August 14, 2025 9:44AM # The Federal Government and Harm Reduction By [Jeffrey Miron](https://www.cato.org/people/jeffrey-miron) --- SHARE Listen to this article Generated with [ ElevenLabs](https://elevenlabs.io/) AI technology. Loading the [Elevenlabs Text to Speech](https://elevenlabs.io/text-to-speech) AudioNative Player... ![harm reduction](/sites/cato.org/files/styles/pubs_2x/public/2025-08/harm%20reduction.jpg?itok=X18V7rsO) On July 24, President Trump [signed](https://www.aclu.org/press-releases/aclu-condemns-trump-executive-order-targeting-disabled-and-unhoused-people) an [executive order](https://www.whitehouse.gov/presidential-actions/2025/07/ending-crime-and-disorder-on-americas-streets/) that, among other things, eliminates funding for harm reduction programs. Such programs (syringe services, naloxone and fentanyl test-strip distribution, overdose prevention sites) acknowledge that risky drug use will occur and focus on minimizing the health, social, and economic harms of those behaviors, rather than advocating for abstinence. These programs appear to generate beneficial effects: needle exchange programs [reduce](https://pmc.ncbi.nlm.nih.gov/articles/PMC4211599/) the prevalence of HIV; supervised injection clinics [save](https://pmc.ncbi.nlm.nih.gov/articles/PMC2582765/) money and relieve disease burden from the healthcare system; and pharmacy-based intranasal naloxone distribution [reduces](https://pubmed.ncbi.nlm.nih.gov/32327162/) opioid overdoses. Yet federal funding of harm reduction has downsides. Such funding might appear to lower the cost of drug abuse, and even if this effect is minor, the perception makes the politics of legalization difficult. Convincing voters to accept other people’s drug use is one thing; convincing them to “pay for it” is another. At the same time, the federal government should not impede state, local, or private support for harm reduction. Currently, federal law bans [opening](https://www.justice.gov/archives/opa/pr/appellate-court-agrees-government-supervised-injection-sites-are-illegal-under-federal-law) a safe injection site or drug “consumption room,” and the federal government can [seize](https://www.law.cornell.edu/uscode/text/21/863) anything “primarily intended” for drug use, including drug-checking gear like fentanyl test strips. The proper approach to harm reduction is legalization. By eliminating underground markets, this [reduces](https://filtermag.org/infographic-the-iron-law-of-prohibition/) the incentive for dealers to lace their substances with fentanyl while allowing consumers to protect themselves through legal channels. Legalization would allow for the safe purchase of needles, reducing disease transmission from needle-sharing. And while some claim that legalizing needles increases drug overdoses, recent research [finds](https://pmc.ncbi.nlm.nih.gov/articles/PMC4297731/) otherwise. Finally, legalization reduces the many ills of underground markets, such as [violence](https://www.nber.org/papers/w6950) and [corruption](https://link.springer.com/article/10.1023/A:1024981601093). In short, the safest—and most principled—way to curb drug-related harms is for Washington to abstain from either subsidizing or criminalizing and instead allow individual decisions and private mechanisms to balance the harms and benefits of drug use. *This article appeared on* [*Substack*](https://jeffreymiron.substack.com/) *on August 14, 2025. Jonah Karafiol, a student at Harvard College, co-wrote this post.* ##### Related Tags [Health Care](https://www.cato.org/health-care), [Drug War](https://www.cato.org/drug-war) [![Creative Commons License](/build/cato_2020/images/creative-commons.svg)](http://creativecommons.org/licenses/by-nc-sa/4.0/) This work is licensed under a [Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License](https://creativecommons.org/licenses/by-nc-sa/4.0/).