Decolonizing harm reduction

Abstract

In this essay, I show that notwithstanding the undeniable colonial origins of punitive drug policies around the world, such policies have figured in nationalist projects and populist platforms in various postcolonial states, and today they are viewed as local responses to the ‘drug problem.’ Instead, it is harm reduction and other efforts to reform drug policies that are seen as a colonial, or Western, imposition. I argue that to overcome such perceptions, there is a need to decolonize harm reduction alongside decolonizing drug policies. I conclude by offering recommendations toward this move, including involving Global South actors in leadership positions within the harm reduction movement, supporting pilot harm reduction programs in postcolonial states, and highlighting local scholarship.

Everywhere and for everyone: proportionate universalism as a framework for equitable access to community drug checking

“…This is of particular relevance when considering services within Indigenous communities, where there may be policies that prohibit substance use as participants noted. Given the complex historical relationships between criminalization, colonialism, and substance use perpetrated against Indigenous peoples and communities, engagement with Indigenous communities and elders is a critical first step in exploring whether such services are appropriate, and if so, how best to deliver them, while taking into account unmet need from people who identify as Indigenous [ 15 , 30 , 31 ].…”

From poppy to pill: A comprehensive strategy to combat illicit synthetic drug production in Southeast Asia

“…Greater regional synthetic narcotics production will likely increase regional use, addiction, crime, and overdose deaths (Brouwer et al, 2006). Southeast Asia generally lacks vital harm reduction services (Kimmons, 2013; Lasco, 2020), such as opioid agonist therapy (OAT), opioid overdose reversal antidotes, and needle exchange programmes, to shield against large‐scale public health crises.…”

“…When drug users in Southeast Asia are convicted of crimes or are awaiting trial, they are often confined in overcrowded prisons with substandard living conditions, where corruption and continued drug use are prevalent (Kamarulzaman & McBrayer, 2015; Lasco, 2020). This prison environment compounds the transmission of HIV, viral hepatitis and other blood‐borne illnesses and increases the probability of physical violence (Lasco, 2020).…”

“…Laos, with approximately 1,600 PWID, offers the fewest harm reduction measures in the region (Lasco, 2020).…”

“…Laos shuttered its last remaining needle and syringe programmes (NSPs) in 2017, instead opting for government-run 'rehabilitation' centres (Lasco, 2020). These rehabilitation centres have been accused of torture and unethical treatment.…”