{"id":3317,"date":"2009-07-28T15:31:10","date_gmt":"2009-07-28T14:31:10","guid":{"rendered":"https:\/\/drugprevent.org.uk\/ppp\/?p=3317"},"modified":"2009-07-28T15:31:10","modified_gmt":"2009-07-28T14:31:10","slug":"world-conference-on-drugs","status":"publish","type":"post","link":"https:\/\/drugprevent.org.uk\/ppp\/2009\/07\/world-conference-on-drugs\/","title":{"rendered":"World Conference on Drugs"},"content":{"rendered":"
Visby, Sweden \u2013 May 3rd to 6th, 2001<\/span><\/div>\n

\u2018The History of Harm Reduction\u2019
\nPaper by Peter Stoker: Director, National Drug Prevention Alliance (UK).<\/p>\n

1. Introduction<\/p>\n

With a title like \u2018the history of \u2026\u2019 you might reasonably expect a historian to be standing here, but I\u2019m not one. Nevertheless I can apply my experience to analysing this situation, and much of that experience, until I moved into the drugs field 15 years ago, was as a construction engineer. Part of my training then was to explore when things collapse, and find out why. Our society has not yet totally collapsed, but it is showing signs of severe stress. Cracks are appearing, and we need to shore the whole structure up quickly, if we are not to be crushed. What is causing this? Basically, our foundations are being undermined.<\/p>\n

In this paper I will try to give you my \u2018structural analysis\u2019 of the Harm Reduction movement, and some indications for avoiding future collapse.<\/p>\n

When Torgny Peterson first asked me to deliver this paper, I misheard him. I thought he asked me to write not about the History, but about the Mystery of Harm Reduction. It seemed a sensible request, but in checking my dictionary I found that a more appropriate word than \u201cMystery\u201d would be \u201cMysticism\u201d – which the dictionary defines as:<\/p>\n

\u2018A belief characterised by self-delusion or dreamy confusion of thought, especially when based on mysterious agencies\u2019.<\/p>\n

How true that is! And some of the agencies are more mysterious than others.<\/p>\n

2. Historical Perspective<\/p>\n

Harm Reduction has always been around. In the Garden of Eden, when Eve ignored the advice to \u201cJust Say No to Snakes\u201d and then peer-pressured Adam into biting that apple, it dawned on them that they were naked and they cried out \u201cWhat shall we do?\u201d. Well, Walmarts hadn\u2019t been invented at that time, so the best they could come up with by way of Harm Reduction was a fig-leaf.<\/p>\n

And ever since then, we have been using the \u201cfig-leaf\u201d approach to society\u2019s drug problems.<\/p>\n

John Stuart Mill, considered by many to be the father of Liberty, was born in London in 1806. A prodigiously intelligent man, the culmination of his career came in the celebrated essays he published between 1859 and 1865; in particular his classic work \u201cOn Liberty\u201d1. Many of those who wish to legalise or liberalise drugs employ philosophic arguments, quoting from this treatise to justify their position. But in doing so they are making a fundamental strategic error. Their favourite quote is:<\/p>\n

\u2018Over himself, and over his own mind and body, the individual is sovereign\u2019<\/p>\n

However this is but one sentence in thousands which speak quite the opposite, which emphasise that the individual has an obligation to society, and that the rights of society outweigh those of the individual. On my copy of Mills classic text \u2018On Liberty\u2019, the dust jacket gives a more apposite quote:<\/p>\n

\u2018the only purpose for which power can be rightfully exercised over any member of a civilised community, against his will, is to prevent harm to others\u2026\u2019<\/p>\n

And therein lies the key phrase. Harm to others. For the driving force in the thinking of a drug aficionado is that the individual is sovereign, and the only harm that is significant is harm to that individual \u2013 harm to others can be dismissed as the deluded invention of prohibitionists. Mill rejects this, taking direct issue with those who abuse substances and making it clear that, because of the harm caused to others by this individual action, such abuse should be repressed by law. This was particularly far-sighted, given that he wrote it in l859, when drug availability was low and its abuse was virtually non-existent in enlightened democratic nations.<\/p>\n

