Online Drug Scenes and Harm Reduction From Below as Phronesis

Introduction

While only malevolence could logically be opposed to “harm reduction,” it is everywhere apparent that in social drug research and in policy, the efficacy of the concept and the practice of harm reduction are highly contested. The reasons for this are many and are perhaps nowhere better laid out than by Helen Keane (2003) in an article that explains the imbrications of harm reduction with the complex ethical and political dimensions of its theorization and its policy implications and practice. Keane eloquently illustrates how all parties to the debate on illicit drug use and “what to do about it”—from drug use libertarians through to anti-drug campaigners—are apt to deploy the conceptual resources of modern critical thought to claim the mantle of harm reduction. They do this, for instance, whenever the harms associated with both illicit drug use and drug policy are understood in terms of the suffering caused and endured or whenever a cost–benefit analysis of harm reduction strategies becomes the basis for calculating likely outcomes—very much along the lines of the consequentialist utilitarianism of Jeremy Bentham and John Stuart Mill. They also do this when they invoke the rationalist principle of individual freedom as both a foundational value to be defended and the ground upon which all forms of “control,” including drug use controls, must be assessed and evaluated. But when the discussion of harm reduction proceeds along these lines, Keane (2003) is clear, all roads eventually lead back to the question of who (or what) has the authority to define harm reduction.

Human rights discourse is no more helpful in resolving the question of who has such authority to define harm reduction, for it is fraught with irresolvable contradictions. For instance, if the actual reduction of harm is adjudged to be a purely empirical matter, then this is likely to conflict with the notion of the a priori right to liberty—namely, for the individual to do as he or she chooses. Individual human autonomy effectively remains the unexamined ground of the human rights perspective, but it is in fact an unrealizable ideal and thinking gets stuck, as Deleuze and Guattari (1987) might say, on the plane of critique, which could also be considered a kind of place or “territory” (MacKenzie, 2004, p. 48)—the significance of which will become clear as we proceed. There will therefore always be a “tension between a demand for care and protection by the state and a demand for freedom from state regulation” (Keane, 2003, p. 230). What the state grants with one hand is what it is already taking away with the other, not least because any claim to, or assertion of, authority—underpinning control over drugs and drug-taking—always begs the question of its legitimacy. As Judith Butler (1997) states in her discussion of censorship, any claim to, or supposition of, the sovereignty of a power (e.g., a state) is in reality a pretension disguising the fact that it can no more guarantee the freedom of the subject which it produces than it can its freedom from anything it is exposed to or has access to.

In this way, high-minded moralistic approaches to harm reduction—of either libertarian or anti-drug persuasions—can be argued to come from on-high (and always expressed via the “grander narratives” of freedom and morality, according to Keane). They both belong to an epistemic–juridical plateau above everyday life “drug worlds,” within which patterns of compulsion, recreation, and experimentation play out vis-à-vis drugs and drug use in a multitude of singular, actual situations. Some of these drug scenes may well include both reflection on and practical strategies for “less harmful drug-taking” on the part of the drug takers who populate them, with regard to their own immediate concerns for the implementation of “harm reduction” in situ. (And “harm reduction” is just one dimension of what it means to “do drugs well” or “badly,” from the perspective of users who may be in pursuit of a variety of effects.) In any case, users make choices in such contexts without waiting for supposedly sovereign powers to act on their behalf. Users act pragmatically from within the diversely contextualized settings of drug-taking itself. Furthermore, if the reduction of harm is simply asserted to be a de facto ethical good, then this is, arguably, just another kind of “pretension” insofar as it hides the fact that we are only ever able to think this equation of ethicality with the reduction of harm on the basis of the problematic entwinement of harm reduction as an idea with the concrete reality of drug-taking as a practice.

Keane (2003) is therefore correct to cite Stengers and Ralets’ (1997) attention to the milieu of drug-taking as central to a radical break with the familiar moralism and repetitive moralizing around the thematic of harm reduction. The importance of the concept of the milieu is twofold. First, there is simply no such thing as a “drug-free cultural milieu” (for the cultural whole is always already given, as much as by anything else, by its delimitation of drugs and its relations to them). ² Second, there is simply no place (lieu) from which to morally pontificate on the matter. If there is no clear divide between “drug culture” and the rest of culture, it would be inconsistent not to acknowledge that the cultural resources for critically conceptualizing and debating harm reduction were themselves not already shaped by the broader cultural totality of which drugs are a determining part (see Boothroyd, 2006). So, rather than interminably revisiting and repeating the arguments surrounding its definition in the discourse of consequences versus rights, or anticipating a philosophical and theoretical resolution of the conundrum, the discussion must move toward the rethinking of the “ethics of harm reduction” at the pragmatic level of actual drug scene milieus (of which, we aim to show, online drug culture is an important dimension). In such scenes, which give form and content to a milieu, the morality of drug-taking, at least in the above senses, is simply not an issue. But it remains an ethical matter in a deeper sense and requires to be understood in an entirely different register—for example, in terms of the ethical subjectivities that specific drug scene milieus give rise to. Thinking harm reduction, and understanding the subjectivities wrapped up in it, must therefore proceed in conjunction with the milieu (Stengers, 2005). ³

