A Typology of Harm Reduction Critics
Guy in suit. Recovery Advocate. You know them when you see them. This is a detailed classification of the types who argue against harm reduction.
It’s common these days to hear that there is a “backlash” brewing against harm reduction. From big cities to small towns, there’s a vocal contingent adamantly opposed to harm reduction interventions. Syringe programs to housing first to overdose prevention centers—you name it, they loudly despise it.
Their arguments are all over the place but the essential point is that harm reduction actually generates harm. Programs and tools designed to mitigate the acute risks of substance use actually enhance risk and hurt people. Harm reduction, in their eyes, also stymies and stifles the possibility of “recovery.” Recovery being narrowly defined as abstinence from all substances (though not nicotine or caffiene). People can’t or won’t recover, they claim, so long as they’re being offered syringes, naloxone, and other utensils.
I think calling this a “backlash” isn’t quite right. At least, not in a temporal sense. It’s not as though Americans collectively embraced harm reduction and then suddenly thought better of it. America still spends five times as much on locking up people with substance use disorders than it does on actually treating them. This is not a country that has embraced harm reduction. People who work in public health, in medicine, and harm reduction know all this very well. A formidable number of Americans are always already opposed to harm reduction. Each tiny step away from a draconian and punitive drug policy approach is met with vigorous opposition. At every step is a certain type of critic ready to yell, “NO!”
That’s not a backlash. That’s just, well, America. Where in many states, syringe programs are still completely illegal. The federal government only last year for the first time ever set aside a measly $30 million for harm reduction programs. That small pittance of funding triggered a complete meltdown over sterile smoking devices (re: the crack pipe panic). Meanwhile, billions upon billions of dollars are still spent on federal, state, and local drug enforcement, interdiction, and incarceration.
Harm reduction’s loudest critics pull off a sleight of hand. They frame harm reduction as America’s dominant approach to dealing with drugs. They claim it’s the ideology of harm reduction that has completely taken over drug policy and treatment. Harm reduction’s critics cast themselves as David fighting Golliath. What they’ve done is create an upside down world. A country that arrests more than 1.6 million people per year for drugs and funds the Drug Enforcement Adminstration to the tune of $3 billion per year has objectively not embraced harm reduction as a project. The birthplace of the Temperance Movements, Alcohoilcs Anonymous, and Tough Love—all rooted in ideals of abstinence and personal responsibility, has not embraced harm reduction.
What the critics do is conflate cause and effect, and confuse symptoms with disease.
Normally, I would now cite a bunch studies and research and figures showing that drug enforcement and abstinence-based programs are by far the most dominant paradigms in America: How overdose is the leading cause of death among people exiting incarceration; how lopsided funding for enforcement over health remains to be. But that stuff does not persuade these critics. It’s fruitless to point stuff like that out to them. Beacuse, well, their personality, temperment, emotions, and experience all lead them to despise harm reduction.
So I thought I’d do something a little different here. I’m going to offer up a typology of The Harm Reduction Critic, a kind of classification system of the various types and their styles. What makes them tick? In this post, I’m going to zoom in on just two types in the Anti-Harm Reduction Cinematic Universe:
“Guy in Suit Hates Harm Reduction” and “The Recovery Advocate.”
Here it goes. I hope you like it.
Guy in Suit Hates Harm Reduction
He wears a suit and tie. His hair is slicked back. He’s articulate. This is a specific type. He’s credentialed. Funded. Organized. And like a hampster on a wheel, the (usually white) guy in a suit opposes reform and harm reduction literally for a living. He gets paid for this.
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