More-than-harm reduction: Engaging with alternative ontologies of ‘movement’ in UK drug services

Abstract

Over the last ten years, UK drug policy has moved towards making abstinence-based recovery rather than harm reduction its primary focus. Drawing on ethnographic fieldwork involving participant observations and interviews at two London drug services, we explore how this shift towards recovery materialises through the practices of drug service delivery as an ‘evidence-making intervention’. We understand recovery's making in terms of ‘movement’. Where previous policies performed harm reduction through ‘getting people into treatment’ and ‘keeping them safe in treatment’, new policies were said to be about ‘moving people through treatment’. Approaching movement as a sociomaterial process, we observe how movement is enacted in both narrow ways, towards abstinence from drugs, and more open ways, in what we call ‘more-than-harm reduction’. We think of the latter as a speculative practice of doing or ‘tinkering with’ recovery to afford a care for clients not bound to abstinence-based outcomes. This is important given the limits associated with a recovery-orientated policy impetus. By engaging with these alternative ontologies of movement, we highlight an approach to intervening that both subverts and adheres to perceptions of recovery, embracing its movement, while remaining critical to its vision of abstinence.