Hi again! While learning more about harm reduction, the drug supply, and drug policy, I have identified two key points that I would like to emphasize.
The first is that the drug supply is very complex and sensitive to change. The volume of a certain substance and its concentration can impact the trends in distribution and/or consumption. For example, while it might seem that a drastic increase in law enforcement should improve overdose trends, the opposite can occur. A situation in which law enforcement spikes can negatively impact these trends by halting the distribution of a certain substance, which can create an opening for another substance that the community – and its health professionals – may not be prepared for. Additionally, if the “original” substance that consumers were previously familiar with returns, but with a higher concentration, a consumer might purchase it at the same volume as before, which could prove fatal. Once again, this demonstrates how ineffective criminalizing drug usage is at preserving health.
The second point is that on a systemic level, socioeconomic status and racial identity are undeniably linked to how drug usage is perceived and how harm reduction might be considered. People who are unhoused are particularly susceptible to harsh consequences that can arise from drug usage, and this is only compounded by inaccessibility to essential healthcare. One striking example of this is the prolonged and unanticipated impact of using Xylazine, an adulterant that causes severe skin wounds. While developing such symptoms would be very unpleasant for anyone, those who are unhoused often face more profound challenges, such as having their wounds constantly exposed to the elements, and yet, due to severe economic strife, are unable to access any relief. Additionally, on the off chance that they gain access to healthcare, the added stigma of being unhoused often results in being disrespected and dismissed by professionals within the system.
With regards to racial identity, the way society continues to approach drugs is highly racialized, and such racialization informs the way any given drug is perceived at a systemic level. For example, cocaine, which was seen as less addictive than opioids, was used widely by white Americans but became racialized in the media after the substance made its way to Black communities. Regardless of how rare cocaine use was among Black Americans, the media was intentional about manufacturing a narrative that would paint Black people in the most violent, criminal way possible. Soon after, laws were passed to tax cocaine usage, and eventually, more laws were passed to completely criminalize nonmedical use of cocaine. This is just one example that demonstrates how systemic racialization leads to criminalization. Even now, the stigmatization of drug usage still undermines efforts to pass policies that promote accessible, inclusive, and evidence-based harm reduction practices. In addition to impeding progress on a policy level, society’s views on drug usage and the racist ‘War on Drugs’ demonize people who use drugs to such a degree that they can find themselves imprisoned, seriously ill, or dead for using a substance.
A future in which humane, evidence-based harm reduction practices, such as drug checking, become standard is a future that has dismantled the terrible remnants of the War on Drugs and centralizes care and justice in public health. We should all strive for this!
-Mabeki Mvuendy