In the context of morality, law and punishment, Mill says \u2018Whenever , in short there is definite damage, or definite risk of damage, either to an individual or to the public, the case is taken out of the province of Liberty and placed in that of morality or law\u2019. Punishment is seen to be right \u2026.\u2019for such actions as are prejudicial to the interests of others \u2026the individual is accountable [to society] and may be subjected either to social or legal punishment if society is of the opinion that the one or the other is requisite for its protection.\u2019<\/p>\n

False reliance on Mill is not the only example of drug liberalisers wishing to live in another time. One of the studies frequently cited as \u2018evidence\u2019 of the innocuous nature of cannabis is the 1896 Indian Hemp Commission report. A premier libertarian in my country, Dr. Colin Brewer, who is a senior member of the International Anti-Prohibition League, frequently eulogises Victorian times as an example of how we might have \u2018drug peace\u2019 instead of \u2018drug war\u2019.<\/p>\n

Those who are more familiar with Mill\u2019s work can take a more objective view. Gertrude Himmelfarb, editor of \u2018On Liberty\u2019 makes the point that \u2018Mill\u2019s principle of liberty is less applicable than before, given that our social reality today is infinitely more complicated.\u2019 For those of us who are familiar with the drug culture, Himmelfarb might be accused of missing the point. The main purpose of ingesting drugs is precisely to depart from \u2018our social reality today\u2019. It follows that anything which facilitates or excuses this departure, including \u2018cherry picking\u2019 useful phrases from 150 year-old documents, is fair game.<\/p>\n

3. America in the Seventies and later<\/p>\n

Although the Office of Substance Abuse Prevention now rejects the term \u2018responsible use\u2019, back in the Seventies many people were more gullible. A rash of deaths from huffing (solvent sniffing abuse) produced a proposal to give guidance on less risky methods of sniffing. This followed on recommendations drafted in the early 1970s for education on \u2018responsible use\u2019 of alcohol, including recommendations for drinking and driving (as distinct from \u2018not drinking and driving\u2019). David Duncan (et al), writing in 1994 in the Journal of Drug Education2, identified this as the start of a paradigm shift; and he remarked that such shifts can often be huge but equally are often incremental, and so creep up on society unawares. Given that Duncan and colleagues were offering an unabashed argument in favour of harm reduction, he would presumably have wished for society to stay unawares \u2013 at least of the moves by his school of thought.<\/p>\n

Society may have been unawares but some people certainly were not. One of those who read \u2018Harm Reduction \u2013 a New Paradigm for Drug Education\u2019 was Dr. Robert DuPont, a drug specialist who had earlier publicly recanted his support for permissive approaches to drugs \u2013 especially cannabis. DuPont sent a stiff letter to the editor of the Journal, saying that Duncan\u2019s article was a regurgitation of the failed \u2018 responsible use initiative of 20 years ago\u2019 , and commenting that whilst there might be a place for harm reduction in tertiary prevention, to mitigate the effects on hard core users, harm reduction was a disastrous idea in primary prevention in schools., in that it would undercut the important goal of non-use. Typical of the \u2018pearls of wisdom\u2019 in the article was the proposition that \u2018Harm reduction is consistent with the human experience \u2026\u2019 and \u2018Prevention often increases harm\u2019. Particularly fascinating were the \u2018findings\u2019 that moderate users of drugs were healthier psychologically and enjoyed higher life satisfaction than either abusers or non-users. You may also be intrigued to learn that marijuana users enjoy better social skills, a broader range of interests and more concern for the feelings of others than non-users. DuPont reacted emphatically. He was in a strong position to make criticism, since up to that point he had been a member of the Journal\u2019s board of directors \u2013 but not any more; he resigned so that his name could \u2018no longer be associated with this dangerous message\u2019.<\/p>\n

