Fighting biden overdoses, damage reduction groups face local opposition

HOUSTON – Casey Massage was just dragged into a 2nd Ward intersection when a woman with tattoos and pink hair unexpectedly climbed into the back seat of her gray machete. He runs outreach for the Houston Harm Reduction Alliance, a nonprofit that helps drug users like him survive.

The woman, Desari Hess, arranged to meet him, but Massage, as usual, was not sure what to expect this recent afternoon. Hess told Massage to take him to the Value Village Thrift Store before he explained why he was so insane.

Earlier in the day, at around 2am, Hess said a woman – a “teenage girl” – had overdosed on the warehouse where Hess was hanging out. No one found naloxone, a drug that reverses opioid overdose and causes a woman’s lips to turn blue. Hess said he blew into the woman’s face, trying to keep her alive, while others covered her with ice. Eventually, someone found some naloxone, often referred to by the brand name Narcan, and sprayed the drug on his nose. After the woman regained consciousness, Hess made a decision.

“I knew I had to call Cassie,” the 39-year-old thought, “to get more narcissism.”

Massage picks up needles, naloxone, cotton balls and condoms from the trunk of his sedan and drives on city streets. But the Houston Harm Reduction Alliance, whose tax records show that it works for less than $ 50,000 a year, can pay a few thousand dollars per massage. Her full-time job as a research assistant at the University of Texas Health Science Center in Houston.

Massage – a 31-year-old man who said he had problems with alcohol and opioid pills before quitting about 10 years ago and then heroin – estimates he can reach about 20 people a month like Hess. Meanwhile, according to the Houston Police Department, drug overdoses killed 1,119 people in the city last year.

President Joe Biden wants to expand the harm reduction program, such as a massage that works as part of a larger strategy to reduce drug overdose deaths, to more than 107,000 nationwide by 2021. But the $ 30 million plan faces a complex reality on the ground In Houston, as in many parts of the country, loss reduction programs are on the verge of legitimacy and on a low budget. Often, lawyers like Massage must navigate the maze of state and local law, local opposition, and hostile law enforcement.

Regina Label, who served as acting director of the Office of National Drug Control Policy until November, credited Biden to the White House as the first presidential administration to openly embrace harm reduction in controlling drug overdose. He said the $ 30 million, $ 1.9 trillion trapped in the American Rescue Plan Act, was still just a first step and that it depended on a turbulent patchwork of many group grants.

“You don’t have to hold back sales for people to get the care they need,” said Label, who now runs an addiction policy program at Georgetown University.

Casey Malish delivered syringes from her sedan in Houston on June 3, 2022. Massage estimates that he can provide resources to only 20 people a month. According to the Houston Police Department, drug overdoses killed 1,119 people in Houston last year. (Mark Felix for KHN)

Also, when the programs are obstructed by the state legislature and local leaders, there are limitations on what the administration can do. “What you don’t want to do is the federal government is coming and will impose something on a volatile state,” he said.

Both Republican- and Democratic-led states have legitimized damage reduction aspects, but many are resisting.

According to Temple University’s Center for Public Health Law Research, by 2017, access to all states and Washington, DC, Naloxone was relaxed. However, fentanyl test strips – which help people avoid strong synthetic opioids or take extra precautions when using them – are illegal in about half of the states. According to the KFF, there is no program in seven states that provides clean needles to people to help prevent the spread of HIV and hepatitis C, as well as bacterial infections and embolism that, when used excessively, weak needles break into veins. And New York is the only city operating injection site where people can use drugs under supervision, although Rhode Island has legalized them and the judiciary has indicated it could pave the way for more sites to open.

Texas is one of the states that has been slow to accept interventions – and has not expanded its eligibility for Medicaid, so low-income Texans have limited access to recovery programs. During the 2021 legislature session, lawmakers repealed a bill that would repeal criminal penalties for possession of items such as drug paraphernalia, clean syringes and fentanyl test strips.

That means the Houston Harm Reduction Alliance works in a “legal gray area,” Massage said. While it has received overwhelming support from Houston police and other local entities, the nonprofit could run into problems if it moves to a neighboring town.

Texas Sen. Ted Cruz, a Republican, wrote to KHN in an email that “programs that provide people with the tools they need to continue their drug use are not helping our community.” In February, Cruz criticized Biden’s grant program, saying it would fund “Cracked pipes for everyoneRetweet a story on a conservative website. Fact checkers have denied the story’s claim, but it continues to feed opponents of the practice of harm reduction in state and local governments, even in places where excessive deaths are on the rise.

Louisiana allows local authorities to approve the syringe exchange program, but only four of the state’s 64 parishes allow the service. “We know in public health how these programs save lives,” said Nell Wilson, project director of the Louisiana Opioid Surveillance Initiative. “But as a more conservative state, many problems are fighting against the widespread misconception that they are not realistic.”

In Kentucky, the local Department of Public Health runs loss reduction programs, said James Thacker, program manager at the University of Kentucky’s Damage Reduction Initiative. In some parts of the state, local law enforcement agencies support the programs In others, they enforce laws that treat fentanyl test strips as illegal drug paraphernalia.

Harm reduction programs also respond in progressive areas, such as San Francisco, where some residents believe they encourage drug use.

However, state and local damage reduction groups say the Biden administration’s $ 30 million grant is not enough money to expand their programs to reach those in need.

Kate Graziani, co-executive director of the Texas Harm Reduction Alliance, said, His group planned to raise funds for local outposts, such as the Houston Harm Reduction Alliance.

“These programs are still running on a shoe,” said Leo Belletsky, a public health law expert at Northeastern University. “Public health is not what it should be.”

Casey Massage, 31, manages outreach for the Houston Harm Reduction Alliance, a nonprofit that helps drug users survive. (Mark Felix for KHN)

To minimize the damage, advocates do not believe that such an effort alone would stop sudden excessive deaths. Addiction is a complex, chronic disease. And in 2021, according to the Centers for Disease Control and Prevention, overdose deaths are up 15% from a year earlier. Today, illicit fentanyl and its analogues from Mexico and China have tarnished the street supply of counterfeit pills, heroin, and even stimulants such as cocaine and methamphetamine, resulting in casual users and long-term addicts who overdose and die.

“Nothing is going to solve the overdose crisis, but it is going to save a lot of lives,” said Dr. Nora Volko, director of drug abuse at the National Institutes of Health, in an effort to reduce the damage.

Many massage clients talk about quitting drugs. According to the CDC, those who use the syringe service program are five times more likely to start treatment and three times more likely to stop using the drug.

When Massage takes Hess across Value Village to an abandoned strip mall where he usually lives, he says he plans to start methadone treatment for heroin addiction as soon as he can get an ID as soon as the city offers it to homeless people.

“I’m very sick to see my friends die,” Hess said.

When he got out of the massage parlor, he loaded his weapon box with syringes, sterile water, injectable naloxone, tourniquets, and fentanyl test strips to share with others.

Hess then asked the masseuse if he could take the two quarts of drinking water he found in his car seat cushion, before walking through the mall’s double door.

Related topics

Contact Us Submit a story tip

Leave a Reply

Your email address will not be published.