scholarly journals Willful ignorance as resistance, harm reduction workers and ruling relations

2021 ◽  
Author(s):  
Christopher Maxim Piercey Dalton
Keyword(s):  
Harm Reduction ◽  
People Who Use Drugs ◽  
Front Line ◽  
Willful Ignorance ◽  
Organizational Policies ◽  
Staff Members ◽  
Neoliberal Governance ◽  
Policies And Procedures ◽  
Study Results ◽  
A Site

This paper will explore how front-line harm reduction workers govern the space of agency services. In order to study how this is done this writer completed an institutional ethnography to illuminate how power operates in the day-to-day practice of a harm reduction agency. Harm reduction services have been criticized as a site of neoliberal governance through risk-management. This study aims to explore how harm reduction workers perform and understand their role within their agency. This writer interviewed front-line staff members that distribute harm reduction material, asking them about their adherence to their organizational policies and procedures. The policies represented by the text of the signage within agencies was also analyzed. Study results showed that staff members used wilful ignorance to allow people to use drugs on agency premises, provided they did so in a discreet manner. Harm reduction workers also tried to reduce the suffering, and promote the larger political goals of harm reduction, to help people who use drugs.

scholarly journals Willful ignorance as resistance, harm reduction workers and ruling relations

2021 ◽  
Author(s):  
Christopher Maxim Piercey Dalton
Keyword(s):  
Harm Reduction ◽  
People Who Use Drugs ◽  
Front Line ◽  
Willful Ignorance ◽  
Organizational Policies ◽  
Staff Members ◽  
Neoliberal Governance ◽  
Policies And Procedures ◽  
Study Results ◽  
A Site

This paper will explore how front-line harm reduction workers govern the space of agency services. In order to study how this is done this writer completed an institutional ethnography to illuminate how power operates in the day-to-day practice of a harm reduction agency. Harm reduction services have been criticized as a site of neoliberal governance through risk-management. This study aims to explore how harm reduction workers perform and understand their role within their agency. This writer interviewed front-line staff members that distribute harm reduction material, asking them about their adherence to their organizational policies and procedures. The policies represented by the text of the signage within agencies was also analyzed. Study results showed that staff members used wilful ignorance to allow people to use drugs on agency premises, provided they did so in a discreet manner. Harm reduction workers also tried to reduce the suffering, and promote the larger political goals of harm reduction, to help people who use drugs.

scholarly journals Harm Reduction for Adolescents and Young Adults During the COVID-19 Pandemic: A Case Study of Community Care in Reach

2021 ◽  
pp. 003335492199939
Author(s):  
Elizabeth Noyes ◽  
Ellis Yeo ◽  
Megan Yerton ◽  
Isabel Plakas ◽  
Susan Keyes ◽  
...  
Keyword(s):  
Young Adults ◽  
Harm Reduction ◽  
Community Care ◽  
Control Measures ◽  
Adolescents And Young Adults ◽  
People Who Use Drugs ◽  
Staff Members ◽  
Infection Control Measures ◽  
Semistructured Interviews ◽  
High Level

The coronavirus disease 2019 (COVID-19) pandemic has challenged the ability of harm reduction programs to provide vital services to adolescents, young adults, and people who use drugs, thereby increasing the risk of overdose, infection, withdrawal, and other complications of drug use. To evaluate the effect of the COVID-19 pandemic on harm reduction services for adolescents and young adults in Boston, we conducted a quantitative assessment of the Community Care in Reach (CCIR) youth pilot program to determine gaps in services created by its closure during the peak of the pandemic (March 19–June 21, 2020). We also conducted semistructured interviews with staff members at 6 harm reduction programs in Boston from April 27 through May 4, 2020, to identify gaps in harm reduction services, changes in substance use practices and patterns of engagement with people who use drugs, and how harm reduction programs adapted to pandemic conditions. During the pandemic, harm reduction programs struggled to maintain staffing, supplies, infection control measures, and regular connection with their participants. During the 3-month suspension of CCIR mobile van services, CCIR missed an estimated 363 contacts, 169 units of naloxone distributed, and 402 syringes distributed. Based on our findings, we propose the following recommendations for sustaining harm reduction services during times of crisis: pursuing high-level policy changes to eliminate political barriers to care and fund harm reduction efforts; enabling and empowering harm reduction programs to innovatively and safely distribute vital resources and build community during a crisis; and providing comprehensive support to people to minimize drug-related harms.

