In terms of drug policy, harm reduction is broadly defined as a range of pragmatic and evidence-based policies, which primarily attempt to reduce the negative consequences associated with drug use. Harm reduction strategies target a variety of risks associated with drug use and misuse, including adverse health, social, and economic consequences. Harm reduction’s defining features include a focus on preventing harm, rather than preventing drug use, and a commitment to respecting users’ human rights. Harm reduction programs also provide resources and referrals for treatment, but respect user autonomy – meaning abstinence is not necessarily required.
Many countries around the world have implemented an array of harm reduction strategies and experienced success. Harm reduction strategies are generally designed to prevent overdoses and the spread of bloodborne infectious diseases, and data shows that the programs are successful in doing both. Ones most familiar to people in the U.S. might be syringe access programs (or needle exchanges), and opioid maintenance therapy (methadone or buprenorphine). However, other countries have seen success in employing more controversial harm reduction programs, such as safe injection sites. An even newer, and more controversial, form of harm reduction program was implemented in Brazil only a few years ago, and it received a wave of praise and criticism all at once.
De Braços Abertos (Open Arms) was implemented in São Paolo in February 2014, and was designed to emphasize social care rather than policing and prohibition. The program was started by the former mayor Fernando Haddad, and is city-run. It was created to intervene in and curb the city’s large open-air drug market, the neighborhood known as “Cracolândia” (Crackland).
Open Arms was built on research that correlated crack use and continued relapses with social vulnerability in Brazil. Program participants are provided a cash stipend and shelter within the Cracolândia neighborhood hotels or older buildings in exchange for completing small tasks or jobs, and abstinence is not required. The Brazilian Platform for Drug Policy reported that two thirds of program beneficiaries claimed to have reduced their crack consumption. Many viewed the program as a successful way to integrate crack users back into society, and an opportunity to teach and engage current and former users to overcome tertiary issues that contribute to their drug habits. Many participants had formerly faced repression, exclusion from outside society, or spent time in prison due to punitive government measures. Before administration changes (there was recent mayoral election that heavily focused on shutting Open Arms down), Open Arms was trying to address issues of drug trafficking within the hotel shelters, and planned to relocate outside of Cracolândia to provide a change in environment. However, the program was significantly downsized recently following the mayoral election, with the goal being to shut it down completely in favor of a more prohibitionist approach.
At its core, Open Arms represents an intriguing innovation in drug policy – one that leans into the goals of harm reduction and truly focuses on reducing the negative consequences of addiction. While its tactics may not be widely accepted, not all drug policies share the same goals. Open Arms seeks to give residents of Cracolândia an opportunity to improve their lives, while respecting the integrity inherent in all human beings…without the stress or potential barrier of requiring abstinence.A Harm Reduction Experiment in Brazil
In terms of drug policy, harm reduction is broadly defined as a range of pragmatic and evidence-based policies, which primarily attempt to reduce the negative consequences associated with drug use. Harm reduction strategies target a variety of risks associated with drug use and misuse, including adverse health, social, and economic consequences. Harm reduction’s defining features include a focus on preventing harm, rather than preventing drug use, and a commitment to respecting users’ human rights. Harm reduction programs also provide resources and referrals for treatment, but respect user autonomy – meaning abstinence is not necessarily required.
Many countries around the world have implemented an array of harm reduction strategies and experienced success. Harm reduction strategies are generally designed to prevent overdoses and the spread of bloodborne infectious diseases, and data shows that the programs are successful in doing both. Ones most familiar to people in the U.S. might be syringe access programs (or needle exchanges), and opioid maintenance therapy (methadone or buprenorphine). However, other countries have seen success in employing more controversial harm reduction programs, such as safe injection sites. An even newer, and more controversial, form of harm reduction program was implemented in Brazil only a few years ago, and it received a wave of praise and criticism all at once.
De Braços Abertos (Open Arms) was implemented in São Paolo in February 2014, and was designed to emphasize social care rather than policing and prohibition. The program was started by the former mayor Fernando Haddad, and is city-run. It was created to intervene in and curb the city’s large open-air drug market, the neighborhood known as “Cracolândia” (Crackland).
Open Arms was built on research that correlated crack use and continued relapses with social vulnerability in Brazil. Program participants are provided a cash stipend and shelter within the Cracolândia neighborhood hotels or older buildings in exchange for completing small tasks or jobs, and abstinence is not required. The Brazilian Platform for Drug Policy reported that two thirds of program beneficiaries claimed to have reduced their crack consumption. Many viewed the program as a successful way to integrate crack users back into society, and an opportunity to teach and engage current and former users to overcome tertiary issues that contribute to their drug habits. Many participants had formerly faced repression, exclusion from outside society, or spent time in prison due to punitive government measures. Before administration changes (there was recent mayoral election that heavily focused on shutting Open Arms down), Open Arms was trying to address issues of drug trafficking within the hotel shelters, and planned to relocate outside of Cracolândia to provide a change in environment. However, the program was significantly downsized recently following the mayoral election, with the goal being to shut it down completely in favor of a more prohibitionist approach.
At its core, Open Arms represents an intriguing innovation in drug policy – one that leans into the goals of harm reduction and truly focuses on reducing the negative consequences of addiction. While its tactics may not be widely accepted, not all drug policies share the same goals. Open Arms seeks to give residents of Cracolândia an opportunity to improve their lives, while respecting the integrity inherent in all human beings…without the stress or potential barrier of requiring abstinence.
