Harm reduction and the ethics of drug use: contemporary techniques of self-governance

ABSTRACT

Drawing on Foucault’s conceptualisation of power, this paper examines public health as a distinctly modern regime of governance. An account of the historical regulation of drug use is traced in order to examine socio-historical shifts and lines of continuity in contemporary technologies of harm reduction. Using qualitative interview data, we examined practices of power in the context of contemporary drug use, including self-governance using techniques of monitoring, self-management and self-tracking. Participants’ accounts revealed that they were encouraged to self-govern their drug use through a variety of reformist technologies that are embedded in harm-reduction programs. It is argued that participants’ subjectivity is formed at the intersection of authoritative governance and self-governance, through ethical practices of the self which have emerged from disciplinary health practices, and incorporate the body as the site of power. We illustrate this by drawing a distinction between hygienist and sanitationist practices of public health. These governmental practices, which are embedded in public health programs, encourage people who use drugs to transform themselves into moral citizens, aligning their ethical practices with governing interests.

KEYWORDS:

• Self-governance
• drug use
• public health
• practices of the self
• power

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1. In this paper we use the term ‘illicit’ to describe the use of illegal substances, or the use of legal substances in ways other than that which is intended or prescribed. We also use the terms ‘addict’ and ‘recreational’ in places where respondents identified as such or where we are describing an historical concept of drug use. We acknowledge that the concepts of addiction and recreational drug use are complex and contested, and references to ‘addicts’, ‘addiction’ or ‘recreational drug use’ in this paper are in no way intended to describe the characteristics of the respondents.