CDC seeks to block ‘never use alone’ messaging used by overdose prevention groups | Trump administration

Officials at the Centers for Disease Control and Prevention have suggested that recipients of overdose prevention funds no longer be allowed to promote the message of “never use alone,” according to details of a meeting held this month, obtained by the Guardian.

The purpose of the meeting was to bring recipients of CDC Overdose Data to Action (OD2A) funding into compliance with Trump’s executive orders, according to a grant memo reviewed by the Guardian. Most notable is the July order “End Crime and Disorder on America’s Streets.”

The order bans federally funded “harm reduction” and “safe use” efforts, stating that they “only facilitate illegal drug use and the harms that result from it.” Harm reduction refers to a broad range of interventions aimed at making risky activities less risky and traditionally encompasses everything from condoms to prevent STIs, clean syringes to prevent HIV and hepatitis, fentanyl test strips and the anti-overdose drug Narcan. “Safe use” refers specifically to drug-related interventions, such as clean needles.

Leo Beletsky, a professor of law and health sciences at Northeastern University, said the philosophy behind this language is called “moral hazard.”

“It’s the idea that by making a risky activity less risky, you encourage people to engage in it,” Beletsky said, adding that if the threat of imprisonment doesn’t stop someone from using drugs, neither will a dirty needle.

Meeting officials told attendees that anything that could be construed as encouraging drug use is now prohibited for funding recipients. Several state and local health department officials asked whether they would be allowed to continue spreading the message to “never use alone.” Officials said it was a gray area and they would not provide a clear answer.

A spokesperson for the Department of Health and Human Services, which oversees the CDC, said: “HHS is committed to implementing the President’s executive orders across the Department. »

Dr. Jennifer Hua, medical director of the Chicago Department of Public Health — which has seen the greatest improvement in overdose deaths among major U.S. cities — said the message is part of “harm reduction 101…our message has always been carry Narcan, never use it alone, check your medications.”

While the executive order’s language demonizes harm reduction in general, CDC officials also explained that Narcan and fentanyl test strips will continue to be allowed, creating confusion around the administration’s definition of harm reduction.

“This is an interesting inconsistency because in some states, test strips are still considered [illegal] paraphernalia,” Hua said.

Beletsky said this “divergence of views” about what counts and what doesn’t count as risk reduction is “absurd” because the administration still allows certain interventions that have always been considered risk reduction, even as it denigrates the concept.

Harm reduction organizations have indeed been promoting take-home Narcan for decades and have also been instrumental in promoting fentanyl and other test strips to help alert users to contaminants.

Hua said providing Narcan and test strips goes hand-in-hand with the “never use alone” message, since someone overdosing needs someone else to administer Narcan.

Although Hua emphasized that this example is anecdotal, she noted that four of the five West Chicago neighborhoods most affected by overdose deaths saw a significant decline in 2024. These were neighborhoods where people primarily use drugs outdoors. Austin, the fifth ward on Chicago’s West Side, where indoor drug use is more common, has not seen the same decline.

“When you overdose outside or in public, that means there’s a much higher chance that someone will use Narcan to help you reverse that overdose,” Hua said.

“Isolation is one of the biggest factors in overdose deaths, not necessarily overdoses, because people overdose and survive,” Beletsky said. “Isolation in general is a major barrier to recovery, and that’s why connection is really essential to people’s recovery process. »

“Never consume alone” is therefore “a message of hope, connection and support, absolutely essential to resolving this crisis,” he continued.

Beletsky said people concerned about ending overdose deaths have had to learn what works and what doesn’t “the hard way.” He fears that the impending changes could turn the clock back “to a time when things were getting worse every year” and “that we could once again see trends reversing in the wrong direction again.”

Andrew Kolodny, medical director of the Opioid Policy Research Collaborative at Brandeis University, said this conversation distracts from the fact that funding for overdose and addiction prevention is inadequate. It is only granted in two-year blocks, making it impossible to create a comprehensive drug treatment system. Kolodny noted that Biden promised to strengthen treatment infrastructure during his 2020 campaign, but failed to double the nation’s treatment capacity as he announced.

“Under Trump, we are even less likely to see a new source of funding,” he said. “There are other things I could think of that concern me more than the wording of an executive order.”