Narrative Politics in Policy Discourse: The Debate Over Safe Injection Sites in Philadelphia, Pennsylvania

2021 ◽  
pp. 009145092199382
Author(s):  
Ryan J. Lofaro ◽  
Hugh T. Miller
Keyword(s):  
Harm Reduction ◽  
Public Discourse ◽  
People Who Use Drugs ◽  
Opioid Overdose ◽  
Policy Proposal ◽  
The Social ◽  
Narrative Politics ◽  
The Face ◽  
Safe Injection ◽  
A Site

Safe injection sites are spaces where people who inject drugs can do so under the supervision of staff at the sites who attempt to revive them if they overdose. Public officials in Philadelphia, Pennsylvania, have proposed the sites as a means to reduce opioid overdose deaths in the city, a policy proposal that has been politically and legally contested. This article uses the Narrative Politics model to elucidate the concerns, values, and aspirations of the competing narratives in the public discourse over safe injection sites in Philadelphia. Despite the aspirations expressed within the Harm Reduction narrative to open such a site, opposition from the Nimby (not in my backyard) narrative has, at the time of this research, successfully precluded such a step. Other narratives in the discourse include the Abstinence narrative opposing safe injection sites and the Social Justice narrative opposed to incarceration but also hesitant to wholeheartedly endorse the Harm Reduction narrative for its delayed advocacy of compassionate treatment of people who use drugs now that the face of the person who uses opioids is a white one. In addition to juxtaposing competing narratives against one another and considering their alignments, disagreements, and interactions, the authors consider absences and shared presuppositions. The social construction of the purported drug addict varies in some ways between and among the prevailing narratives; in other ways, all the narratives problematize “addiction” as an affliction that justifies techniques of discipline aimed at caring for and controlling the population.

scholarly journals Harm reduction must be recognised an essential public health intervention during crises

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Robert Csák ◽  
Sam Shirley-Beavan ◽  
Arielle Edelman McHenry ◽  
Colleen Daniels ◽  
Naomi Burke-Shyne
Keyword(s):  
Public Health ◽  
Harm Reduction ◽  
Social Services ◽  
Public Health Intervention ◽  
Health Interventions ◽  
People Who Use Drugs ◽  
Front Line ◽  
Public Health Interventions ◽  
Substantial Impact ◽  
Health And Social Services

AbstractThe COVID-19 had a substantial impact on the provision of harm reduction services for people who use drugs globally. These front-line public health interventions serve a population that due to stigma, discrimination and criminalisation, faces barriers to accessing health and social services and are particularly vulnerable to public health crises. Despite this, the pandemic has seen many harm reduction services close, reduce operations or have their funding reduced. Simultaneously, around the world, harm reduction services have been forced to adapt, and in doing so have demonstrated resilience, flexibility and innovation. Governments must recognise the unique abilities of harm reduction services, particularly those led by the community, and identify them as essential health services that must be protected and strengthened in times of crisis.

scholarly journals Space, place, and perceived illegality: the unsanctioned Parkdale Overdose Prevention Site

2021 ◽  
Author(s):  
Erika Dupuis
Keyword(s):  
Harm Reduction ◽  
Service Provision ◽  
Community Mobilization ◽  
Provincial Government ◽  
Community Activism ◽  
People Who Use Drugs ◽  
Front Line ◽  
Overdose Prevention

In August 2018 the Ontario provincial government ordered the halt of several overdose prevention sites across the province. This paper will focus on an unsanctioned site that opened out of response to resist said closures. This study aims to explore how front-line volunteers navigated opening, maintaining, and closing an unsanctioned overdose prevention site amidst a neoliberal government, and whether it had any impact on service provision. The writer interviewed volunteers who frequently worked at the unsanctioned site, discussing their community, activism, and the ongoing efforts to support people who use drugs. The findings of this research suggest that the perception of illegality had impacts on funding, burnout, and community mobilization. Keywords: governmentality, harm reduction, people who use drugs, unsanctioned overdose prevention sites

scholarly journals Space, place, and perceived illegality: the unsanctioned Parkdale Overdose Prevention Site

