Slacker’s Syllabus: Harm Reduction

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Have you heard of “harm reduction”?

Most people have come across the term before, but not everybody knows how common it is — or what it looks like in practice.

In short, harm reduction is common sense. It’s measures you take to ensure people’s safety even if they’re doing something dangerous, like safety gear on a rollercoaster.

As a movement, though, harm reduction in the United States focuses on drug use and has very specific roots.

Let’s get into it.

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The National Harm Reduction Coalition defines it as a “set of practical strategies...aimed at reducing negative consequences associated with drug use.”

Harm reduction can also refer to broader movements around the rights of drug users.

Some advocates are moving away from using the term “harm reduction” in favor of “drug safety.”

But overall, both terms are about reframing narratives around and approaches to drug use.

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Harm reduction is based on the concept that people have autonomy and naturally engage in behaviors that can pose risk. ... Wearing a seat belt and using condoms are harm reduction strategies. However, when considering drug use, some deem addiction a moral failing of choice that merits penalty rather than assistance.

Why is harm reduction necessary?

Drugs have always been political.

Whether or not a drug is considered “bad” often doesn’t have much to do with its risks, but rather who it becomes associated with. Anti-drug policies date back to as early as the 1800s, with opium legislation aimed at stigmatizing Chinese immigrants.

But one particular anti-drug political effort had an especially a disastrous impact, most egregiously on Black Americans: The U.S. “war on drugs,” declared by former president Richard Nixon in 1971.

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Nixon’s administration increased federal funding for drug control agencies and treatment efforts; proposed stricter enforcement measures (like mandatory prison sentencing); and, in 1973, formed the Drug Enforcement Agency (DEA).

Things got worse when president Ronald Reagan took office in 1981 and expanded the war on drugs with a focus on criminalization.

While Nixon’s administration touted public safety, that was never really the point. As top Nixon aide John Ehrlichman later said, “Did we know we were lying about the drugs? Of course we did.”

“[Nixon] had two enemies: the antiwar left and black people. ... We knew we couldn’t make it illegal to be either against the war or black, but by getting the public to associate the hippies with marijuana and blacks with heroin, and then criminalizing both heavily, we could disrupt those communities.”

The war on drugs is far from over.

In some areas, officials are slowly moving way from criminalization and other sinister tactics.

But the war on drugs is still felt deeply today — especially in communities of color — and it’s literally costing all of us.

The federal government has spent trillions on enforcement since 1971, and they’re showing no signs of stopping. In March, the Biden administration requested a historical $42.5 billion for the National Drug Control Program agencies.

So, harm reduction may be needed now more than ever.

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1 in 5

the proportion of incarcerated people who are in jail for a drug offense

Prison Policy Initiative

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Ultimately, harm reduction is about reframing how drug use is approached.

It also places an importance on recognizing that some people are never going to stop using drugs — and that doesn’t mean they deserve to be abandoned and endlessly criminalized.

People don’t die because they use too much. They die because there is no one there to help them.

Harm reduction doesn’t look a one single way.

There’s no single blueprint for what harm reduction looks like in practice. Instead, it’s about upholding the rights of people who use drugs — and to work, it must respond to the needs of individuals and communities.

That said, some common examples include distributing opioid overdose reversal medicine naloxone, a.k.a. narcan, and offering supervised consumption sites.

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Safe consumption sites started in Europe in the 1980s. Now, there are about 120 sanctioned sites worldwide. But as American Medical Association (AMA) reported, the road to getting one in the United States has been long and difficult.

In 2020, Philadelphia came close, but judges ultimately ruled against it. Finally, in 2022, New York City launched the United States’s first official safe injection sites.

Sam Rivera, the executive director of OnPoint NYC, which runs the centers, told PBS:

“We’re showing up for people who too many people view as disposable.”