The main point: The Trump administration is escalating its push against harm reduction.

The details:

Last month, in an executive order targeting homelessness, President Trump directed the Department of Health and Human Services (HHS) to not fund “programs that fail to achieve adequate outcomes, including so-called ‘harm reduction’ or ‘safe consumption’ efforts that only facilitate illegal drug use and its attendant harm.” While not law, the order directs agencies to take regulatory action.
Following that order, the Substance Abuse and Mental Health Services Administration (SAMHSA) told states that harm reduction is used to “advocate for policies that are incompatible with federal laws and inconsistent with this administration’s policies” and that “SAMHSA funds will no longer be used to support poorly defined so-called ‘harm reduction’ activities.” The letter says that naloxone would continue to be funded, along with test kits and other services (e.g., wound care supplies, hepatitis and HIV services). But it says federal funding cannot be used to “purchase pipes or other supplies for safer smoking kits nor syringes or needles used to inject illicit drugs,” “any other drug paraphernalia,” or “any other supplies to promote or facilitate drug use.”
Last week, the administration began removing educational materials related to harm reduction from government websites. SAMHSA has removed from its website a version of its overdose prevention toolkit that included sections on harm reduction and a separate “harm reduction framework.”

The context: Federal law already restricts federal funding for some harm reduction practices, including for needles used at syringe exchanges, and there are only a few safe consumption sites in the U.S.

Why it’s important: But a shift in messaging from the government could have a chilling effect on state and local governments, which handle much of the opioid response. These actions could threaten progress in reducing overdose deaths, particularly coming amid other funding cuts for addiction programs and the proposed dismantling of SAMHSA.