Exploring Politics, Practices, and Discourses of Harm Reduction in the Overdose Crisis: the Case of the Tenant Overdose Response Organizers and the “Therapeutic Riskscape”
Bibliographic record
Abstract
Harm reduction, its aspirations, politics, and discourses, have changed dramatically since its origins as a grassroots, drug user-led movement in Canada. Public health played a critical role in helping implement harm reduction, but in doing so has aligned it in ways that have accommodated neoliberal priorities and technocratic discourses, thus contributing to its depoliticization as a social movement. By absconding from meaningfully attending to social determinants of health, which underlie drug-related harm in favour of risk-mitigating individual approaches, public health’s implementation of harm reduction has fallen short in challenging social injustices and inequities at the root of Canada’s legacy of drug criminalization. The arrival of fentanyl and the overdose crisis in Vancouver’s Downtown Eastside (DTES) has proven to be a turning point in this history by leading marginalized tenants of privately-owned single room occupancy (SRO) hotels to organize overdose response for one another. In December 2016, the Downtown Eastside SRO Collaborative Society, a housing advocacy organization, partnered with public health to develop the Tenant Overdose Response Organizers (TORO) program, which uses community organizing to support these efforts. Through participant observation and key stakeholder interviews undertaken between November 2017 and April 2018, this research explores harm reduction’s politics, practices, and discourses through a case study of the novel, peer-led TORO program. I found that despite the hesitancy of public health to support housing advocacy as a critical component of harm reduction, TORO has supported SRO tenants in their responses to oppressive physical, social, and structural environments. My analysis of the work of TORO within the broader context of the DTES has also supported the development of the “therapeutic riskscape” as a theory that attempts to provide an approach to harm reduction that recognizes the recursive relationship between community-driven responses to structural environments and relational experiences of place-based healing.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.012 | 0.013 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.054 | 0.061 |
| Scholarly communication | 0.019 | 0.008 |
| Open science | 0.003 | 0.013 |
| Research integrity | 0.006 | 0.014 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".