Others have \u2013 perhaps wishfully \u2013 perceived a paradigm shift in drug policy. In a retrospective paper entitled \u2018A Kinder War\u2019 the high priest of drug liberalisation, Arnold Trebach3 spoke of a change being in the air. There was, he perceived, greater understanding of \u2018\u2026[the] enduring reality of drug use, the absurdity of even attempting to create a drug-free society, and the need to treat drug users and abusers as basically decent human beings\u2019. In l980 an organisation called the Drug Abuse Council spent $10 million , most of it from the Ford Foundation, to produce a 300 page report entitled \u2018Facts About Drugs\u2019. It included such gems as the statement that users are no threat to society, only abusers are; it supported the idea of giving heroin to heroin addicts and \u2013 not surprisingly \u2013 it proposed, as a Harm Reduction expedient, the decriminalisation of cannabis. It suggested that there should be a distinction between what it called \u2018recreational use\u2019 and \u2018misuse that harms society\u2019. It went on to say that \u2018by adhering to an unrealistic goal of total abstinence from the use of illicit drugs, opportunities to encourage responsible drug using behaviour are missed\u2019. The Drug Abuse Council comforted itself in the supposed validity of its recommendations by predicting that \u2018\u2026heavy use would prevail for the next few years\u2026.\u2019. In fact from the year of their report\u2019s publication and for the succeeding 11 years, America brought about an astonishing public health success which yielded an overall reduction in the use of all substances by all ages of 60%, removing 13 million drug-users from the slate. In this as in everything else the Drug Abuse Council had got it wrong.<\/p>\n

Unfortunately, expression of Harm Reduction philosophy was not confined to the private sector. In 1996 at Emory College in Atlanta, Georgia, the first South Eastern Harm Reduction Conference4 was \u2013 appallingly \u2013 co-hosted by America\u2019s prestigious Centre for Disease Control. Some of the very well known libertarian groups with which CDC rubbed shoulders included the Drug Policy Foundation, the Lindesmith Foundation and Eric Sterling\u2019s Criminal Justice Policy Foundation. A specimen statement from this bizarre grouping was \u2018In allowing users access to the tools needed to become healthier, we recognise the competency of their efforts to protect themselves, their loved ones, and their communities\u2019. The notion that one way of becoming healthier might be to stop or indeed never start being drug users would presumably have been lost on this gathering.<\/p>\n

At about the same time a much more negative assessment of Harm Reduction came from body called the Family Research Council. In the council\u2019s magazine \u2018Insight\u2019 writer Rob Maginnis5 produced an exemplary analysis of Harm Reduction; he noted the support from William F Buckley and the ACLU (American Civil Liberties Union) which he cited as \u2018a leading promoter of Harm Reduction\u2019. ( I have been advised by one of my gurus \u2013 the marvellous Otto Moulton \u2013 to constantly watch out for the ACLU; they have always been a major player in drug liberalisation, yet they are rarely seen or mentioned in this context. A possible explanation for this protected position may be the high percentage of ACLU members or supporters amongst the media). Maginnis gives an early example of Harm Reduction in Holland in the l970s, when they were handing out needles in an attempt to limit the spread of hepatitis \u2013 this was before the AIDS epidemic had become apparent.<\/p>\n

ACLU are quoted as asserting that \u2018Harm Reduction assumes drug-users civil rights and individual autonomy should be respected, it treats drug users as important participants in the process of gaining and maintaining control over their drug use, and makes no moral judgement based solely upon an individuals\u2019 use of drugs\u2019.<\/p>\n

American drug policy experts, Sue Rusche and Stephanie Haynes, whose assistance with this paper I gratefully acknowledge, both define the Seventies as a period in which responsible use was the lubricant that allowed a whole generation to slide down the slope into drug abuse. Rusche cites use prevalence figures which are stark and inescapable. In 1962, less than two per cent of the American population had had any encounter with any illegal drug. But by 1979, 34 per cent of adolescents, 65 per cent of high-school seniors and 70 per cent of young adults had tried drugs. It was responsible use policies which fuelled this escalation. Between 1973 and 1978, 11 American states decriminalised marijuana. Some 30,000 \u2018head shops\u2019 sprang up to supply a curious population with drug paraphernalia. At the same time schools drug education materials taught children how to \u2018use drugs responsibly\u2019.<\/p>\n

At first, parents were unwitting collaborators in this unfortunate process, in that they were blind to what was going on. But when their eyes were opened, they reacted strongly and assertively. Parent groups, such as Sue Rusche\u2019s National Families in Action, PRIDE – the Parents Resource Institute for Drug Education, and the National Federation of Parents for Drug-Free Youth sprang up all over America, until at one time there were more than 8000 such groups. The parent movement hammered the professionals who had swallowed the Harm Reduction notion, and the parents were extremely successful in producing a paradigm shift of their own, back to prevention. The parent movement defined \u2018Drugs\u2019 as any and all illegal drugs, plus any legal drugs (such as alcohol and tobacco) used illegally – for example by those who were under age. Simple strategy goals were defined:<\/p>\n

