Harm reduction is explored, historically, in terms of ideologies, concepts, processes, types, stakeholders, legal, policy, service delivery, and ethical considerations and their micro and macro consequences. Necessary critical conditions underpinning ideologies and programs throughout their life cycle are examined, as are selected unresolved issues and paradoxes. Importantly, harm reduction can inadvertently result in distancing drug users (DUs) from mainstream ("normed") care by institutionalizing specialized care for DUs who remain "marginalized" from the community at large. Also, harm reduction can become harm production when program staff, who should be foster autonomy and self-care in partnership with DUs, are co-opted into becoming social control agents acting on compliant, passive, pathologized, and dehumanized stereotypes - Them.
A ministudy was carried out with 50 male and female adults who are "regular" cigarette smokers to investigate the potential role(s) which contagion plays in smoking. Notwithstanding their reports that they were introduced to smoking by others 40% of the time, only 12% reported-remembered initiating someone else to smoking. The report of self-activated cigarette use is congruent with with most views about smoking, but not regarding drug use. As long as drug use intervention utilizes contagion as a concept, deviance as a classification and varieties of isolation as control techniques will be associated with drugs, users, and drug use. By definition, social substances have no source of contagion by others. The decision to use or abstain is viewed as being personal notwithstanding the reality that is related among other factors to a variety of market economies.
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