When Marlatt spoke about what harm reduction means in other countries such as the Netherlands, I was surprised at the approach those foreign countries took to control the consequences of drug usage and prostitution. I definitely felt like one of those foreign visitors when I read the chapter, “struck with what appears to be a liberal and permissive approach to drugs and sex”. (31) As we know, in the United States, it is illegal to use illicit drugs like marijuana, and if you get caught using it or possessing it, the police will arrest you and eventually, you will be sent to court and even perhaps to jail for breaking the law and taking part in life-threatening activities. Sure, there is rehab but that’s usually not until you go through all of these criminal proceedings. However, in places like Amsterdam, their public health policies are quite the opposite. They are not particularly promoting drug use and unsafe sexual activities, but they are doing what they can to help the people avoid facing the consequences of engaging in these matters. It is shocking to me to hear about how accessible drugs are given to its users in settings like the “coffee shops” but yet I am rather relieved that free sterile syringes, and condoms are widely available too to back up those actions. I understand that many people just can’t help it but to keep using drugs due to addiction or having sex with strangers because that is their way of making a living so at that point, it would be quite ineffective to have the justice system jump in and make these people’s lives more difficult just like what happened in the War on Drugs. I personally believe too that it is more effective to have these low-threshold and high-threshold programs which gives these people a variety of options on how to go about getting their lives back together and not fall under pressure with the government on how they should live their lives that I’m sure these people consciously chose to live.

It seems as if the United States would be much more efficient in following through with the Dutch model of harm reduction but I know it would be very controversial because it would seem as if the government doesn’t mind that all these illegal and dangerous activities are allowed or even favored. I think the government has to realize that the reason there are laws on these matters is because using drugs and having many sexual partners without protection can lead to very bad consequences for everyone involved in it. If these actions were beneficial to our health, of course there wouldn’t be laws limiting these actions. We have to get over the stigma we expect and protect our people the best way over the reputation we want. The Dutch model strikingly reminds me of the van we visited on our Coney Island class trip that gave counseling, free sterile syringes, condoms, etc. Their goal wasn’t to encourage people to do more drugs and sex to ruin their health or to arrest these ‘potential criminals’ but to support them in being as healthy as possible while doing these things and hopefully, on their way to ending their drug usage and safe from diseases like STDs, HIV and AIDs. Perhaps that van is the start of a new and reinvented approach to dealing with these public health matters in the United States.

Do you think the current way of harm reduction in the United States is ideal, or is there a more effective, efficient and productive approach?