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“Shelters are no different from a jail”: Historical Trauma, Biopower, and Culturally-grounded Harm Reduction Initiatives in Aboriginal Communities

Montgomery, Enkhe-Tuyaa

Harm reduction exists antithetically to abstinence-only treatment, wherein the focus is to both reduce the negative effects of substance use without necessarily extinguishing the problematic health behaviors completely, and to alter the material and social conditions predicating harmful substance use. It is more importantly a means by which disaffected groups can unite and seek mutual liberation through the lens of public health and social justice. While harm reduction’s origins lie in radical politics, its current iterations in Canada are becoming increasingly neoliberal in practice and ultimately present a barrier to healing and recovery to those most affected by systems that create conditions for drug-related harm. The state’s institutionalized responses to substance use, including child removal, drug courts, and abstinence-only homeless shelters, represent oppressive biopolitical interference with Indigenous existence and mirror practices of carceral genocide enacted by the Indian Residential School (IRS) system. Harm reduction initiatives are intended to exist in opposition to these practices, yet ultimately fall short and indeed enforce harmful settler hierarchies. Settler-colonialism and the open wound of historical trauma left upon Aboriginal communities by this system—manifesting as higher rates of violence and substance use, among other disparities—remain unaddressed by most harm reduction initiatives that are not culturally safe or specific. The pathologization of substance use disorders (SUD) as an individual issue among Aboriginal peoples minimizes the culpability of the state in enacting community-wide, historical traumas that are specific to Aboriginal peoples. This review attempts to advocate for culturally-grounded harm reduction initiatives for Aboriginal peoples in Canada, utilizing a sociohistorical analysis that draws a narrative link between projects of governance and notable manifestations such as residential schooling, historical trauma, contemporary substance use, and the failure of sanitized neoliberal harm reduction initiatives that do not provide genuine recovery for Aboriginal peoples residing in the fourth world. This paper closes with an analysis of salient themes from Aboriginal-led, culturally grounded harm reduction initiatives, and a recommendation for further emphasis on community-based care.

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More About This Work

Academic Units
Sociomedical Sciences
Thesis Advisors
Hopper, Kim J.
Degree
M.P.H., Mailman School of Public Health, Columbia University
Published Here
April 12, 2021