2021 ◽  
Author(s):  
Erika Dupuis
Keyword(s):  
Harm Reduction ◽  
Service Provision ◽  
Community Mobilization ◽  
Provincial Government ◽  
Community Activism ◽  
People Who Use Drugs ◽  
Front Line ◽  
Overdose Prevention

In August 2018 the Ontario provincial government ordered the halt of several overdose prevention sites across the province. This paper will focus on an unsanctioned site that opened out of response to resist said closures. This study aims to explore how front-line volunteers navigated opening, maintaining, and closing an unsanctioned overdose prevention site amidst a neoliberal government, and whether it had any impact on service provision. The writer interviewed volunteers who frequently worked at the unsanctioned site, discussing their community, activism, and the ongoing efforts to support people who use drugs. The findings of this research suggest that the perception of illegality had impacts on funding, burnout, and community mobilization. Keywords: governmentality, harm reduction, people who use drugs, unsanctioned overdose prevention sites

The neoliberal governance of heroin and opioid users in Philadelphia city

2021 ◽  
pp. 174165902199119
Author(s):  
Philip R Kavanaugh ◽  
Jennifer L Schally
Keyword(s):  
Public Health ◽  
Harm Reduction ◽  
Drug Users ◽  
Policy Documents ◽  
Media Portrayals ◽  
Neoliberal Governance ◽  
Public Nuisance ◽  
Fiscal Austerity ◽  
Opioid Users ◽  
Governmental Response

Drawing on 147 news accounts and five policy documents on the heroin and opioid crisis in Philadelphia, Pennsylvania published between 2016 and 2018, our analysis highlights how media portrayals of opioid users as both tragic victims and public nuisance prompted a schizoid governmental response that draws on rhetorics of treatment and harm reduction to legitimate more punitive interventions. By describing how the state’s quasi-medical responsibilization strategy devolved to fold criminalization into its broader response, we argue the effort to wage a kinder/gentler war on overdose invests in familiar tropes of a recalcitrant drug user class that is a threat to public health. In doing so we provide a basis to critique how drug users are governed in this time of fiscal austerity, resource hoarding, and perpetual, continually evolving drug crises.

scholarly journals Civil society involvement in harm reduction drug policy: reflections on the past, expectations for the future

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Aileen O’Gorman ◽  
Eberhard Schatz
Keyword(s):  
Civil Society ◽  
Harm Reduction ◽  
Lived Experience ◽  
Political Institutions ◽  
Drug Policy ◽  
Policy Development ◽  
Policy Decision ◽  
People Who Use Drugs ◽  
Annual Conference ◽  
Health Crisis

Abstract Background A range of civil society organisations (CSOs) such as drug user groups, non-governmental/third sector organisations and networks of existing organisations, seek to shape the development of drugs policy at national and international levels. However, their capacity to do so is shaped by the contexts in which they operate nationally and internationally. The aim of this paper is to explore the lived experience of civil society participation in these contexts, both from the perspective of CSOs engaged in harm reduction advocacy, and the institutions they engage with, in order to inform future policy development. Methods This paper is based on the presentations and discussions from a workshop on ‘Civil Society Involvement in Drug Policy hosted by the Correlation - European Harm Reduction Network at the International Society for the Study of Drugs Policy (ISSDP) annual conference in Paris, 2019. In the aftermath of the workshop, the authors analysed the papers and discussions and identified the key themes arising to inform CSI in developing future harm reduction policy and practice. Results Civil society involvement (CSI) in policy decision-making and implementation is acknowledged as an important benefit to representative democracy. Yet, the accounts of CSOs demonstrate the challenges they experience in seeking to shape the contested field of drug policy. Negotiating the complex workings of political institutions, often in adversarial and heavily bureaucratic environments, proved difficult. Nonetheless, an increase in structures which formalised and resourced CSI enabled more meaningful participation at different levels and at different stages of policy making. Conclusions Civil society spaces are colonised by a broad range of civil society actors lobbying from different ideological standpoints including those advocating for a ‘drug free world’ and those advocating for harm reduction. In these competitive arena, it may be difficult for harm reduction orientated CSOs to influence the policy process. However, the current COVID-19 public health crisis clearly demonstrates the benefits of partnership between CSOs and political institutions to address the harm reduction needs of people who use drugs. The lessons drawn from our workshop serve to inform all partners on this pathway.

