'Harm reduction' fails in fentanyl era
Cathedral School parent shares recent research
A member of Stadiumhood Neighbors sent a letter to Sen. Lisa Reynolds regarding the science on “harm reduction” as a therapy for drug addiction. For personal safety reasons, he did not want his name published.
The current debate around syringe exchange and drug paraphernalia distribution programs in Multnomah County has become dangerously disconnected from reality. Public officials and advocacy organizations continue to frame these programs as unquestionably evidence-based while ignoring a growing body of research and the lived experiences of residents who are dealing with the fallout every day.
The science on syringe exchange programs is far more complicated than advocates often admit.
Research does show that syringe exchange programs can reduce HIV transmission among intravenous drug users. One major analysis found Syringe Exchange Programs openings associated with reductions in HIV diagnoses of up to 18%. But newer research examining modern fentanyl-era conditions paints a far more troubling picture.
A widely discussed study by economist Analisa Packham published in the Journal of Public Economics found that counties opening syringe exchange programs experienced a 21.6% increase in opioid-related overdose deaths following implementation. Her research estimated approximately three additional overdose fatalities per county per year and concluded that SEP openings were causally linked to increases in fentanyl-related deaths.
Critically, many traditional public health studies focus narrowly on disease transmission among users while failing to measure broader community harms. They rarely account for impacts on nearby schools, businesses, neighborhood livability, psychological stress on residents, retail theft, open-air drug markets or the normalization of public drug use around children.
In Stadiumhood, we have watched mobile distribution programs hand out needles and crack pipes within walking distance of Cathedral School. Portland People’s Outreach Project’s distribution site near Cathedral was about 850 feet from the school itself. Parents and residents repeatedly raised concerns after witnessing open drug use, discarded needles, dealing activity and individuals passed out near school routes.
To be clear: I support treatment, recovery and real compassion for people suffering from addiction and mental illness. What I do not support is a version of “harm reduction” that ignores the harm being inflicted on everyone else in the community, especially children.
There is no “safe” way to use fentanyl. The policy failures of the “harm reduction” and “housing first” crowd surround us in Portland and cities like LA, Seattle and SF (although Laurie is meaningfully improving the situation in that city). It’s really common sense. Why would anyone believe giving addicts the tools to take drugs would yield a positive outcome? Similarly, why would anyone believe providing a home, without treatment, to someone who is mentally ill or drug addicted would yield a positive outcome. The only people who believe this stuff are those fresh out of university with social science degrees and no real world experience (ie. Portland’s city council).