City explores harm reduction strategies to address the overdose crisis

The Texas Harm Reduction Alliance addressed the Public Health Committee last week about the overdose crisis in Travis County. More than 300 people in the area died of a preventable overdose last year, and more than 100 of those deaths were from a fentanyl overdose – a 237 percent increase from the year before.

The Public Health Committee is aware of the severity of the crisis and met to discuss how it can improve local policy to better target the problem. Representatives from THRA said that incarcerating people for drug use instead of regulating drug use to make it as safe as possible – i.e., the policies of the war on drugs – is at the root of the problems we’re facing today. Harm reduction, which has proved to be a much more effective public health approach, aims to reduce the risk of drugs, keep drug users alive and provide them help getting clean when they’re ready.

Some harm reduction strategies that are being or could be employed in the area include things like making clean syringes available, providing access to medication-assisted treatment like buprenorphine and methadone, distributing naloxone or other drugs that reverse opioid overdoses, treating wounds caused by injections, and providing access to drug testing and drug use education, THRA Director Cate Graziani explained.

“When we think about prevention, drug education is really important,” Graziani said. “Similar to sex education, we understand that kind of abstinence-only models are not working. We have to arm people with good information about drugs and how to use them more safely so that they stay alive. … Which drugs don’t you mix? How do you use with a buddy so that you’re not alone if you do overdose?”

Death from drug use is the No. 1 cause of accidental death in Travis County, ahead of even car crashes. This glaring fact is directly linked to Austin’s homelessness crisis, THRA’s Paulette Soltani told the Public Health Committee. “While overdoses are rising, our homelessness crisis has continued to rage on and people continue to be swept deeper and deeper into places where they’re not connected to their networks and places that are harder for us to make sure that we are able to serve them,” Soltani said.

A previous resolution passed by City Council in 2018 failed to prevent the opioid crisis from getting to this point. In advance of Council’s next policy effort to address the issue, Graziani asked, “What lessons can we learn from what y’all put in place then? How can we do things differently this time around? We don’t want to pass another resolution that doesn’t make a difference in saving people’s lives.” 

The representatives from the alliance offered a handful of immediate and long-term strategies that would help address the crisis. First of all, Austin needs to build a robust infrastructure to provide harm reduction – many other service providers are capable of partnering with THRA to expand these services; they just need the funding. Access to overdose-reversing drugs like naloxone needs to be drastically expanded. Police sweeps of homeless communities need to be stopped and access to housing expanded and equipped with harm reduction strategies. And the criminalization of unwitting possession or sale of fentanyl should be stopped, they said.

In the long term, THRA staff explained, Texas should have an authorized program to provide access to safe syringes, housing options for current or former drug users should be expanded, all service providers should be trained in harm reduction strategies, overdose prevention centers should be expanded, and policies should work to make sure drug supplies are safer.

Photo made available through a Creative Commons license.

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