scholarly journals From #MeToo to #TimesUp: Identifying Next Steps in Sexual Harassment Research in the Organizational Sciences

2020 ◽  
pp. 014920632098051
Author(s):  
Nitya Chawla ◽  
Allison S. Gabriel ◽  
Anne O’Leary Kelly ◽  
Christopher C. Rosen
Keyword(s):  
Sexual Harassment ◽  
Organizational Policies ◽  
Policies And Procedures ◽  
Organizational Scholarship ◽  
Scholarly Attention ◽  
Organizational Sciences

Organizational scholarship on workplace sexual harassment has been dormant in recent decades. Yet, the #MeToo and #TimesUp movements—which have shed critical light on experiences of sexual harassment in organizations—suggests that renewed scholarly attention on this topic is both crucial and warranted. In the current commentary, we provide recommendations for ways that scholars can revitalize attention to this topic, extending both scholarly and practitioner understanding of this phenomenon. In addition, we encourage scholars to begin expanding the conceptualization of sexual harassment to also encompass more subtle forms of harassment. Critically, broadening our scholarly knowledge of workplace sexual harassment can inform organizational policies and procedures aimed toward reducing its prevalence and impact.

scholarly journals Peer driven or driven peers? A rapid review of peer involvement of people who use drugs in HIV and harm reduction services in low- and middle-income countries

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Judy Chang ◽  
Shaun Shelly ◽  
Machteld Busz ◽  
Claudia Stoicescu ◽  
Arif Rachman Iryawan ◽  
...  
Keyword(s):  
Harm Reduction ◽  
Resource Scarcity ◽  
Rapid Review ◽  
People Who Use Drugs ◽  
Financial Barriers ◽  
Community Knowledge ◽  
Middle Income ◽  
Peer Involvement ◽  
Stigma And Discrimination ◽  
Low And Middle Income

Abstract Introduction Peer involvement of people who use drugs within HIV and harm reduction services is widely promoted yet under-utilised. Alongside political and financial barriers is a limited understanding of the roles, impacts, contexts and mechanisms for peer involvement, particularly in low- and middle-income settings. We conducted a rapid review of available literature on this topic. Methods Within a community-academic partnership, we used a rapid review approach, framed by realist theory. We used a network search strategy, focused on core journals and reference lists of related reviews. Twenty-nine studies were included. We developed thematic summaries framed by a realist approach of exploring interventions, their mechanisms, outcomes and how they are shaped by contexts. Results Reported outcomes of peer involvement included reduced HIV incidence and prevalence; increased service access, acceptability and quality; changed risk behaviours; and reduced stigma and discrimination. Mechanisms via which these roles work were trust, personal commitment and empathy, using community knowledge and experience, as well as ‘bridge’ and ‘role model’ processes. Contexts of criminalisation, under-resourced health systems, and stigma and discrimination were found to shape these roles, their mechanisms and outcomes. Though contexts and mechanisms are little explored within the literature, we identified a common theme across contexts, mechanisms and outcomes. Peer outreach interventions work through trust, community knowledge and expertise, and ‘bridge’ mechanisms (M) to counter criminalisation and constraining clinic and service delivery environments (C), contributing towards changed drug-using behaviours, increased access, acceptability and quality of harm reduction services and decreased stigma and discrimination (O). Conclusion Peer involvement in HIV and harm reduction services in low- and middle-income settings is linked to positive health outcomes, shaped by contexts of criminalisation, stigma, and resource scarcity. However, peer involvement is under-theorised, particularly on how contexts shape mechanisms and ultimately outcomes. Efforts to study peer involvement need to develop theory and methods to evaluate the complex mechanisms and contexts that have influence. Finally, there is a need to expand the range of peer roles, to embrace the capacities and expertise of people who use drugs.

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