Exploring Politics, Practices, and Discourses of Harm Reduction in the Overdose Crisis: the Case of the Tenant Overdose Response Organizers and the “Therapeutic Riskscape”
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Harm reduction, its aspirations, politics, and discourses, have changed dramatically since its origins as a grassroots, drug user-led movement in Canada. Public health played a critical role in helping implement harm reduction, but in doing so has aligned it in ways that have accommodated neoliberal priorities and technocratic discourses, thus contributing to its depoliticization as a social movement. By absconding from meaningfully attending to social determinants of health, which underlie drug-related harm in favour of risk-mitigating individual approaches, public health’s implementation of harm reduction has fallen short in challenging social injustices and inequities at the root of Canada’s legacy of drug criminalization. The arrival of fentanyl and the overdose crisis in Vancouver’s Downtown Eastside (DTES) has proven to be a turning point in this history by leading marginalized tenants of privately-owned single room occupancy (SRO) hotels to organize overdose response for one another. In December 2016, the Downtown Eastside SRO Collaborative Society, a housing advocacy organization, partnered with public health to develop the Tenant Overdose Response Organizers (TORO) program, which uses community organizing to support these efforts. Through participant observation and key stakeholder interviews undertaken between November 2017 and April 2018, this research explores harm reduction’s politics, practices, and discourses through a case study of the novel, peer-led TORO program. I found that despite the hesitancy of public health to support housing advocacy as a critical component of harm reduction, TORO has supported SRO tenants in their responses to oppressive physical, social, and structural environments. My analysis of the work of TORO within the broader context of the DTES has also supported the development of the “therapeutic riskscape” as a theory that attempts to provide an approach to harm reduction that recognizes the recursive relationship between community-driven responses to structural environments and relational experiences of place-based healing.
URI for this recordhttp://hdl.handle.net/1974/24964
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