Elsewhere, Stengers (2008) explicitly expresses her own indebtedness to the “collective voice from below” of drug user groups and references this in relation to her account of the pragmatics of subjectivity and its production in general:

My own intellectual and political life has been marked by what I learned from the appearance of drugs users’ groups claiming that they were “citizens like everyone else,” and fighting against laws that were officially meant to “protect” them. The efficacy of this new collective voice, relegating to the past what had been the authorized, consensual expertise legitimating the “war on drugs,” convinced me that such events were “political events” par excellence, producing … both new political struggle and new important knowledge. I even proposed that what we call democracy could be evaluated by its relation to those disrupting collective productions (Stengers & Ralet, 1997). A “true” democracy would demand the acceptance of the ongoing challenge of such disruptions—would not only accept them but also acknowledge those events as something it depended upon. (Stengers, 2008, p. 39)

By “practical wisdom,” we allude to the Aristotelian sense of phronesis, a form of knowing that combines the performance of one’s “well-being” with an ethical sense of pursuit of the “good life” (as distinct from episteme, which corresponds to scientific knowledge, and techne, which corresponds to skill or craft). ⁴ Our purpose in deploying this terminology stems from the desire to think through the ethics of harm reduction from the perspective of drug-taking itself, as it were, and to do so on the basis of an evidence base both constituted and rendered analyzable by virtue of its manifestation, expression, and publicity as online drug culture. Through an analysis of the data collected over an 11-month period from a cross section of drug use web forums, blogs, and story sites, our study aims to better understand how “harm reduction from below” is being practiced—an analysis which eschews the ultimately all-too-conventionally philosophical, and all-too-human-centered, debates about the ethics of harm reduction, articulated in terms of either consequentialist or deontological ethical theories. We argue that harm reduction understood in terms of phronesis—as a form of ethical practice based on knowledge derived from experience—is instantiated and available for investigation as a mediational cultural form. It is part of a drug use assemblage and as such it takes place and happens “online” just as much as it happens anywhere else: The online is a materially manifest dimension of “doing drugs” for many people, just as many other aspects of daily life today are subject to mediation and are empirically approachable in this dimension and on this basis.

Phronetic Social Enquiry

Reference to phronesis in the context of contemporary social enquiry is not in itself new. It is perhaps most closely associated with the work of the Danish sociologist Bent Flyvbjerg (2001; Flyvbjerg, Landman, & Schram, 2007). Flyvbjerg calls for a radical shift in the self-understanding of social enquiry and for its redirection toward

enhancing a socially relevant form of knowledge, that is, phronesis (practical wisdom on how to address and act on social problems in a particular context) … Phronesis in this sense is knowledge that is sensitive to its application in specific settings and is therefore able to manage itself (and more), which is what gives it prominence in social thought and action. (Flyvbjerg et al., 2007, p. 1)

Phronetic social science differs from traditional social science in that it rejects the privileging of the epistemic principle of modernity that expert knowledge alone can solve the social problems that it abstractly identifies and describes. It recognizes that the capacity to “live better” or to “live well” in relation to such things as the epochal dysfunctionality surrounding the relationship between drugs and society is located within the nexus of practices that constitute the sociopolitical context of a society and the specific constellation of relationships to the supposed “source”—in this case, the conventionally hypothesized “cause”—of harm. This is more generally the case with whatever supposed “social toxin” is singled out as a source of harm to individuals, groups, or society as a whole. The Flyvbjergian account of phronetic social science acknowledges that the social subject in a specific situation and from a particular perspective already knows the risk/danger of harm. No matter how well or how badly social subjects are able to address and live with the risks and dangers associated with certain social situations, the fact is they are living such situations. The traditional academic researcher only knows about them and produces knowledge about them (in Aristotle’s schema this corresponds to episteme). The argument of phronetic social science is that episteme without phronesis will always fail to accomplish a properly ethical relationship to the “problem” and that “social problems” are always contiguous with the question of how to live well.

