services programs (SSPs), which were introduced in the 1980s and '90s as a community-based response to injection-drug use amid the HIV/AIDS epidemic.

Today, they provide syringes, overdose-prevention education, syringe-litter cleanup, infectious-disease testing, and — crucially — naloxone, the lifesaving overdose antidote. SSPs also connect their clients to treatment for substance-use disorder, as well as primary care and social services.

Despite this vital work, U.S. laws have long constrained service providers. In 1988, bipartisan opponents of syringe services prohibited providers from receiving federal funds until the government determined they were safe and effective. The ban remains partially in effect, even as reams of research have shown the benefits of syringe services, from reducing emergency medical costs to lowering rates of HIV and hepatitis C. SSPs still cannot use federal funds to purchase syringes, which help prevent infectious disease among people who inject drugs.

Since the COVID-19 pandemic began, I've seen a dramatic spike in people receiving syringe services through my work managing AIDS United's Syringe Access Fund, which disburses about $1 million in philanthropic funds to SSPs annually. And it is happening at a time when public and private funding for harm-reduction services was already inadequate.

Although Congress has allocated billions of dollars to combat the opioid crisis, many of those programs stop short of addressing the complex health, psychosocial, and socioeconomic factors underlying chronic substance use. For instance, half of all State Opioid Response (SOR) grants — a major federal initiative designed to help states expand their opioid addiction treatment services over the course of two years — went unspent, a federal watchdog has found, by the time the program was wound down. At the same time, our Syringe Access Fund grantees are struggling to meet their clients' needs and pay their bills. This not only imperils lives and public health but strains local resources.

It is time Americans recognize that the best way to reduce the staggering number of lives lost to overdose each year is to invest in services that support people while they are using drugs. To do that, we need to reach people who use drugs where they are. Syringe services programs are a cost-effective way to serve communities that many see as hard to reach, but which actually are hardly reached, as well as an opportunity to invest in a more holistic and inclusive public health infrastructure.

Without greater investment in that infrastructure, hundreds of thousands of Americans are likely to slip through the cracks and die from overdose in the years to come. We have the tools to prevent these deaths, so long as we invest in the lives of people who use drugs.

Zachary_Ford_AIDS_United_philantopicZachary Ford is a senior program manager at AIDS United, where he oversees the Syringe Access Fund, a grantmaking initiative focused on improving health outcomes for people who use drugs.

Addressing Drug Addiction: A Major Opportunity for Private Philanthropy

April 19, 2019

AddictionDrug overdoses kill more people in the United States than guns or car accidents and are the leading cause of death for Americans under the age of 50. According to the Centers for Disease Control and Prevention, seventy-two thousand people in the United States died from drug overdoses in 2017, compared to sixty-four thousand in 2016.

Despite this growing substance-abuse epidemic, private philanthropy has been barely visible when it comes to addressing the crisis and supporting new approaches to addiction treatment based on scientific research. This is especially surprising given that substance abuse is having such a broad impact among individuals and families of means.

While the University of Indiana Lilly Family School of Philanthropy's recently issued Philanthropy Outlook projects that individual charitable giving will increase 2.1 percent in 2019 and 3.4 percent in 2020, there is no reason to believe that a meaningful portion of these dollars will be directed to addiction treatment and research. At the same time, many foundations have made the strategic decision to focus on the "upstream" social and economic factors that lead to addiction.

The reality is that drug addiction has become the deadliest public health crisis in recent U.S. history, and the funding gap that exists between the problem and solutions to address the problem will not be closed without significant private funding.

Why Private Sector Giving?

It's imperative that the private sector become a major contributor to solutions aimed at addressing the substance abuse epidemic. The reasons are varied, but key among them is that healthcare policy too often discriminates against those with addiction issues, while insurance companies have been reluctant to provide coverage for people who are addicted. Moreover, many federal and state agencies are focused on an "arrest and incarcerate" approach and often ignore the root causes of addiction such as family history, child abuse, and so on.

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Most Popular PhilanTopic Posts (April 2017)

May 03, 2017

For those in the Northeast, April was rainy, cool, and dreary. Here on the blog, though, things were hopping, with lots of new readers and contributors. The sun is back out, but before you head outside, check out the posts PhilanTopic readers especially liked over the last thirty days.

What have you read/watched/heard lately that got your attention, made you think, or charged you up? Feel free to share with our readers in the comments section below. Or drop us a line at mfn@foundationcenter.org.

Reframing Addiction: Removing Stigma, Saving Lives

April 03, 2017

Addiction_disease_brain_300Every parent worries about the harm his or her child might encounter in the world. As parents, we dedicate our time and energy to protecting our children from every preventable danger — accidents, violence, illness. Why, then, don't we take steps to stop the epidemic that is claiming more American lives than car crashes or gun violence — the devastating disease of addiction? Addiction is killing our children. Even worse, the stigma associated with addiction keeps many people who are affected from seeking treatment.

In 2011, I lost my son Brian to addiction. He didn't die of an overdose or as a result of a drug-related crime. In fact, he had been in recovery for more than a year. The undeniable reality is that it was not just addiction that claimed my son's life — it was the shame he felt every morning when he opened his eyes that led him that day to research suicide notes, light a candle, and take his own life.

Brian had struggled with the disease of addiction for nearly ten years, cycling through eight different treatment programs. He desperately wanted to lead a normal life. His substance-use disorder was not indicative of a lack of willpower on his part; rather, the chemistry of his brain continually worked against him. Brian wasn't irresponsible. He was always curious, cheerful, and consistently caring. A dear companion and a beloved child. Full of compassion.

I wish I could say my anguish has subsided over the years since his death. But it has only intensified with the knowledge that addiction is a disease that is preventable but that we don't prevent; that is treatable but that we don't treat; that is undeniable but that we continue to deny.

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