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American Journal of Public Health ; 112:S99-S103, 2022.
Article in English | ProQuest Central | ID: covidwho-1777065

ABSTRACT

The harm reduction approach entered British national policy after the Thatcher government-which was no friend of the welfare state-accepted the 1988 recommendation of the Advisory Council on the Misuse of Drugs, which asserted that preventing HIV transmission was more important than insisting that people stop using heroin.16 Rates of HIV and hepatitis C among people who inject drugs are still much lower in the United Kingdom than in the United States. Since the 1990s, support for harm reduction in UK policy and funding has waxed and waned. Cuts to treatment budgets, recommissioning of treatment services, and a push for people to leave treatment drug-free were followed byannual increases in drug-related deaths starting in 2013 and a decrease in the number of people in treatment.20 The most recent UK government drug strategy (published in December 2021) makes little direct mention of harm reduction but does include it in the wide range of services in which GBP780 million of new funding is to be invested from 2022 to 2025 in England.21 The UK government is also reviving punitive rhetoric alongside its new investment in treatment services, blaming drug users rather than blanket prohibition for the harms of organized crime and ruling out DCRs on spurious legal grounds.22 It was left to an activist with a lived experience of problematic drug use to set up the first overdose prevention service in the United Kingdom, which they did in a secondhand vehicle on the streets of Glasgow in 2020-2021. Graduated goals meant that treatment "should not only aim to 'heal' addiction, but to provide rehabilitating measures while drug abuse continues"28(p132) and should include basic improvement of physical health and improvement of the situation of those who use drugs, including through abstinence. Danish drug policy as It was developed during the 1960s and 1970s was based on the Ideas that criminal sanctions should reduce the supply of drugs and that social welfare measures should reduce the demand for drugs.29 This meant that possession of Illicit drugs for personal use was depenalized from 1969 to 2004.

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