The Harm Reduction debate and where I stand. (Part II)

[continued from previous entry - again, all comments are welcome!]

Now, my personal opinion on this (as one who is active in HR on- and off-line), and I'm pretty sure the opinion of a large selection of BL'rs if DITM responses tell us anything, heavily leans toward the "HR-as-a-philosophy" (principled) side rather than the "HR-as-a-set-of-practises" (pragmatic) side. However, from the outset allow me to clarify that my extreme disagreement with the pragmatic side does not prevent me from working with them to achieve this common goal. It is with the latter point that I actually agree with the CCSA: that ideology ought to be secondary to goals.

With that said, allow me to begin by quoting Hunt's own definition of HR:

In essence, harm reduction refers to policies and programmes that aim to reduce the harms associated with the use of drugs. A defining feature is their focus on the prevention of drug-related harm rather than the prevention of drug use per se. One widely-cited conception of harm reduction distinguishes harm at different levels - individual, community and societal - and of different types - health, social and economic (Newcombe 1992). These distinctions give a good indication of the breadth of focus and concern within harm reduction.

I have bolded a line that I think is critical, and I couldn't help but note that community and society were simply left out of their formal definitions. This is because if we are to accept that that individuals are shaped by their communities, and if we are to accept that societies emerge from the individuals and communities whom they comprise, then we would have to agree that reducing harm for the individual and community necessarily means reducing harm for society, and vice-versa. This would inevitably lead to the question of the societal-harms of criminalization and penalization.

If we are to examine society as a power-dominant structure which is comprised of various smaller structures or institutions (Education, Law, Medicine, etc.), themselves comprised of hierarchies of power-relations; we would clearly find in policies, textbooks, and diagnosis manuals an implicit, but very clear lack of acceptance of the drug-user’s validity as a human. This is demonstrated primarily through the criminalisation of the drug-user, and in some cases the medicalization thereof. As such, we are not surprised that drug-users are ostracized within their own communities, thus compromising their social-integration. The drug user, when not behind bars, is either a criminal or a sick person, or potentially either, or both. He is a mythological creature that exists on the periphery of human reality, occasionally appearing and disappearing, but never recognized as essentially-human. This, of course, is the conclusion derived through a systemic-analysis to arrive at the status-quo. There may be individuals and groups (such as BL and the HR-related ones discussed here) that have a more humane outlook on drug-users, but their opinions are, as it stands, heterodox with regards to the abovementioned reality-consensus implied by the dominant structure.

This systemic stigmatisation of the drug-user is every bit as, if not even MORE harmful, than the drug-use itself. It harms the community by alienating its youth, it harms society by allowing atrocities like the War on Drugs to gnaw on financial and social resources endlessly and legitimating the imprisonment of what could have been a productive members of society otherwise. Going back to Hunt’s paper, we find a very succinct survey of research examining the social and community harms of the penalization of drug-users (subsection 3.4, see link above).

Ignoring the social impacts of penalization makes life easy, but doesn’t change the fact that we’re lying to ourselves by ignoring the social aspect of HR. So long as the dominant structure ostracizes the drug-user, the pragmatic part of HR (it’s apparently-successful application), is at best incomplete. So long as the War on Drugs is alive and well, any successful application or HR is successful in spite, rather than because of the power-dominant structure. It would take a systemic paradigm shift, a “turn” in all institutional practises that exclude or otherwise subjugate the drug-user by denying her humanity, for HR to become an integral part of society, hence extending its scope to Social-HR.

And indeed, even with those who left out society from their formal definition, nevertheless implicitly but clearly express the fact that society is just as important as the individual when it comes to HR. Observe the subsections as you scroll down IHRA’s. And as for bodies like the CCSA, it is understandable that one seeking change within the bounds of the system would attempt to present their view as objective and free of ideology. But as such, they are in fact implicitly consenting to the same status-quo that has been shown to cause harm to individuals and communities that they are trying to help.

I do not purport to be neutral on the matter. I have strong biases shaped by my (limited) training in Social Theory, namely the neo-marxist point of view. That said, I also realize that the current reality only allows me to work within the bounds of the law. I think it is wrong not to take an opportunity to help others, even if you realize that said opportunity is nothing more than bone thrown to us by the master, and can be taken away any time at his whim.

(Thank you for reading!)
 
A very interesting read. My personal opinion on the legal/societal aspect is all recreational drugs should be regulated in similar manners to alcohol and tobacco. It would cut down on the organized crime and violence associated with the black market drug trade. It would keep non-violent drug users out prisons, where they may learn to become violent criminals. It would regulate the purity of the substances, reducing the possibility of overdose, etc.

I also think extensive, well-run, high quality addiction rehabilitation and harm reduction systems should be readily and affordably available to those wishing to manage an uncontrollable and/or harmful addictive disorder. These programs could even be funded by taxation of recreational substances.

I tend to feel harm reduction techniques are ways to keep people who are dangerously addicted alive until they reach a point where they want/can quit. I feel in my life a huge harm reduction aid was the ability to have weekly psycho-therapy sessions while I was still using. Most therapists require drug users be clean before starting therapy, however if one is using drugs to self-medicate mental disorders in the first place then it seems only logical that the mental disorders should at least began to be examined before the individual quits drugs. I know I'm going on a tangent here so I'm going to stop here and go more in depth on this subject in a blog of my own.

Again though, a very interesting read.
 
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