Austin advocates urge more support for harm reduction amid high overdose, fentanyl deaths

Felix Gonzalez first used drugs at 9 years old.

Decades later, he continues to cycle in and out of drug use as a way to cope with the trauma from his life, he said. But in the past two years, as someone experiencing homelessness, he has seen more family and friends die on the streets of Austin than at any other time of his life. Most of those deaths are due to fentanyl.

“So much death around fentanyl,” Gonzalez said, as he began tearing up. “I really don’t know what a solution to this is. … But we need help.”

Gonzalez was one of dozens of advocates, local officials, and former and current drug users who stood outside of the Texas Harm Reduction Alliance’s drop-in center in East Austin on Wednesday to call for more resources to be put into harm reduction as both the city of Austin and Travis County look to begin their budget processes. The alliance offers services to people at risk of opioid overdoses in the Austin area.

Wednesday’s news conference comes nearly a week after the Travis County medical examiner, J. Keith Pinckard, presented the office’s annual report, which found that overdoses were the county’s leading cause of accidental deaths — a trend driven by an increase in the deadly drug fentanyl, a synthetic opioid 50 times stronger than heroin that has been found laced in other drugs such as methamphetamine and cocaine.

Overdose deaths and fentanyl-related overdoses increased last year, the report found, with 486 people dying of an overdose.

So far, this year doesn’t seem to be bringing much of an improvement, as the county recently saw an overdose surge that resulted in 79 overdoses and nine deaths in less than a week. Fentanyl was present in each of the nine deaths, county spokesperson Hector Nieto has said. No arrests have been made in connection to this surge.

“We’ve been raising the alarm for so long, and we do not have the support we need,” said Alexandra White, director of services for the Texas Harm Reduction Alliance. “We are so tired. We are working so hard to keep our people alive that we don’t even have time to mourn our dead.”

During the previous state legislative session, harm reduction efforts such as legalizing fentanyl testing strips in Texas stalled in the Senate despite a measure passing in the House.

Many of the people who spoke at Wednesday’s news conference urged state lawmakers to make fentanyl testing strips legal during next year’s legislative session.

Travis County has the highest rate of fentanyl-related deaths in the state compared with other major metropolitan counties. Experts have partially attributed the rate to the area’s lack of treatment options and local policies that have made implementing a successful harm reduction strategy more difficult.

What is harm reduction?

Harm reduction includes making things available to drug users that can help limit some of the adverse effects that are typically associated with illicit drug use. Some of those items include clean needles, wound care and Narcan, a nasal spray that, if administered soon enough, can reverse an opioid overdose.

However, Maggie Luna, executive director of the Texas Harm Reduction Alliance, said harm reduction is a lot more than just providing Narcan to people. She said it’s providing support to drug users, and oftentimes people who are homeless, with dignity and without judgment. This can include offering people a meal, a place to shower or safe sex supplies, all things that the organization provides.

The alliance offers harm reduction in two forms: through its drop-in center in East Austin and through its outreach teams, which go to various places throughout the city where campsites or large numbers of people experiencing homelessness are typically found.

Currently, the alliance employs 11 people, including four on the outreach team and another four in the drop-in center. That’s not enough for Travis County, Luna said, and it’s why the group is asking Austin Public Health to increase its current yearly budget of $684,000 to $1 million.

White said that, in six months, the Texas Harm Reduction Alliance has handed out supplies to more than 1,800 people.

What are county leaders saying?

Leaders such as County Judge Andy Brown and Commissioner Ann Howard both spoke at Wednesday’s news conference and said they would be asking the Travis County Commissioners Court for more funding.

“We have pledged at Travis County to listen and to learn and to invest where it matters,” Howard said. “We need to do more, and we are in agreement about that. It is a struggle. There’s lots of needs in Travis County, we’re growing fast, but I think nothing compares to this one.”

Brown said increasing funding for harm reduction is a short-term solution and that, long term, the county is looking to increase permanent supportive housing for people who are homeless. Additionally, he said the upcoming mental health diversion center is another option to help treat people who are arrested on a low-level crime in a way other than sending them to jail.

While the building is likely years away from being completed, Brown said a pilot program between the county, the city of Austin and Central Health, the Travis County hospital district, has been given the green light. The pilot can handle up to 25 people and will begin taking people soon, if it hasn’t already, Brown said.

Other solutions

In addition to calling for more resources to be put into harm reduction, many called for an end to stigmas and for increased access to permanent supportive housing.

Permanent supportive housing is one of the two types of rental assistance offered to people experiencing homelessness in Austin. These vouchers have no time limit and come with intensive services, such as mental health treatment. The city has increased its capacity in recent years and expects to have an additional 1,000 permanent supporting housing units by 2026, with some being made available this year.

However, the number of people moving into permanent supportive housing units each year is far lower than the total number of people seeking such assistance, the American-Statesman reported.

White and others said the continued sweeps of homeless camps are making it more difficult to provide harm reduction supplies to the people who need it the most. White also called for investigations anytime there’s an overdose death in one of the city-funded shelters or housing projects.

Gonzalez, who said he is a veteran who served in the U.S. Navy in the late 1980s, said people living in campsites often won’t call 911 for fear that doing so will put them on the radar of police or city officials, which will then cause them to lose all their belongings.

“I just wish the public would open up their eyes a little bit and not be so close-minded,” Gonzalez said. “They think a lot of this is taboo and stuff, but, no, it’s real life. Basically, it’s just a little more consideration for other human lives.”