Harm Reduction and the politics of language.

Anyone who interfaces with the federal government will have noted its pathological phobia with the term “harm reduction”.  That generic set of two words that inferences that as humans we sometimes chose to engage in activities that have a higher risk for hurting or potentially even killing ourselves, and that we can reduce the likelihood of harm by invoking any variety of activities.  Helmets for cyclists and boarders, barrier and contraceptive protection for sexual intimacy, seat belts in cars, wearing sunscreen, donning a parka during the winter – the list can go on and something each of us engages in constantly in our lives without a second thought.

The more specific definition that has caused angst suggests harm reduction is an activity limited to persons who suffer from addictions, often but not exclusively associated with illicit drugs. This blog has spoken to many types such as supervised injection sites, cannabis decriminalization, needle exchange/distribution, methadone distribution programs, safer alcohol consumption guidelines, alcohol distribution in some homeless housing initiatives.   Some of these you may be comfortable with, others might cause some to raise their shackles as a stretch of their moral frameworks.

Health is a science and should be driven by evidence.  From a health perspective, many of the listed harm reduction for addictions result in a demonstrable benefit for individual and societal health.  Most have a net cost reduction to the taxpayer through deferred health and social services.  So they should be an easy sell. Differing perceptions of morality, religion and politics are often barriers to doing the right thing.   So how has the current government influenced the discussion on harm reduction.

So lets do an experiment and obtain some evidence.   Go to a government home page – we tried Health Canada and PHAC.  Take a search on the term “harm reduction.   Respectively the searchers returned 668 and 340 document references. Now try to learn about where public government documents reference harm reduction.  Most of the material is related to pesticide and product regulation so finding relevant materials is not as straightforward.   If you expand the search by collection on the right hand menu and pick “health concerns”, most of the addictions materials are listed, some 177 documents.   The PHAC site is more generic and most of the material returned is related to addiction concerns. Presented as a linear time trend as below:

As a reminder,  Harper was elected in 2006, reelected in 2008 and obtained a majority government in 2011. Minister Aglukkaq was first elected in 2008 and immediately began her long standing term as Minister of Health.   PHAC supposedly operates at arms length from the government, but is somewhat handcuffed by federal political structures.  

So, in a world where governments have long used manipulation of language and words to meet their own purposes – here is clear evidence of political ideology affecting the science of health and the operations of Health Canada.  And clear evidence of the social impact that governments can have by imposing views and curtailing dialogue – reminiscent of dictatorial regimes.