– Prevent use before it starts.
\n– Persuade users to stop.
\n– Help those who can\u2019t stop to find treatment so that they can.<\/p>\n

Parent campaigns closed the Head shops and put a stop to any decriminalisation. Several states have more recently succumbed to expensive PR campaigns and have swallowed the notion of using raw cannabis as \u2018snake oil\u2019 medicine, which just goes to show that you can fool the people some of the time, if your advertising budget is big enough. But in terms of non-medical use, no state has decriminalised marijuana since 1978, and several have actually re-criminalised it. Under the sterling work of the Parent movement in the Seventies and later, the \u201cresponsible use\u201d message went into the garbage can, to be replaced by the \u201cno use\u201d message.<\/p>\n

Would that it were that straight forward today! How was it that the American parent and family movement, consisting almost entirely of volunteers, managed to intercept and prevent this collapse? I plan to give you an explanation later.<\/p>\n

4. Britain in the Eighties and early Nineties<\/p>\n

When my wife and I first became workers in the drugs field, for the first seven or eight years we worked in \u201cStreet agencies\u201d – face-to-face with addicts, alcoholics, and others at various points along the continuum of substance abuse. We also worked to assist the families and significant others around the user, and we worked as specialist advisers to the teachers in more than 100 schools. We were blissfully ignorant of the storm clouds gathering in the Liverpool area, and we pursued our duties on exactly the same strategic basis as the American parent movement had eventually developed, that is:<\/p>\n

Stop it starting. If it\u2019s started, stop it.
\nIf it\u2019s still not stopped then help it to stop. Full stop!
\nThe first signs of trouble came when we, in concert with other Drug Education Advisers across England and Wales started attending National drug education conferences. We might have expected a few radical statements in an arena populated by teachers, but we were unprepared for the virulence of what we heard. It quickly became apparent to us (but sadly not to enough of our contemporaries) that the Drug Education Advisers were being hijacked by a small but well-organised bunch of libertarians. The radicals all sounded like the Beatles, with their nasal Merseyside accents. Liverpool was COOL, so you listened to anyone who came from there \u2013 whether they were carrying a guitar or not.
\nOne of these exponents of Scouse charisma was former teacher and Sociology\/Criminology graduate Pat O\u2019Hare, now better known as the Director of the International Harm Reduction Association. O\u2019Hare and colleagues were well enough resourced to be able to run a glossy magazine – \u201cthe Mersey Drugs Journal\u201d which in due course became the even more glossy \u201cInternational Journal of Drug Policy\u201d (IJDP). The list of contributing editors to in the IJDP read like a \u201cWho\u2019s Who\u201d of drug libertarianism.<\/p>\n

Liverpool in the eighties was a swirling pool of powerful undercurrents. Anger at its social and economic situation compared to the affluent south-east had flared up into serious riots in the Toxteth area of the city, in 1981. Although these eventually subsided, a sharp antagonism remained. Dislike for the Establishment as a species translated into identification with subculture \u2013 including drugs. Whether jealous comparison of economies was at the root of the next factor or not, the fact is that there was also antipathy towards all things American amongst the so-called \u2018caring professions\u2019 \u2013 not reflected in the general population \u2013 and out of this came a striving for new directions. The up-swelling of libertarian philosophies at this same time seemed to fuse naturally into the process. One specific outcome was a vigorous seeding of the idea of Harm Reduction; a seeding which took root not just in Liverpool but also \u2013 through energetic propagation \u2013 across the rest of Britain and internationally.<\/p>\n

Whilst other British cities with a high incidence of drug use were obvious places for the Harm Reduction gospel to be spread, it was by no means limited to these centres. Obviously the onset of AIDS, at the start of the Eighties, was a catalyst in the development of Harm Reduction; as a drug agency worker at that time I can vividly remember that we were all deeply concerned at this new major health hazard, and we were invited to regard AIDS as a greater threat to society than drug abuse, a notion which helped to undermine the significance of drug abuse as something to be arrested or prevented. With hindsight it is clear that though AIDS is a terrible disease it is also preventable – as is drug use, and that of the two, widespread drug use is in fact a much bigger threat to society at large. Prevent drug use and you are well on the way to preventing AIDS.<\/p>\n

