Harm Reduction

The New England Journal of Medicine is again promoting failed progressive public policies. This time, it is “harm reduction.” From “The Erosion of Harm Reduction,” by Joshua Barocas, M.D. (citations omitted):

Unlike the targets of many other recent attacks on public health and medicine in the United States, harm reduction is not a formal bureaucracy, but a philosophy and an approach to health care. As defined by the Drug Policy Alliance, it is “a set of ideas and interventions that seek to reduce the harms associated with both drug use and punitive drug policies.” Harm reduction is embodied in syringe-services programs (SSPs), naloxone distribution, overdose education, overdose-prevention centers [i.e. “safe injection sites”], and decriminalization of drugs.

Barocas decries the Trump administration’s executive order that limits such policies:

Perhaps most concerning, an executive order focused on homelessness and civil commitment issued on July 24, 2025, prohibits federal SAMHSA discretionary grants from being used to fund harm-reduction activities, proposes a freeze on federal funding to organizations that provide “drug paraphernalia,” and threatens legal action against harm-reduction organizations. The executive order states that these approaches “only facilitate illegal drug use and its attendant harm.”

My wife, the Las Vegas Review-Journal columnist Debra J. Saunders, covered San Francisco’s harm reduction drug policies extensively back when she worked for the San Francisco Chronicle. It started with “needle exchange,” which she initially supported as a means of preventing the spread of HIV. The idea was for addicts to “exchange” dirty needles — a prime source of HIV transmission — for clean ones. The rule was: no used needle, no free clean replacement. Unfortunately, the program led to greater drug abuse. “Harm reduction” zealots eventually dropped the exchange requirement, which resulted in dangerous used needles littering San Francisco’s sidewalks and even children’s playgrounds.

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Homelessness has reached crisis proportions. Few issues of human dignity are as heart wrenching as the wretched scenes in our most prosperous cities — San Francisco, Los Angeles, Portland, and Seattle — where one can drive down main thoroughfares and be confronted with tent encampments lining streets that provide scant shelter for thousands of destitute people. The crisis is as Read More ›