The Doctor is Out: Harm Reduction, Health Care, and the Relational Dynamics of Well-Being

• In Event: Drugs and Society Section Open Call Paper Session

Abstract

Syringe exchange programs (SEPs) are often the only healthcare organizations with which people who use drugs regularly interact with. Besides injection-related supplies, tools for smoking, preventing and reversing overdoses, hygiene and wound care supplies are regularly distributed by program staff. While these organizations serve public health goals, they advance the healthcare needs of drug users in ways distinct from traditional public health and biomedicine. Resisting pathological understandings of drug use, SEP workers render care through building relationships with drug users and supporting their self-defined health goals. Relationships help workers render interventions that act coterminously on both the socio-material and biological scales. Workers’ socio-material interventions, such as arrears payments and nutrition assistance, come to matter at the biological scale by safeguarding the physical integrity of program participants. Interventions understood to be more biological in scope also come to matter at the socio-material scale as new forms of sociability are engendered in harm reduction interactions. Workers appropriate biomedical techniques (such as wound care strategies) and technologies (such as syringes or naloxone) and rework them into relational circuits of care. This paper, building off two years of ethnographic investigation at a SEP on the westside of Los Angeles, analyzes how the interventions rendered within SEPs and other harm reduction organizations re-articulate the relationship between drug use and pathology.

Author

• Jason Louis Contino, University of California-Los Angeles