Liverpool was one of the areas where AIDS was a particular threat, largely due to the already high prevalence of drug abuse. But what is not widely known is that this drug use, and in particular heroin use, did not generally involve injecting; \u2018chasing the dragon\u2019 (\u2018smoking\u2019) was the preferred method. It was then that the Liverpool Harm Reduction activists entered the arena. . What happened next was related to me by the mother of two heroin addicts, who later became one of our leading Parent campaigners. In the words of one of the Harm Reduction crusaders, International Journal editor Peter McDermott6:<\/p>\n

\u2018As a member of the Liverpool cabal who hijacked the term Harm Reduction and used it aggressively to advocate change during the late 1980s, I am able to say what we meant when we used the term. Its real value lay in its ability to signify a break with the style and substance of existing policies and practice. Harm Reduction implied a break with the old unworkable dogmas \u2013 the philosophy that placed a premium on seeking to achieve abstinence\u2026\u2019<\/p>\n

McDermot goes on to talk about the importance of the \u2018availability of a legal supply of clean drugs and good supplies of sterile injecting equipment\u2019. Note that he incorporates legalisation and needles as part of the Harm Reduction package; note too that he talks about \u2018supply\u2019 – not \u2018exchange\u2019 of injecting equipment.<\/p>\n

What McDermott and his colleagues meant by good supplies was more than just a rejection of the idea of needle exchange, a process which was supposed to be associated with dialogue between the drug worker and the user, with the aim of encouraging transition to a healthier lifestyle. McDermott & Co. had much more in mind than handing out a pack of needles without dialogue. The reality was, as the Liverpool mother told me, giving out needles by the bag full, and even giving out needles to known drug dealers, whom the police had agreed they would overlook if they found them carrying bagfuls of injecting equipment, to be given out with the drugs they sold. The net effect of this policy was that over a period, Liverpool moved from being an area with a low incidence of injecting drug users to one of a high incidence of injecting.<\/p>\n

What the \u2018Liverpool cabal\u2019 had as their driving force may be judged from McDermott\u2019s editorial of the time, that said:<\/p>\n

\u2018\u2026we must continue to guard Harm Reduction\u2019s original radical kernel, without which it loses almost all of its political power.\u2019<\/p>\n

This movement, piously promoted in the name of treating drug users with respect, was in fact an exercise in radical politics. At least one of the \u2018cabal\u2019 was known to be a Stalinist.<\/p>\n

The political angle was generally masked by rhetoric around the prevention of disease (and in particular AIDS) and the dignity of the user, but their preaching across Britain was both energetic and rapid. The message was promoted to drug workers, teachers, health workers and \u2013 not least \u2013 to police forces. In 1988 I sat in on a presentation to a regional health authority given by Alan Parry, another leading light in the Liverpool cabal. Parry outlined their policy: money would be moved from Abstinence and Detoxification into Harm Reduction. Prevention was dismissed as ineffective and they would therefore block any drug education scheme unless it could be proved to be innovative and with evaluation built in. When a questioner from the floor asked Parry what evaluation they were doing on their Harm Reduction work, he answered that there was very little funding available and so they would not be evaluating what they were doing – but they did feel it was \u2018working well\u2019.<\/p>\n

[In this context, it is enlightening to hear the comment made a decade later to one of our member groups by Anna Bradley, at that time Director of Britain\u2019s Institute for the Study of Drug Dependence. Pushed back from her opening gambit, which was to allege a lack of evidence for Prevention, Bradley was forced to concede that \u2018\u2026 there is no research base for harm reduction\u2019. She has now left ISDD.]<\/p>\n

At the time that I took on additional work as an education advisor, assisting our local schools with their drug education work \u2013 if any – the whole of England and Wales, a population of some 50 million people, had its drug education coordinated by just over 100 people like myself. Most of these were teachers who had moved sideways into becoming Drug Education Coordinators. They had little or no knowledge of drugs and they were therefore eagerly looking for guidance from those they considered to be more experienced. One hundred is a very small number for a group of determined radicals to penetrate and persuade, and I saw this taking place at drug education conferences and training sessions at the time, without realising how wide-reaching and profound it was to become.<\/p>\n

The British Harm Reduction movement did not content itself with staying in Britain \u2013 it soon established links elsewhere. We knew that those involved were using electronic means of communication globally long before e-mails were common. One of the \u2018travelling salesmen\u2019 was Julian Cohen, co-author of the ambiguously-titled \u2018Taking Drugs Seriously\u2019. Cohen7 argues for the \u2018plusses of drug taking\u2019; a typical item in Julian\u2019s carpetbag is:<\/p>\n

