Using Our Imagination in Harm Reduction

Source: Alex Andrews/Pexels (Stock Free)

This has been quite the month for drug policy. It started on election night with multiple wins for progressive drug policy across the country. Most notably, in Oregon voters approved a measure that would decriminalize possession of small amounts of drugs and of course, more marijuana ballot initiative passed in other states. A few weeks later, a settlementwould be reached in the lawsuit against pharmaceutical giant and manufacturer of Oxycontin – Purdue Pharma. The company agreed a $8.3 billion dollar settlement between them and the Department of Justice; and would be reorganized to become a public benefit corporation, with future profits potentially going towards programs to address addiction.

Last year, I wrote in the Washington Post with Professor Brandon DL Marshall of Brown University that we should be using this money from the opioid lawsuits towards harm reduction programs as opposed to going to fund and reimburse government budgets. This happened with the tobacco settlements of the late 90s, very little funding ended up going towards programs to help people quit smoking. With state governments looking to cut programs in the aftermath of the pandemic – the redirection of these funds has only become a bigger concern.

News just also broke in the last few days about the role played by the global consulting giant, McKinsey and Company. The New York Times reported that the in 2017 the company advised Purdue to consider offering rebates to distributors for every overdose that was attributable to an opioid sold. These presentations even included projections of how many overdoses would occur per client and how much Purdue would end up paying to them in rebates. All of this, to boost sales of the product. So often it seems, those who seek to boost their profits use the most imaginative ways possible – as harmful and atrocious as these ideas are.

Using the word imaginative in that context seems wrong to me. It feels odd to type; but I use that word specifically to ask; if they can be bold with their ideas to harm, why can’t we bold with our ideas to heal? While voters in this country have signaled their intention to move beyond the regressive drug policies of the past, politicians are far less enthusiastic. Most jurisdictions across the country have only considered drug policy to consist of drug courts, expanded naloxone access and expanded access to treatment. With the exception of drug courts (which I have covered here), these things are good – but they are not sufficient. Overdoses are skyrocketing during the pandemic and we still have not moved to expand our range of solutions. Safe consumption sites, where people can use drugs safely, have been caught up in a myriad of court disputes and the idea of providing a safe supply of drugs - so people don’t use adulterated unsafe drugs from the street - is still considered by some in the United States to be wishful thinking.

My comment to those in harm reduction spaces across the country is this; be bold and imaginative with your ideas. Keeping talking about what a world that treats people who use drugs with dignity and respect looks like; propose imaginative ideas that are necessary to meet the moment we are in, not the ideas you think politicians will go for. Part of changing the landscape to make things politically feasible involves talking about our ideas; our job is to change the landscape, not to change our solutions to make them politically tenable. A few years ago, a decriminalization initiative passing on the ballot may have been unthinkable and yet, just a few weeks ago; it was done. This doesn’t mean we oppose meaningful reforms that reduce harm; it just means that we do not abandon our vision and goals for the sake of getting those reforms. We can do both.

I’ll leave you all with a quote from the poet Adrienne Rich:

“But nothing less than the most radical imagination will carry us beyond this place, beyond the mere struggle for survival, to that lucid recognition of our possibilities which will keep us impatient, and unresigned to mere survival.”