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The rise of harm reduction in the war on drugs

1 7 19

The war on drugs may profess to be waged against narcotics, but it overwhelmingly targets people — a view increasingly shared by experts on drug use. Nora Volkow, director of the National Institute on Drug Abuse, touched on this recently when she wrote about addiction stigma in STAT, noting that "societal norms surrounding drug use and addiction continue to be informed by myths and misconceptions."

Starting in the 1980s, a rowdy group of individuals began advocating for a different approach to drug policy called harm reduction. These activists, researchers, social workers, attorneys, and others, from a myriad of different backgrounds, have focused on the harms of drug use — not the drugs alone.

Maia Szalavitz's new book "Undoing Drugs: The Untold Story of Harm Reduction and the Future of Addiction" is an in-depth history of a powerful idea, exploring many angles of drug policy, including prescription drug use, supervised consumption, and legalizing cannabis. Throughout, she also details the racial inequities and social justice tensions that have defined the drug war.

Szalavitz, a science journalist, unwraps the many layers of harm reduction, a philosophy that has also been adopted in approaching sex work, restorative justice, Covid-19, and other areas. When it comes to illicit substances, harm reduction runs the gamut from sterile syringe access programs to supervised drug injection rooms to distributing the opioid-overdose antidote naloxone.

Depending on who you ask, harm reduction has many different definitions, including "radical empathy" which requires "meeting people where they're at." Szalavitz offers multiple interpretations, but writes that, simply: "Harm reduction applies the core of the Hippocratic oath — first, do no harm — to addiction treatment and drug policy. This takes the focus off of psychoactive drug use itself."

Tracing the roots of the movement, Szalavitz introduces us to characters like the "Goddess of Harm Reduction" and the "Johnny Appleseed of Needles," whose lives are dedicated to spreading evidence-based practices of harm reduction. Some advocates were arrested, ostracized by friends and family, or lost their lives to overdose.

For years, the U.S. government rejected harm reduction services, even going so far as to ban federal funding for needle exchange programs. But now there are jobs, conferences, and nonprofit organizations committed to harm reduction. And in President Joe Biden's budget for the 2022 fiscal year, $30 million has been earmarked for services like syringe access, the first time Congress has........

© Salon

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