\u2018The primary prevention approach ignores the fun, the pleasure, the benefits of drug use \u2026 drug use is purposeful, drug use is fun for young people and drug use brings benefits to them.\u2019<\/p>\n

The European Movement for the Normalisation of Drug Policy (EMNDP) had its first meeting in Swindon, England in 1989. The Merseyside campaigners soon found themselves off to America [1988] where they were feted by libertarians, \u2018in the street and on the Hill\u2019. Amongst those on this promotional trip was Pat O\u2019Hare, now Director of the International Harm Reduction Association. O\u2019Hare and colleagues presented a paper8 with the innocuous title of \u2018Drug Education, a Basis for Reform\u2019 to a Maryland conference, convened by a relatively new organisation called the Drug Policy Foundation, about which we now know a little more! Thanks to Otto Moulton I have a tape of what was actually said by O\u2019Hare and his companion Ian Clements at that conference; it bears little relationship to the written paper. O\u2019Hare told his largely American audience that \u2018England has absolutely nothing to learn from America\u2019 and added that \u2018\u2026this 12-step rubbish is absolute cr*p\u2019. One member of the audience made so bold as to ask O\u2019Hare \u2018What are the 12-steps ?\u2019 . \u2018I don\u2019t know\u2019 he responded. (but he did know they were \u2018cr*p\u2019). He then invited his audience to consider the notion that:<\/p>\n

\u2018If kid\u2019s can\u2019t have fun with drugs when they\u2019re kids when can they have fun with them?\u2019<\/p>\n

O\u2019Hare was demonstrating that when it comes to radicalism, we Brits can show the former colonies a thing or two.<\/p>\n

One milestone on the Harm Reduction road was the establishment of European Cities on Drug Policy (ECDP). Their first International Conference, held in 1990, in the German city of Frankfurt, produced the so-called Frankfurt Resolution, calling for heroin distribution to addicts, decriminalisation of cannabis and the provision of shooting galleries. It initiated a recruiting drive, and one of its first disciples was Scotland, much to the disgust of our Scottish prevention colleagues. According to Glasgow\u2019s Families For Change organiser Maxie Richards \u201c\u2026harm reduction has become a vested interest of the Social Service industry, and with only one purpose: keeping social peace at the cost of dispensing drugs\u201d.<\/p>\n

5. Taking stock. Where are we now?<\/p>\n

We\u2019re in big trouble, that\u2019s where we are. Through a combination of strong adversaries and weak friends we can see the Harm Reduction Movement approaching critical mass in several countries. In England we have many, perhaps most schools adopting a Harm Reduction approach to their education, and the libertarian elite are well entrenched in the Education ministry\u2019s corridors. A self-appointed and exclusive pressure group of educationists and related disciplines, the Drug Education Forum, seems curiously able to protagonise – with impunity – a philosophy which effectively neuters prevention in our schools. We do our best to alert and galvanise those in control, and we have had several meetings with Keith Hellawell, whom you heard earlier. But even a senior advisor like Keith, with all the experience of being a Chief Constable to stiffen him, is likely to find that changing the direction of our government officials is like boxing with cotton wool. It is small comfort \u2013 in fact no comfort at all – for colleagues in Australia to tell me that the situation is even worse there, and has been for at least a decade, with Harm Reduction education being the mandatory norm, and cannabis decriminalisation a fact of life in some areas.<\/p>\n

I don\u2019t think I need to take time in this gathering by telling you about Switzerland, since I am reasonably sure that you are familiar with that disaster area. An avalanche of Harm Reduction. When looking for the reasons why Switzerland has gone downhill, one explanation may lie in the fact that the director of the so-called \u2018Swiss Experiment\u2019 also happened to be the President of the Swiss branch of the International Anti-prohibition League!<\/p>\n

Similarly, I believe you will know a good deal about the Netherlands. Their particular brand of Harm Reduction was visible for many years before drugs became the issue, and cannabis cafes opened. As a young man in the late Fifties, I can remember walking in astonishment along Canal Street in Amsterdam, looking at brightly lit and decorated shop-windows in which the \u2018Item for Sale\u2019 was not a washing machine; it was a human being.<\/p>\n

