Harm reduction — a historical view from the trenches

Abstract

Friedman et al., (2001) provide us with an overview of harm reduction from a left wing political perspective. While their paper will likely be of considerable interest to those of similar political persuasion, I was struck by the fact that it did not ring a very deep or resonant cord in relation to my own experience or way of looking at the field. This despite the fact that harm reduction has been a central theme in much of my thirtyodd year career immersed in drug use scenes and in researching drug use and abuse. The authors’ depiction of harm reduction as a vehicle to ‘‘promulgate policies’’ rather than primarily as a way to save lives or at least to improve the health of those receiving intervention services seems to me a misplaced emphasis on means rather than ends. Further, though they acknowledge that ‘‘working with workers and other ‘forces of general social unrest’ still are marginal within the harm reduction movement,’’ they go on to encourage this but fail to persuade me that this is a particularly important or desirable direction to move. The extent to which this will be the case for other readers is, of course, unknown. But, the fact that there are divergent opinions and ideologies in the field may be indicative of its growth and maturation over the years. Independent roots do converge to nourish the same tree. In this spirit, I will explore below an alternative frame of reference derivative of my own experience in the hope that it encourages others to do the same and that, in so doing, enrich the field as a whole. My personal introduction into the world of drugs coincided with the onset of the youth counter-cultural rebellion in the 1960s. This era had its own, drug-influenced, origins in the literature of Jack Kerouac, Allan Ginsberg and William S. Burrows; the stinging comedy of Lenny Bruce, and the often-dissonant notes of improvisational jazz music. Yet these merely set the stage for what was to be a mass social movement with profound implications for the future. In rejecting much of the status quo and embracing the use of illicit intoxicants to achieve altered states of consciousness, a subset of 1960s youth drove a wedge between themselves and older generations which rapidly spread throughout much of the western world. E-mail address: drugs@uic.edu (W. Wiebel).