To the Editor: “Decades of research have shown that some harm reduction strategies provide significant individual and public health benefits, including deaths from overdoses and preventing transmission of deadly diseases among people who use drugs and the larger community. Others reduce emergency department visits and costly healthcare services, while in some cases offering people who use drugs opportunities to connect to substance abuse treatments and other healthcare services in settings relatively free of stigma.” — NIH National Institute on Drug Abuse.

I find this assessment, which relies on the results of numerous peer-reviewed studies, to be particularly relevant in light of the ongoing efforts of some in our county legislature to put an end to any county funding for Samadhi to provide-much needed outpatient substance abuse recovery services. Resolution 207, which I understand will be before the legislature at next week's meeting, with a petition to discharge successfully executed, refers back to Resolution 273 and the execution of a contract with Samadhi to provide these services in May of last year. What has happened in the interim? According to the Ulster County Department of Mental Health’s Status of the System Report, published in January 2024, although the number of overdoses increased by 5 percent, those that were fatal fell 19 percent. In addition, the number of overdoses reversed by naloxone rose 9 percent as well. While not all of this significant decrease may be attributed to Samadhi's harm reduction model, some of it most certainly is and this translates to lives saved which otherwise may have been lost. That should matter. A lot.

In the months since last February’s press release from Legislators Roberts and Maloney calling for any relationship between Samadhi and the county to be immediately terminated, I have read and heard various reasons given as a rationale for doing so. In that statement, they cited an “alarming surge” in police calls to their Washington Avenue, Saugerties, facility, a sentiment echoed by Police Chief Nuzzo and Town Supervisor Murphy. Yet, the editorial from this publication on the matter noted the number of those responses from Ulster PD to be 35 in 59 weeks. Perhaps some other law enforcement agencies responded as well? If not, in my opinion, less than once a week, particularly when dealing with troubled individuals, hardly equates to an alarming surge.

There have been other justifications for terminating this relationship as well. In a Daily Freeman article dated May 5, Legislator Roberts is quoted as saying “ We need to get something to help people, not encourage them to do drugs” I can’t say what’s his basis for making that determination but according to Travis Rieder, PhD, MA and an associate research professor at Johns Hopkins Berman Institute of Bioethics, that’s simply not the case when it comes to harm-reduction practices. “Opponents sometimes argue that giving people sterile syringes, clean pipes, naloxone, a space to use drugs under supervision etc. incentivizes drug use or leads to drug use. But people are going to use drugs whether they have these resources or not, and so withholding them doesn’t prevent that use, it just makes it more dangerous. Making an activity more dangerous doesn’t stop people who are engaged in that activity, it just hurts and kills more of them.” (What is Harm Reduction?” Johns Hopkins 2022)

It’s also been suggested by Legislator Maloney that harm reduction relies on “questionable practices.” Susan Sherman, PhD at Johns Hopkins School of Public Health disagrees. Speaking to this issue she says, “Harm reduction isn’t only useful in and of itself, but it also brings people into services who may not otherwise come into services.” Again quoting Dr. Rieder: “In my view of harm reduction and treatment, they can be the same thing because making drugs safer can prevent some of the negative consequences that define addiction. One can take the first steps of recovery while still using drugs fairly chaotically and continue their road to recovery though small, slow steps that reduce the harms of drug use.” (What Is Harm Reduction?” 2022)

The intent of Resolution 207 is stated as being to “maximize and prioritize the procurement of safe, effective and comprehensive outpatient and substance abuse withdrawal and stabilization services,” and some feel sending out a Request for Proposal for different providers to be the best course of action. The notion that they don’t already exist in Samadhi frankly seems based on little more than rumors, unsubstantiated fears and personal biases. Along with experts in the field who I’ve cited, there also exists decades of research that demonstrates harm reduction to be an effective alternative treatment option.

Do their financial practices need to be addressed? Absolutely, and Director McNamara has said that new policies around some of their past practices have already been sent to the comptroller’s office. I urge the legislature to defeat this Resolution next Tuesday so we can continue to fight the devastation cause by the opioid epidemic and save lives.

Craig Kelly

Town of Ulster