6. How did we get into this mess?<\/p>\n

In reflecting on the development of Harm Reduction, one stark contrast emerges. How was it that there are two virtually identical philosophies; one from only 20 years ago, operating under the title of \u2018Responsible Use\u2019 \u2013 was quickly identified as \u2018The Emperor\u2019s New Clothes\u2019 and kicked out, and yet here we are now, faced with Harm Reduction deeply embedded, with its tentacles reaching everywhere \u2013 even into government ? What caused the difference ?<\/p>\n

If I asked all of you here today to come up with one word as an explanation, that word would probably be \u2018Soros\u2019. In one sense you would be right; the money that George has injected into the libertarian movement, compared to that which we can marshal, is like us attacking their artillery with our cavalry. We British tried that once, it was heroic but futile.<\/p>\n

I would like to offer you the deeper explanation of why Harm Reduction flourished where Responsible Use failed, in the push for liberalisation.<\/p>\n

It was in the 1960s both in the UK and in the USA that a sea change in educational approaches really took hold; morals-based education gave way to individual rights. Apparently disparate subjects such as reading, mathematics, history, geography and religious education fell victim to the excesses of an overheated individual rights approach in which some pupils could even decide whether to participate in classes or not. It goes without saying that lifestyles subjects such as sex education, drugs education and personal\/social education would be swept along at the front of this wave.<\/p>\n

One book you might care to read, if you want to get into this in more depth, called \u2018The Great Disruption\u2019 \u2013 is by Francis Fukuyama9. Fukuyma concludes that there has been a major paradigm shift. Who created that shift ?<\/p>\n

I believe the answer lies in a process known as Values Clarification, also associated with Outcome-Based Education. This originated in Wisconsin, USA in the 1970\u2019s under the leadership of a man whom we regard as one of the fathers of psychotherapy \u2013 Carl Rogers, together with Professor Sidney Simon and psychologist William Coulson. Rogers started with a very laudable concept i.e. that pupils should be facilitated to discover, and thus reach consensus on values which are beneficial to society. Sadly, within a short time the concept was diverted into one in which pupils were facilitated to discover values which were beneficial to them as individuals. External constraints were to be viewed as obstacles to the individual\u2019s \u2018Self-Actualisation\u2019 – as Abraham Maslow, another contemporary of Rogers termed it. Thus, the notion was advanced that \u2018\u2026 children should be left to create their own autonomous world, and that adults would be anti-democratic if they tried to pass their values to their children\u2019. This was echoed by co-author Sidney Simon in the statement \u2018..the school must not be allowed to continue fostering the immorality of morality. An entirely different set of values must be nourished\u2019.<\/p>\n

Similar approaches were observed in Gestalt-based education practices in Switzerland. A typical guiding assertion was that \u2018Morals are regarded as obstacles which hinder the development of \u2018my authentic self\u2019 and the teacher has no right to impose his sense of values about what is right or wrong\u2019. In Australia, classroom techniques resembling group therapy were deployed to produce changes in children\u2019s attitudes and behaviour and challenge their previously held values.<\/p>\n

Carl Rogers eventually expressed his own concern about the monster he had created, referring to it as \u2018this damned thing\u2019 and wondering \u2018did I start something that is in some fundamental way mistaken, and will lead us off into paths that we will regret?\u2019. But by then the wave had swept things beyond his reach. Britain now has a Journal of Values Education which invites school classes to discuss such questions as \u2018Are drugs really bad for you?\u2019, \u2018What are the benefits and risks of drug taking?\u2019 and \u2018If adults drink alcohol why should I not take Ecstasy ?\u2019<\/p>\n

I believe that study10 of the Values Clarification process and related movements helps explain how we have reached where we are today. This is why Harm reduction has taken root, when Responsible Use died off quickly after a first flourish of growth, having fallen on stony ground.<\/p>\n

But we cannot blame Rogers for everything that has happened in the last 20 to 30 years, anymore than we can blame George Soros. One is an idealist and the other an opportunist, but they both sowed seeds in grounds which we ourselves have made fertile.<\/p>\n

