Katherine Dunham is a harm reductionist and researcher at the People, Place and Health Collective at the Brown University School of Public Health.

In January 2022, Rhode Island joined the national opioid settlement which provided over $90 million for state and local efforts to address the overdose crisis. It’s imperative that these funds be used to comprehensively and equitably support the well-being of harm reduction staff — the front-line workers who will be carrying out many of those lifesaving efforts.

Harm reduction is a set of strategies that addresses the negative outcomes associated with drug use. Notably, research has found that those working in the field — harm reduction workers — face common stressors in their roles such as overextension, grief and feelings of burnout, all of which take a toll on staff members’ mental health and all of which are exacerbated by the growing overdose crisis.

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Additionally, studies out of Philadelphia and Massachusetts found that, during the COVID-19 pandemic, harm reduction organizations were experiencing staff shortages, staff members were unable to work remotely, and staff were experiencing significant feelings of isolation. Working in harm reduction myself during this time, I felt these feelings of loss, exhaustion and tension firsthand, and saw that organizations often didn’t have the resources to sufficiently address them. 

Rhode Island has a long history of supporting harm reduction and a recent report found that there is currently an “unprecedented demand” for harm reduction services in the state. While it’s wonderful that opioid settlement funds are being used to create and expand these services, it’s critical that we properly support the well-being of the local harm reduction workers who will be providing these lifesaving services. Such funding could be used to support facilitators of staff well-being, such as sufficient pay, job security and benefits. It will also be important to speak directly with local harm reduction workers about what support they most need and formally support the ways in which staff members have already been taking care of themselves and their coworkers.

Importantly, Rhode Island has already begun to allocate funds in this way. This month, it was announced that opioid settlement funds are being used to create a million dollar grant that will fund trauma support for local peer specialists and first responders. This prioritization of peer specialists’ well-being is especially key since these staff members often face unique stressors while working in the field but often receive less institutional support. That being said, the implementation of this grant will be incredibly important. These funds need to be made known and made easily accessible to local harm reduction organizations; this is especially important given that harm reduction workers often don’t have access to the same level of occupational resources and benefits as the other named first responders.

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Additionally, it’s critical that the state makes sustained, long-term commitments to support harm reduction workers beyond this specific grant, funding additional support services and creating opportunities for workers more broadly. That being said, this grant is an important, early example of ways in which states and localities can use opioid settlement funds to support harm reduction workers’ mental health.

We need to set harm reduction staff up as best as possible to implement these new initiatives and save lives. If not, we will just be putting additional pressure on a workforce that’s already burdened by many mental health stressors. In this way, opioid settlement funds are an important and hopeful opportunity to explicitly allocate funds for this purpose.