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Crime, technology and society by Angus Bancroft
 
Harm reduction is not the point, what is useful is what happens around it

Harm reduction is not the point, what is useful is what happens around it

Nothing is a silver bullet. Except when it is.

I was reminded reading Nicholls et al (2022) report on drug consumption rooms of the critique of them as ‘not a silver bullet’. This term means a dependable solution to a otherwise tricky problem . It put me in mind of a meeting with MPs where I and others had explained that they were useful, but not in themselves a solution to Scotland’s drug problem. I said that harm reduction services like DCRs are never an end in themselves. The ‘service’ you want to offer is not providing a safe environment for drug consumption. It is having a contact point for users who have particularly disrupted lives where you can talk about other services that they need – welfare, housing, psychological, health etc.  What matters is what happens when you provide that service. Later I heard, ‘they are not a silver bullet’. Does anybody think they are? As Nicholls et al outline, everyone involved thinks they have to defeat this strawman argument first of all.

We should make ourselves aware of why this argument exists in the first place. Nobody used it for Scotland’s needle exchange policy which was vital in fighting the HIV epidemic. Objections then were moral as it was seen as a moral and a technical project. It has come about because our harm reduction thinking has become increasingly technically focused in practice evidence and justification. This is just perfectly reasonable. We could work together with very different moral and political views  to agree on the technical benefits of needle exchange. It was quite remarkable that conservative, and liberal, politicians could agree on this approach.

The problem of relying on the technologically justified approach is that it can ossify over time and displace the wider moral claim you’re making. Everyone starts to expect naloxone to act in this way. We know it is its most effective when it is part of a toolkit owned by users – meaning not a magic bullet.

So we can perhaps work with some different means of understanding:

What kinds of conversations and communities are created and supported through it?

What kind of knowledge came from it?

Does it connect different elements of a wicked problem?

and so on

Nothing is a silver bullet. Except when it is. There are plenty of technological solutions. HIV is now a disease to live with, not die of. Obesity may be preventable. Semaglutide might treat addiction. Yet many campaigns reject silver bullets on principle because the real aim is different – usually to end capitalism in some form. Imagine a party campaigning against child poverty. They are offered a solution – eg here’s a ton of cash. They reject it. ‘No to solutions that do not change society’. We would think them disgraceful, immoral. Certainly we would assume they were not really opposed to child poverty. But that is exactly what happens.

In the social sciences, we have been sometimes reluctant to accept that there can be magic bullets, technological solutions, because we are a bit in love with our wicked problems. If some of these problems have simple technical solutions like the weight loss pill, then it reduces our role to technical administrators. Similarly we refuse the great man idea of history because it gets in the way of our ability to theorise. It is a bit hard to argue now that individuals do not influence history.

Nicholls, James, Wulf Livingston, Andy Perkins, Beth Cairns, Rebecca Foster, Kirsten M. A. Trayner, Harry R. Sumnall, Tracey Price, Paul Cairney, Josh Dumbrell, and Tessa Parkes. 2022. ‘Drug Consumption Rooms and Public Health Policy: Perspectives of Scottish Strategic Decision-Makers’. International Journal of Environmental Research and Public Health 19(11):6575. doi: 10.3390/ijerph19116575.
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