Paper short abstract:

Harm Reduction approaches are situated between two poles: biopolitical and humanitarian. The former transforms people who use drugs into responsible risk-averse citizens; the latter reconceptualizes them from criminals to suffering beings who achieve legitimization due to their biologic condition.

Paper long abstract:

Historically, policy surrounding illicit substance use focused heavily on criminalization, an approach which has been under scrutiny since the 1980s with the advent of the Harm Reduction (HR) movement as part of Thatcher’s New Public Health in GB. Traditionally seen as criminals, the HR movement construed PWUD as individuals engaging in risky health behaviour who can make the responsible choice to live “healthier” lives without abstinence. Meanwhile, HR has become an important approach for governing at risk populations by targeting the mortality and morbidity of these populations, which foregrounds the physical and biological existence of PWUD and precludes questioning the underlying causes of increased substance use in our societies. Simultaneously, HR promotes a human rights platform thereby conceptualizing life as a supreme good that justifies every action undertaken in its name. With Fassin’s (2019) concept of biolegitimacy we will demonstrate that HR perpetuates a hierarchy of lives as the COVID-19 pandemic makes explicit. Despite living in biopolitical societies, the pandemic systematically worsened the exaggerated vulnerability and precarity of expendable groups such as PWUD. What is most striking about HR is that PWUD are only intelligible as suffering beings in need of help to physically survive. Paradoxically, it is the use of drugs itself, and therefore the increased risk of death from overdose or infection from unhygienic consumption practices that becomes the only venue for PWUD to achieve limited forms of visibility and to make claims in the name of the sacredness of life.