I know what it looks like...

The Great American Recovery Initiative Misses the Mark

The first batch of funding released under the Great American Recovery Initiative has been framed as a bold shift in America’s response to substance use disorder. At Prevention Day, the largest government sponsored gathering dedicated to advancing substance use prevention and hosted by Substance Abuse and Mental Health Services Administration, Robert F. Kennedy Jr. announced a $100 million investment intended to correct what he described as decades of failed policy.

According to the announcement, previous approaches allegedly focused on “non-effective interventions” such as harm reduction and Housing First models, which were blamed for enabling continued drug use rather than preventing addiction, overdose, homelessness, and crime. This framing is deeply flawed. Harm reduction does not enable drug use, it enables breathing. Naloxone saves lives. Overdose prevention sites reduce death and connect people to care. These are not experimental ideas; they are evidence-based public health tools supported by decades of data.

The initiative cites a stark statistic: nearly 8 in 10 people with substance use disorder in 2024 did not receive treatment. That number should not be used as an argument to cut harm reduction; it should be the strongest possible case for expanding all pathways to care. Treatment access, recovery services, housing, mental health care, and harm reduction are not competing strategies. They are complementary. When one is weakened, the entire system suffers.

There are pieces of the funding package worth supporting. The $10 million Assisted Outpatient Treatment grant program for adults with serious mental illness is a step in the right direction, though it is vastly underfunded relative to the scope of need. Likewise, expanding federal eligibility for all three FDA-approved medications for opioid use disorder as prevention services is a positive and overdue move. Preventing family breakdown by treating addiction as a medical condition, not a moral failure, matters.

Where the initiative fails is in its attempt to redirect funding away from harm reduction and Housing First models under the banner of “evidence-based” programming. This is not evidence driven policy; it is ideology dressed up as reform. We already know what happens when administrations swing the pendulum, one cycle expands services, the next cuts them. This inconsistency destabilizes providers, confuses communities, and ultimately costs lives.

A $100 million investment, while headline friendly, will not meaningfully move the needle. It reads more like a public relations strategy than a serious response to a national crisis. If the goal is to reduce overdose deaths, homelessness, and family devastation, the scale must match the problem. That means billions, not millions, and sustained funding, not political whiplash.

The path forward is not choosing between harm reduction and recovery. It is funding both, robustly, consistently, and without moral hierarchy. Lives depend on it.

This issue is not theoretical for me. My perspective is shaped by lived experience, by watching someone I loved move through addiction, brief stability, relapse, and loss. I have seen firsthand how harm reduction kept my son alive long enough to have another chance, and how gaps in treatment access, mental health care, and continuity of support ultimately failed him.

I know what it looks like when harm reduction exists without enough recovery infrastructure. I also know what it looks like when recovery is demanded without the safety net that keeps people alive long enough to reach it. Neither works alone. Framing this as an either or choice between harm reduction and sobriety or prevention and accountability ignores how people actually move through addiction and recovery.

Salena Garten and her sons Steven (RIP) and Logan

All roads must be available. Some people enter recovery through treatment. Some through housing stability. Some through medication. Some through harm reduction services that keep them alive until they are ready for the next step. Removing any one of those roads does not strengthen the system. It narrows it, and people fall through.

The path forward is not choosing between harm reduction and recovery. It is funding both, robustly and consistently, without moral hierarchy. Evidence, lived experience, and outcomes all point to the same conclusion. Systems save lives when they are integrated, not when they are divided.

Lives depend on it.

Salena Garten

Family Support Provider

Missouri Recovery Support Specialist

Founder, The Phoenix Network

Mother with lived experience