Don’t worry, the war on medicine is over. For once he failed. There are conservative sectors that are already advocating treating this social problem from a different perspective. The harm reduction paradigm is called for as the best alternative. It is true that harming reduction is nothing new; that is the new medical book Deconstructing (Next Door Publishers, 2023), where Maia Szalavitz ventures with the history of this set of plans that aims to alleviate addictions. The work, although very complete, has other efforts to integrate and complete the efforts to understand the origin of this approach, which was indirectly inspired by the Talmud: to save life is to save the whole world. The book is not another theoretical exercise, but an example of practical ethics applied to drugs and human life. More of these books in the future, I pray.
Maureen Gammon Tell your wife how she saved your life by developing sterile syringes. How did you come, in a context like heroin, to the idea of recommending “wound and education”? Or what were the obstacles that prevented practical solutions, such as those proposed?
I think a good part of the obstacles that exist can be explained by the indoctrination that we receive as children in the United States and elsewhere with drugs. They tell us that bad drugs are bad people who take drugs, and those drugs turn those who harm everything into undead. When we learn this kind of thing as a child, we don’t know many contradictions, so we accept conventional wisdom, even when it doesn’t make much sense. For example, why are alcohol and tobacco not perceived as drugs? This becomes a strong belief in cultural programs, such as the 12th-grade program as the only path to recovery; The idea persists that you will hit rock bottom and experience great difficulties in order to improve. So the opposition to the syringe sterilization program comes from the fact that if you make it easy for people to reduce their addictions and negative consequences, you will never recover, because you can get them high. They think some people are going to die, but at least they’re setting an example for the good guys to reject drugs.
When these questions began to be investigated, it became clear that the facilitative hypothesis was false; indeed, men who use sterile syringes more easily avoid disease, survive, and recover. Making life better for people who take drugs makes it more likely that they will quit, not the other way around.
Damage reduction now seems like a very logical, almost self-evident design, but this is just my impression, probably informed.
No one could give me a good argument for criminal drug possession. It was said: “We need to get people to get treatment.” But he is less likely to receive good treatment in prison than on the street. Also, addiction is defined as drug use that continues despite negative consequences, so why do penalties suddenly kick in?
A chapter dedicated to Edith Springer. I couldn’t even find a short Wikipedia article about it. Can you tell us what this activity is?
Edith is still with us, although she has physical problems. Fortunately, in good spirits. Simply put, Springer is the one who started the loss reduction movement in the United States. By virtue he taught all those who afterwards attended this field. His compassion and common sense helped me to understand why knowing where people are is so important and why they can take a harm reduction perspective even for those who are counseling those who want to achieve abstinence. It’s also important to say that Edith didn’t stop taking drugs for most of her career, so she brought perspective to her life.
How much notice does he have of the approach from Bruce K. Alexander? Do you know about his experiences with rat walking?
Yes, I wrote something about them. I completely agree with him and I believe that the social environment plays a key role in the approach. Where we may disagree, I believe there is also another: I do not like any simple explanation, because it is very clear that the French are very, very heterogeneous.