External factors across and within society have, by their confluence, brought about enormous changes. Emancipation of the young, their greater disposable income, disempowerment of traditional authority \u2013 including parents and teachers, a more materialistic society and a \u2018me first\u2019 outlook, dismantling of \u2018community\u2019, the highlighting of \u2018personal rights\u2019 at the same time as the downplaying of \u2018responsibilities\u2019, effects of structural unemployment and the need for a more mobile workforce \u2013 this last factor adding to the breakdown of the nuclear family. The \u2018contribution\u2019 of the professions in being part of the problem rather than part of the solution is a major influence, as Professor Norman Dennis11 makes clear. I could say more, but you get the picture \u2026<\/p>\n

And the results of this we can now see in our undisciplined classrooms; in a police force which is perceived as sometimes more ready to arrest victims than criminals in order to reduce the harm to the latter; in drug workers campaigning to free colleagues who have apparently allowed drug dealing to be pursued on their premises, and in Education Authorities that will not allow school nurses to issue Aspirin or Paracetamol for fear of a negative reaction, but are receptive to the idea of issuing \u2018morning after pills\u2019 to young girls without their parents\u2019 knowledge.<\/p>\n

Harm Reduction is no more than an extension of this much deeper and wider paradigm shift. Addressing only Harm Reduction in seeking to strengthen our society against structural collapse is an over-simplification that could prove fatal.<\/p>\n

7. What should be our rational response?<\/p>\n

This paper is about the history rather than the solution, but I don\u2019t feel I can leave you without at least trying to offer some provocation. Here are a few possibilities:<\/p>\n

Option 1 – find another George<\/p>\n

Option 2 – react less, act more. Define the \u2018Harm\u2019<\/p>\n

Option 3 – identify and study the processes that brought us to today, and from this
\ndevelop promising corrective strategies<\/p>\n

Option 4 – carry on doing what you are doing, but better<\/p>\n

Option 5 – save the world, and in doing so<\/p>\n

Option 6 – take heart from good news such as this12 .<\/p>\n

REFERENCES<\/p>\n

1. Mill. J.S. \u2018On Liberty\u2019 (1985 Penguin Classics)<\/p>\n

2. Duncan et al \u2018Harm Reduction\u2019 \u2013 an emerging new paradigm for Drug Education (1994 Journal of Drug Education)<\/p>\n

3. Trebach A. \u2018A Kinder War\u2019 (1993 Scientific American)<\/p>\n

4. Drug Policy Foundation\/Center for Disease Control \u2018Southeastern Harm Reduction Conference (1996 Conference Advisory)<\/p>\n

5. Maginnis R. \u2018Harm Reduction\u2019 \u2013 an Alternative to the Drug War ?\u2019 (1996 Family Research Council)<\/p>\n

6. McDermott P. \u2018Editorial\u2019 (1992 International Journal on Drug Policy)<\/p>\n

7. Cohen J. Clements I. Kay L. \u2018Taking Drugs Seriously\u2019
\n(1991 Healthwise)<\/p>\n

8. O\u2019Hare P, Cohen J, Clements I. \u2018Drug Education \u2013 a Basis for Reform\u2019 (1988 Drug Policy Foundation Conference)<\/p>\n

9. Fukuyama F. \u2018The Great Disruption\u2019 (1999 The Free Press)<\/p>\n

10. Stoker P. \u2018Moralising\u2026.Demoralising: The Fight over Personal and Social Education\u2019 (2000 pre-publication edition)<\/p>\n

11. Dennis Prof. N. \u2018Social Irresponsibility \u2013 How the Social Affairs Intelligentsia have Undermined Morality\u2019 (1997 The Christian Institute)<\/p>\n

12. Sullivan Dr. L \u2018Drug Policy \u2013 a Tale of Two Countries\u2019 (1999 News Weekly)<\/p>\n

\u00a0<\/p>\n

<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

Visby, Sweden \u2013 May 3rd to 6th, 2001 \u2018The History of Harm Reduction\u2019 Paper by Peter Stoker: Director, National Drug Prevention Alliance (UK). 1. Introduction With a title like \u2018the history of \u2026\u2019 you might reasonably expect a historian to be standing here, but I\u2019m not one. Nevertheless I can apply my experience to analysing […]<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[23],"tags":[],"class_list":["post-3317","post","type-post","status-publish","format-standard","hentry","category-harm-reduction"],"_links":{"self":[{"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/posts\/3317","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/comments?post=3317"}],"version-history":[{"count":0,"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/posts\/3317\/revisions"}],"wp:attachment":[{"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/media?parent=3317"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/categories?post=3317"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/tags?post=3317"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}