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Harm Reduction and drug use

beTWeen ProHibiTion, PUblic HealTH anD socieTal rUles Anne Coppel 18 19


ith the exception of foodstuffs, there are no substances on earth which have been so closely associated with the lives of people in every country and in every age. Humanity uses them deep in primeval forests, in leaf huts […] people use them in the splendour of civilisation. […] For some, they light the darkest night of passions with moral impotence, for others, they accompany hours of the purest joy, the happiest states of moral wellbeing or serenity’, wrote Louis Lewin in his introduction to Phantastica. Published in 1924, this was one of the first works to summarize psychotropic substances (Lewin 1928). For thousands of years, humans have indeed consumed what today we call drugs, but it was not until the middle of the 19th century that scientists grouped together these ‘artificial stimulants of the brain’ and implemented the first public health policies. At

Anne Coppel is a sociologist specialising in the field of drugs and HIV/AIDS policies. From researching to putting that research into action, she has been behind experimental projects which have helped bring about adoption of the harm reduction policy with community health activities in Paris region: the Bus des femmes, an early experimental methadone programme in 1989 and creation of a care and treatment centre in Bagneux in 1993, followed by another one in Paris in 1995. A committed campaigner, she has led the French public debate since 1993 as chairwoman of ‘Limiter la casse’, an inter-organisation collective and then of the French Harm Reduction Association. She has written numerous articles and publications and is the author of three books: Coppel A & Bachmann C 1989, Le Dragon domestique. Deux siècles de relations étranges entre les drogues et l’Occident, Albin Michel. Coppel A 2002, Peut-on civiliser les drogues ? De la guerre à la drogue à la réduction des risques, La Découverte. Coppel A & Doubre O 2012, Drogues, sortir de l’impasse, La Découverte.

the time, the main blight on society was alcohol, but by reinstating prohibition for opium and other narcotic substances, the international agreements of 1909 and 1912 created an exceptional regulatory system which would increase the intrinsic dangerousness of the products. In this way, the history of drugs, illicit by definition and as opposed to medicines, began exactly a century ago. Why was this exceptional regulatory system adopted? In what way were 19th-century health policies gradually diverted and used for the fight against ‘drugs’? Why is this exceptional regulatory system making such a comeback today? What regulations governing use are they based on? What future drug policies may be hoped for?

Before drugs became drugs The history of drugs is also that of their control. But until the 19th century and with few exceptions, people have lived with these substances without feeling that they were a scourge which needed to be fought against. In traditional societies, drugs were only evoked when being blessed. The Maya praised ‘the flesh of the gods’, the sacred mushrooms which opened the way to immortality; the Inca revered Mama Coca, the goddess of health and happiness; and it was ‘the plant of joy’ that Sumerian tablets celebrated in 4000 BCE. Considered by ethnologists like Peter Furst to be ‘founding experiences of human culture’, the use of psychedelic substances in traditional societies had a religious function which could also be therapeutic (Furst 1974). In some cultures, only the shaman had access to the sacred plant by which he physically

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The history and Principles of Harm Reduction  

Between public health & social change.

The history and Principles of Harm Reduction  

Between public health & social change.