Amid a lingering overdose pandemic in the United States, leading federal health agency the National Institutes of Health (NIH) is striving to advance studies into the value of various harm reduction policies. 

Included in the NIH’s efforts – which were announced on Wednesday, December 29 – are strategies for decriminalization and safe substance consumption sites.

Specifically, the NIH issued a request for application (RFA) to obtain adequate funding for investigations into the prospective benefits of implementing harm reduction policies during the drug crisis.

According to an official statement from the NIH, the agency wants to establish a Harm Reduction Network that seeks to “increase our understanding of the effectiveness, implementation and impact of existing and new harm reduction practices to address the ongoing opioid crisis and substance use disorder more broadly.”

A similar RFA urges for the establishment of a coordination center within the system. The center would be focused on “research and clinical practice resources,” “logistical and coordination support” and “data harmonization and data sharing supports.”

Application process is open for numerous projects 

The newly-issued notices from NIH and associated organizations – including the National Institute on Drug Abuse (NIDA) – describe the “emerging” harm reduction policies as the “decriminalization of various drugs, police and prosecutor-driven deflection and diversion efforts and the authorization of safe consumption sites.”

At the current time, applications are open for plans that cover the following:

• “Developing and testing new harm reduction strategies;”
• “examining how to effectively implement new and existing harm reduction strategies;” 
• “expanding the settings and delivery models through which harm reduction strategies are deployed;”
• “examining the impact of new harm reduction policies implemented at state and local levels.”

The notice goes on to say that the agency’s services will include tactics for reducing harm, as well as schemes that successfully deter people from participating in substance use-related activities that may otherwise result in a negative outcome, such as infectious disease transmission and/or fatal overdose. 

“Examples of established harm reduction approaches include naloxone, fentanyl test strips (FTS), safer smoking equipment, and sterile syringes, as well as human immunodeficiency virus (HIV) and Hepatitis C virus testing,” reads an excerpt from the notice.

Additionally, so as to ensure that the risk of overdose is as low as possible, the White House Office of National Drug Control Policy (ONDCP) is reportedly making harm reduction policy a priority.

Director of the NIDA, Nora Volkow, has voiced her concerns about the negative implications of drug possession criminalization. In particular, she has drawn attention to the racial disparities that tend to cause problems for law enforcement; this, she says, is an area that requires major improvement.

In terms of safe consumption sites, Volkow said earlier last year that she is willing to investigate “how these support systems as a community can help people, for example, engage in treatment, how they can prevent them from getting infected from HIV and how they can prevent them from overdosing and dying.”

Other elements of the NIH’s research initiative on harm reduction

The elements discussed above are just a drop in the bucket in terms of what the NIH’s research initiative on harm reduction covers. 

Let’s take a look at some more subject areas that will be explored by those who participate in the research effort:

• Research into the development and testing of original strategies and/or settings for harm reduction. Such strategies should focus on industries beyond the healthcare system and methods that do not rely on face-to-face interaction;
• Research that aims to figure out which individual- and system-level obstructions are currently hindering the scalability, efficacy and sustainability of harm reduction services, e.g. job shortages, financial restraints and negative attitudes toward people with substance use disorder (SUD);
• Research on tactics that could broaden access to harm reduction services for individuals from understudied populations;
• Research on harm reduction programs for people who suffer from SUD associated with methamphetamine and various other types of stimulants;
• Research to improve the scalability, efficacy and sustainability of harm reduction services through strategy development and/or test strategies;
• Research into the potential outcome of advancing harm reduction policies, such as their ability to lower the risk of unfavorable outcomes, as well as the limitations/facilitators for victorious results in real-world environments.

A total of nine applicants will be chosen to carry out studies under the five-year program. For fiscal year 2022, as much as $6.75 million will be approved for the projects.