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Harm Reduction Strategies in Texas: What’s Illegal & What Isn’t

Millions of people in the United States are affected by substance use each year. In Texas, there were 4,172 recorded drug overdose deaths in 2020 alone.1 With such high numbers of fatalities, community members and legislators are taking action, but not everyone agrees on the best approach.

What Is Harm Reduction?

Harm reduction is an approach to substance use prevention, treatment, and recovery that involves implementing strategies to reduce the negative impact of drug use. The harm reduction model strives to prevent dangers like overdose and the spread of infectious diseases as well as make care options and resources more accessible to people who use drugs. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), the various strategies are meant to meet people “where they are” and on their terms.2

Harm reduction can take many forms. Some strategies include:2

  • Overdose reversal education.
  • Distribution and increased access to overdose reversal supplies like naloxone kits.
  • Distribution of substance test kits including fentanyl test strips.
  • HIV education.
  • Safe-injection sites.
  • Home testing kits for viral hepatitis and HIV.
  • Resources on safer injection practices.
  • Needle exchange programs.

While there are several strategies, there is some debate about the pros and cons of harm reduction. As a result, not all of these programs are legal in the United States, and some are not readily used in certain areas. Harm reduction in Texas, for instance, is somewhat limited.

The Harm Reduction Model in Texas

The Biden Administration released a $30 million plan to expand harm reduction measures across the United States, but the harm reduction approach to drug use in Texas faces some opposition.3

Current harm reduction strategies in Texas operate with limited funding, and these organizations often must navigate strict laws and local opposition. One such organization, The Houston Harm Reduction Alliance, hands out harm reduction supplies in the community like naloxone—an opioid overdose-reversing drug—and clean needles from the trunk of workers’ cars. It is also unable to provide workers with a steady paycheck.3

While The Lone Star State has followed suit with other states by increasing access to naloxone and offering sterile syringe exchange programs, other harm reduction strategies in Texas remain illegal or are limited.3, 4

Texas was among the states who decided not to expand Medicaid eligibility. Medicaid includes coverage for substance use disorder treatment, and advocates argue that expanded eligibility can increase access to addiction treatment in Texas for those with limited means.3

In 2021, lawmakers also avoided passing a harm reduction bill in Texas that would have removed criminal penalties for the possession of drug paraphernalia including items like fentanyl test strips or clean syringes.3 Fentanyl test strips are used to test for the presence of fentanyl, a powerful opioid that is 50 to 100 times more potent than morphine and is involved in a large number of drug overdoses.5 This bill would have allowed organizations to legally hand out fentanyl test strips.

Representatives like Ted Cruz continue to push back against implementing some of these harm reduction strategies in Texas, claiming they do more harm than good. However, organizations like The Houston Harm Reduction Alliance continue to provide resources to the community as best as they can to hopefully get people into a Houston addiction treatment center.

If you or someone you care about needs help in Texas, don’t wait to take action. Greenhouse Treatment Center is an American Addiction Centers facility in Grand Prairie that provide high-quality addiction treatment and care. Call today to learn more about this program or to speak with our admission navigators about other treatment options.