Short abstract:

There are multiple harm reductions, each with its own conception of ‘harm’. This paper elaborates the tension between these two, pushing STS scholars to think with harm reduction and drug users before translating concepts. I elaborate how we may hold the tensions of these harms together.

Long abstract:

‘Harm reduction’ is a word to describe the radical forms of care that sex workers and drug users have always done for each other (Hassan 2022). Simultaneously, harm reduction as a movement has always been, and/or facilitated, a reterritorialization of the work that drug users and sex workers do to keep each other safe by/with public health/medicine as a discipline. As Hassan (2022) and others have noted there is a distinction between the public health-ification of harm reduction (top-down) and sex worker and drug user-led liberatory harm reduction (bottom-up). In the former, the ‘harm’ in harm reduction serves a neoliberal logic, in the latter the ‘harm’ names the perpetual state violence manifested in interactions between state, user, seller and illicit drug economies. In unequal worlds, where drug users live with both epistemic and material injustice, those who practice the latter, must often appeal to the former. This paper examines this tension, emphasizing how STS scholars can take drug user liberatory projects as technoscientific possibilities enacted in uneven biopolitical topologies (Murphy 2012). I argue that STS should take drug users as actors capable of creating their own concepts. I then explore several areas of “undone” STS (Frickel et al. 2010) necessary to thinking the ‘harm’ in harm reduction and drug user liberation. By examining past technopolitical struggles by harm reductionists with contemporary events I aim to explore how we may hold together the tensions of ‘harm’ in harm reduction.