Could the “Ithaca Plan” become a model for harm reduction in America?
A young man, 26 years old and white, stood and spoke. His back to the panel of experts, he addressed the crowded room of community members in Ithaca, New York, who had gathered to hear about the launch of a new municipal-level drug strategy. He was casually dressed, gaunt, and had a nervous quiver in his voice. “Four hours ago,” he said, “I was lying on the floor, unconscious, overdosing on a bad bag of heroin.”
His left wrist was wrapped in a hospital bracelet, and a mound of gauze was taped to his right forearm where an IV had recently been withdrawn. After his overdose, his girlfriend found him, dragged him to the hospital, and saved his life. He had been using off and on for 10 years—attempts at detox and medication-assisted treatment had so far failed.
He had spent time in jail for his drug use and still struggled to manage his addiction. While in the hospital just a few hours before, a friend encouraged him to show up at a public event where a new drug policy for the city was being discussed.
Ithaca has launched a bold and innovative plan to address drug consumption. Structured around the four pillars of prevention, treatment, harm reduction, and public safety, the “Ithaca Plan” is a pragmatic approach to managing the challenges of drug use in the city. It envisions fact-based drug education, meaningful youth engagement, and economic development for at-risk communities.
It also seeks to improve access to low-threshold and harm reduction services for current drug users, including a nurse-monitored safe consumption room and a 24-hour crisis center. It promotes expanded treatment options and greater availability of medication-assisted therapies. It also allows police to divert drug users to social support services without arresting them. In short, the Ithaca Plan is built on evidence-based, public health–oriented drug policies.
Crucially, the Ithaca Plan is not built on the false hopes of one day living in a drug-free community. It’s not reliant on the unrealistic demand that all drug users kick the habit, nor does it attempt to arrest its way out of the problem. The plan is aware that, despite decades of coercive suppression efforts, drugs will continue to find their way to the city and into the bodies of those who desire them.
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