Year: 2009
Type: article
Abstract: There are two issues at stake when we choose our professional jargon (well, really three, but let us not dignify the use of obfuscatory jargon as a barrier to entering the guild). First, does the jargon clarify our thinking and thus improve our theories, research and program design? Secondly, does the jargon have effective marketing properties? I would hope the first criterion would trump the second. With respect to policy marketing, it is an empirical question as to whether a program will muster more political support and resources depending on whether it is labeled harm reduction, harm minimization, public health or secondary prevention. One can never go wrong by being cynical about the politics of drug research [1], but our labels are confounded with many other factors that bedevil government support for needle exchange and safe injection sites, not the least of which is the lack of a large and well-organized political lobby. For jargon to make a decisive difference here, one has to believe that skeptics and opponents will not notice the switch, or will find it so palatable that they will convert. This is possible, but seems unlikely to me. I feel much the same way about the use of the term ‘entheogen’ as a replacement for ‘psychedelic’; the old term accumulated a great deal of baggage, but it is only a minor cognitive operation to transfer those bags to the new cart, and the new term asserts what ought to be an open question about these drugs' properties. Also, it seems likely that opponents dislike the harm reduction label in part because it is such a good one; it highlights a worthy goal that is neglected by the near exclusive emphasis on abstinence and deterrence in our mainstream policies [2]. With respect to clear thinking, harm reduction is an excellent label to be used without apology, as long as it is used as a goal or strategy rather than a program. It is true that not all harms can be quantified or compared (see [3] for a detailed taxonomy and discussion); but the same can be said of love, dignity, respect, passion, creativity, pettiness, cruelty, arrogance, obnoxiousness and many other criteria we seek to monitor and influence in human life. All our interventions affect harms, the intensity of drug use and the prevalence of drug use, whether or not the effects are intended and are beneficial or not. Because total drug-related harm is the product of prevalence of use, intensity of use and harm per unit dose, we should recognize explicitly three criteria—prevalence reduction, quantity reduction and average harm reduction [4]—for any drug program, no matter how it might be labeled. None.
Source: Addiction
Author: ROBERT J. MACCOUN
Institution: University of California, Berkeley
Language: English
Topic: HIV, Drug Use, Sexual Risk
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W1607508523