I don't deny that there are some forms of harm reduction which are proven to be effective. But I also think it's a vague weasel word for just give them drugs or just make it all legal. Which is not a good policy as we have seen here.
Ironically just using vague terms like harm reduction without putting forward a specific strategy is a sort of moralizing of its own
Every time I hear a politician talking about safe supply, they say it's not a silver bullet. Which is weird because nobody claims it's a silver bullet. Know what else isn't a silver bullet? Criminalization. Or, everything else that's ever been tried. It's a hard problem, there isn't a silver bullet solution, get over it.
What's harm reduction good for? Reducing harm. It isn't harm prevention, it isn't free housing, it isn't free addiction counseling, it doesn't fart roses.
Safe injection sites keep users close to medical professionals so we can keep people from dying alone. Safe supply would ensure that users aren't going to accidentally OD on kerfentanyl thinking it's ordinary fentanyl. Needle exchanges keep users supplied with sterile equipment to reduce risk of injections such as HIV and hepatitis C. Each policy is an example of harm reduction. The general philosophy is to not let perfect be the enemy of good.
https://www.google.com/amp/s/www.cbc.ca/amp/1.7071004
And this is a part of my problem with all this. I live in Toronto's downtown core and the explosion in drug issues since these policies came into effect is something I see and live with. And it's the same in our other major cities.
And too often the response from the proponents of these policies is outright misinformation, accusations of moralism. As someone living in an area where I am watching a drug problem spiral out of control, this is frankly infuriating.
This is my city and I see these people with addiction as neighbors I want to help. But these policies don't appear to be helping them. It looks to me like it's making things worse
If it's so good, if it's so helpful, why are there tent encampments full of people with drug issues popping up. We have shelters so it's not an issue of lack of shelters. Why are there so many more people high or doing drugs on our streets, why are overdose deaths the same or higher
This was done because Portugal did it and people in places like hacker news started pushing it as evidence based because of self proclaimed success in Portugal. Well overdose and drug use is up in Portugal, it's up in Portland and it's up here. How long are proponents going to suggest other factors - this safe supply idea is starting to look less evidence based and more like a religious belief.
We certainly shouldn't shame people suffering from addiction. No one would choose that life if they knew what was coming or if they had sufficient control at any given moment. We also shouldn't pretend it isn't normal, because addiction is extremely common.
Yet it's ironically unkind to encourage someone, in any shape or form, to consider their addiction acceptable on any level. It's purely only welcoming death into life and burdening the world around you. It's a net loss and nothing more. To accept anything about it is absurd. Yes, accept the person and their shortcomings, but don't pretend the state of their life, especially contrasted with their potential, is anything like acceptable.
The hard thing here is that this kind of engagement and narrative arguably demands a lot more support than we're willing to give people. Telling them it's okay and giving them safe sites and supplies is a lot easier if it's financially viable. This sort of calculus, in my opinion, is a major cause of the tear in the social fabric which has lead to such widespread suffering in an unprecedentedly rich society where you might otherwise intuitively expect addiction to be eradicated. We're eager to invest financially before we do so emotionally or spiritually.
Drug policy in North America seems to be ideologically fixated both on addiction as a singular problem, and on singular solutions to that problem. Addiction is an important and very hazardous part of someone's life, but it's only one part. Lots of people who live in tents or behave erratically in public aren't addicted to drugs; lots of people who are addicted to drugs don't live in tents or behave erratically in public.
Giving someone an adequate and reliable supply of pharmaceutical opioids is quite likely to reduce their risk of overdose if it gets them away from a highly variable supply of very potent synthetic opioids, but thinking that it'll solve all of their problems is pure fantasy. Keeping people alive is a prerequisite to fixing the rest of their life, but nothing more than that.
To many ignorant people have an opinion on this though, as you can see in some of these comments. If you never used drugs, don't know people that died needlessly, you don't get to have an opinion.
Only if it's part of an evidence-based and empirically validated strategy. We know that safe access to drugs can work as part of a harm reduction strategy, but there's also good reason to believe that thoughtless moves towards decriminalisation or legalisation can exacerbate harms. The Swiss model has worked incredibly well after a lot of difficult trial-and-error, but the Portuguese model is increasingly looking like a mistake. Even with the relatively lower-risk example of cannabis legalisation, we're seeing a very mixed picture in terms of outcomes. The devil is in the details.
Source: https://www.washingtonpost.com/world/2023/07/07/portugal-dru...
The Issue, imo, is when death is not a certainty, but a surprise consequence (or sudden) due to bad or inconsistent supply, etc.
I recently met someone who it took 6 NARCAN to revive last time he overdid it. Frankly, I’m surprised his body was able to handle it - apparently it was an extremely unpleasant experience.
And, frankly, he might not come back next time.
He seemed to take it seriously. We’ll see.
Not letting your kid touch the hot stove at all is as bad as letting them pull a pot of boiling water down on their head.
This is not true at all for some significant part of this demographic.
And I feel compelled to mention that I am well-aware that this is totally counter-intuitive.
So it's great that we can provide people 6 doses of narcan and act like they're big strong adults who are down on their luck, but it's incredibly harmful to pretend that this is the only possible solution to motivating behavior.
While kids are over-protected these days, I strongly disagree with this.
Over protective is the definition of ‘they never get a chance to get a non-serious burn’ isn’t it?