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A plethora of harm reduction practices for addiction have been proven to be effective. Why have they not become more widespread? In this panel, we explore how in different contexts two ideologies of responsibility clash putting the responsible citizen against the responsibilized addict.
Harm reduction for addiction is generally understood to be enabling a more responsible treatment of the addicted body. Whether it is through the use of clean syringes and needles, ear acupuncture or (pharmaceutical) replacements of illegal substances, harm reduction practices are largely focused on producing a more 'responsible addict'. Such interventions acknowledge the individual's agency and responsibility in determining the terms of their recovery. Given the ongoing (neoliberal) climate of increasing responsibilization, one would assume that this set of practices would be widely adopted by public health systems and (Western) states. Yet, there are less than a hundred authorized safe consumption sites in Europe, and none in the United States. While methadone maintenance has been more widely embraced by physicians, resistance abounds. Papers in this panel dive into different geographical, regulatory and administrative contexts to tease out the fault line at the core of this paradox: on the one hand, society is increasingly obsessed with 'responsibilizing' its individual citizens. On the other hand, this seems to stop short when it comes to addiction and the addicted body. Who - e.g. homeless people versus financial professionals - is affected (and how) by these conflicting responsibilities? Concretely which kind of harm reduction practice is more easily adopted and why? What are the effects on different groups of people with addiction? Finally, we ask, responsibility for whom?