Harm Reduction as Pedagogical Praxis: Confronting Capitalism in the University Classroom.

• Date: 22 March 2023
• Author: Mackenzie, C.E.

From Syringe Exchange to the University Classroom

For years I spent my Monday nights parking an old RV at the terminus of Blair Street in Eugene, Oregon. Having stocked the RV with sterile needles, cookers, condoms, hot coffee, tampons, Naloxone kits, and day-old baked goods, the needle exchange (NEX) team and I would then climb in and head to the fray of downtown. We always parked on the same dead-end next to the railroad tracks to set up tables and unload supplies while clients gathered. Often the train thrashed past and I found myself trying to yell over the metal scream of tracks, have you exchanged needles with us before?! Collecting their used needles and offering packs of 27 and 29-gauged sterile syringes in return, the scene at exchange was one of motion--people coming and going, relationships forming, laughter alongside ache, and care as a humming, shifting thing.

Our knowledge on drug use has been manipulated and overexposed by the War on Drugs and the opioid epidemic. Told that drug use is only pathological, is only criminal and disordered, we are left to imagine rehabilitation as the only legible solution. But this narrative is coerced. It defines drug use through capitalism and manages the flow of profits through privatized carceral regimes. Meaning, drug use has been made a spectacle in order to maintain the image of the white, working citizen while simultaneously regulating, suppressing, and incarcerating communities of color. As I use it here, I borrow from Lauren Berlant (2011) to define capitalism as a force that overwhelms our lives and impels us always and inevitably toward profits and products, saturating our social worlds in consumption, commodification, and co-option (p. 192). At NEX, even as I saw people living dynamic, vibrant lives marked by care and connection, I also witnessed the body as exhausted by the compulsory demands of capital--that one pursue health, wellness, and recovery at all costs.

Rather than insist on recovery, rather than demand delineated futures, harm reduction rejects these iterations of capitalism to meet people in their moment of need. Harm reduction offers care without requesting one work toward recovery in order to access resources and services. Harm reduction links non-judgment with non-coercive service, describing drug use as multi-faceted and located on a continuum. Meaning, we're all in process. If traditional healthcare has privileged the cured condition, then harm reduction dismisses this "telos" (that there should be some defined end state) to instead take up the temporal uncertainties of the moment. Harm reduction recognizes that all of human experience hums within the mess of now, that we may or may not arrive at scripted destinations. We may not seek recovery, but that should not preclude access to needed resources, services, and care.

If we cannot escape capital--and I don't believe we can--how do we find ways to resist the force it applies to our bodies and the definitions it gives our lives? As I began my doctoral program, leaving street exchange for the university classroom, I began to translate harm reduction beyond public health. By subverting the recovery model and its capitalist logics, harm reduction is not only efficacious health policy, but a whole way of thinking rooted in care, temporality, and process. Its pedagogical possibilities could transform our classrooms.

In this essay, I first define harm reduction, expanding on my own experiences with my needle exchange crew in Eugene, OR from 2016 to 2018. I then translate these experiences into my teaching philosophies and methods that I developed as a TA, clarifying explicitly how harm reduction as pedagogical potential can deepen student engagement with their writing and work. I use an assignment I created called The Mixtape to illustrate the uses of harm reduction-driven pedagogy and to point toward ways of adapting harm reduction in our writing, rhetoric, and communication classrooms. Finally, I conclude with specific suggestions for those interested in pursuing this approach in their own teaching.

The Rhetorics of Harm Reduction and its Pedagogical Import

Our collective take on drug use in particular, but wellness more broadly construed, is rooted in capital. We need only look toward our origins. The US healthcare industry was founded through the imperialist drive to own and to make known, to make the flesh an identity, and to contain and "civilize" what was in excess. (1) C. Riley Snorton (2017) argues this explicit point when he asks, "What does it mean to have a body that has been made into a grammar for whole worlds of meaning?" (p. 11). Likewise, Siobhan Somerville (2000) lays bare the eugenic rhetorics that came to define early sexology, how sex and gender were braided within racial taxonomy to optimize a culture of regulation, what she names "a discourse saturated with assumptions about the racialization of bodies" (p. 4). By applying her analysis to rhetoric, Somerville brings attention to the recursivity of both bodies and languages, that "the particular meanings of socially constructed identities gain currency through repetition, resistance, and appropriation" (p. 14). The more we call someone "clean" the more we re-inscribe drug use as dirty. By regulating our definitions of health through recursive iterations of capital--through the teleological language of betterment, intervention, and progress--we coerce one another...