On drug policy, Canada shows where the West is heading. In 2018, it became the second country in the world to fully legalize cannabis, which is now sold via a state-run licensing system and stores. In recent months, the province of British Columbia was given special permission to decriminalize hard drugs under the rationale of “harm reduction,” a policy framework premised on the idea that a continuing level of drug use is inevitable. Around the same time, a member of the Canadian parliament proposed a bill to decriminalize drugs for personal use across the entire country. The bill was ultimately voted down, but future versions are expected to win more votes.
Up until about the 1970s, drug use in the West was approached through the frames of prohibition and temperance, which promoted abstinence from alcohol. While prohibition and temperance are commonly understood as having “failed,” the reality is that many now common-sense restrictions on alcohol, such as prohibitions on serving alcohol to minors and in hospitals, are as a result of these movements. Prohibition and temperance succeeded in dramatically transforming the social and legal framework around alcohol.
While harm reduction proponents love to claim that abstinence promotion doesn’t work, the truth is that millions did moderate or quit drinking as a result of the abstinence approach promoted by temperance and prohibition. This is not to say that American prohibition was without serious faults. But the claim that harm reduction is a better, more “humane” response to drug use than prohibition is not accurate.
The harm-reduction approach was institutionalized as a result of the AIDS crisis in the mid-1980s. Its basic premises are that we can never live in a drug-free society, abstinence is a not realistic goal for most people, and that drug use is amoral. A drug-free society is utopian nonsense; instead we should set out to mitigate ill-effects of drug use as best we can.
Harm reduction approaches vary but include shifting drug users’ habit towards another “less harmful” substance, providing safe-injection sites, or even a clean supply of drugs, as British Columbia has recently done by distributing fentanyl.
It is no coincidence that harm reduction spread in the wake of the defeat of the organized working class throughout the West. Whatever their faults, prohibition and temperance were broad-based social movements with an important working-class base. They drove an infusion of democratic will into state policy. Harm reduction, in contrast, presents itself as “scientific” and therefore above politics—a common disguise for undemocratic policies applied from the top down.
Harm reduction would not be possible without the medicalization of mental health and the creation of a disease called “drug addiction.” But drug use is always a choice. While it is true that the physiological effects of drug use can make ending drug use a difficult choice, it is a choice nonetheless. “Addicts” are told that they are victims of compulsions that overcome their will, and must submit themselves to “treatments” delivered by public health bureaucracies. These “addiction” treatments do not work, and at best shift the use towards a “less bad” drug. But that is a good enough result for harm reduction advocates: Less bad is now good.
“Restrictions on drugs and alcohol came about through popular pressure.”
If we instead acknowledge that drug use is a choice made by beings with rational capacity, we can recognize that people take drugs for reasons. They may be bad reasons, but they are reasons nonetheless. Indeed, the strongest correlate for ending drug “addiction” is the user having a job. The fall in political participation, religion, productive work, and family formation has meant that individuals have fewer and fewer reasons to choose not to take drugs. Instead of confronting the reasons people use drugs, state health bureaucracies promise to treat the so-called disease of addiction.
The disempowerment inherent in the notion of harm reduction mirrors that of the depletion in democratic participation across the West. The mass of people are no longer active participants in politics. Instead, they are objects to be managed via a class of technocrats who, through Science, know the objectively best approach for them.
Millions are funneled into bureaucratic bodies to enable drug habits through a clean supply, needles, safe-injection sites, and ineffective mental-health treatments of various kinds. All the while, drug use increases every year, with working-class neighborhoods and people suffering the brunt of drug normalization. The capitalist state was not, by default, overly concerned with illicit substance use. Restrictions on drugs and alcohol came about through popular pressure. Capitalists already had tools of coercion to moderate drug use within the places that they care about, that is in workplaces. Those that are not sober enough to work are simply fired. This is not a viable or easy option for those of us with friends, family, or neighbors whose drug use causes adverse social or individual effects. You cannot fire your child. And now that harm reduction is the dominant paradigm, we are robbed of the commonsense moral and political critique that once existed of drug use: that drug use is bad, restraint is good, and abstinence is a virtue.
As Marx said, “Men make their own history, but they do not make it just as they please; they do not make it under circumstances chosen by themselves.” Individuals use drugs because they find more meaning in doing so than abstaining or moderating. Harm reduction, amongst other policy tools, delivers an ideology that stems an individual’s will from freeing themselves of their servitude to the false god of “addiction.”