This approach thus recognizes the specific value of what is learnt/known from this living-out, or living-with, “the problem”—in our case, the problem (and the undertaking) of “how to live well with drugs.” Emphatically, it does not mean that only those who are actual drug users can participate in the working out of how to live well with drugs (such that all social drug researchers should become drug users so as to better understand the reality of drug-taking). But it does call for valuing what can be learnt about how to live well with drugs from the specific relationships drug users have with drugs and from within the ecology of practices that encompass their drug use. As Stengers (2005, p. 187) states, “no theory gives you the power to disentangle something from its particular surroundings.” This involves more than allowing the “voice” of drug users to be heard and learning from what it has to say—although we do contend this is one implication. It also involves paying attention to how drugs and drug use affectively influence and give form to communicative drug milieus. A more important implication is that attaining phronesis with respect to drugs involves considering how practices of researching the drugs field intersect and interact with the practices of drug-taking and drug culture more widely. (The research of harm reduction itself—either in practice or as a substantive theme—is essentially a part of the same ecology of practices.) Drug researchers and drug takers are thus to be viewed as located in different, yet overlapping, situations, and are thus equally oriented toward the same “ethical problem” with respect to drugs. Whether we should indeed continue to refer to this as the problem of harm reduction at all or whether it is better to speak of the “quest to get along well with drugs” remains to be seen.

The Mediation of Drug Culture and the Study of Online Harm Reduction

To meet the universe of drug-taking half way, phronetic social scientists must be prepared to divest themselves of the epistemological privilege normatively afforded to the discourse of representation along with its supposed power of truth telling, understood in terms of the power to distinguish between veridical representation and misrepresentation. Rather than mediate between one realm of “the real” and its representation in the account (logos) given of it—a “spectator theory of knowledge” (Frank, 2007, p. 56)—phronetic social science recognizes that knowledge is always relational, dialogical, and participatory (Frank, 2007). We argue that in the context of researching online drug culture, this difference corresponds to the transition from the age of mass media to the age of networked media. So, when considering harm reduction in the contexts of online drug culture, what needs to be understood and clarified is not, for example, how harm reduction and drug scenes are represented “in the media” or “by media” (including technical reports and medical textbooks as much as TV, newspapers, etc.) but rather how drug scenes have come to inhabit media—how they are literally in the media, such that we can identify them meaningfully as being in media res (in the midst of things).

The study of online drug culture on which this article is based was carried out as part of a multiresearcher, transdisciplinary project examining the roles of trust and empathy in online communications around “situations of extremis.” ⁵ Boothroyd is a media theorist/philosopher whose background includes writing on drugs and drug culture; Lewis is a sociologist of health and illness experienced in the research of online communities. These biographical details are noted because, consistent with our theoretical starting point, such parameters are materially relevant to the process of developing a research design and methodology to meet the research object as such. (The point we are making here is that every research situation is unique, not simply a scenario in which the conventions of professional expertise and skills are deployed by anyone-whoever or by-any-means-whatever.) It is not so much the case that there are few conventions to simply adopt and apply to the study of online life, but that every research project is contingently constituted by the assemblage, or the ecology of practices, with which the research process “conjoins.” Expressed simply, our study is of the online drug scene it is enmeshed with (the “of” in this phrase being a double genitive.)

A simplistic way of thinking of online drug culture is to think of it as existing “on the Internet” or “on the web.” The Internet is conventionally thought of as a medium, the means by which Internet culture is carried. The Internet is, of course, a technical apparatus and infrastructure comprising of globally interlinked hardware devices of many kinds, software and cables, and so forth. The web, on the other hand, is ostensibly a metaphor expressing a popular way of imagining the operation of supposedly higher level fluid, dynamic, and evolving connections between entities—between people, websites, platforms, organizations, governments, lurkers, stalkers, texts, images, videos, software programs, and protocols communicating with one another, and so forth, ad infinitum. But given our characterization of online drug culture as the (Internet/web) manifestation of drug culture per se, studying it, we contend, should begin by considering how various scenes are internally and externally bounded in relation to everything else online, and not least by the various technical aspects of platforms and programs that determine each scene’s communicative capacities. It is in view of this that we devised a framework for examining what we think of, by way of another common metaphor in social science, as a “cross section” of that culture—effectively a sample, a sort of biopsy of the culture as a whole. Any such cut is a pragmatic decision taken in relation to many variables, but these were perhaps the most significant for our study: (1) variety of data gathered across a manageable number of online settings, (2) suitability of the sample in relation to the subject matter, and (3) diversity of drugs and drug culture practices—necessarily limited by precisely such research design decisions.

A communicative environment dedicated to drugs and drug use that expresses a specific cultural formation within the wider, open, hyperlinked system can be considered an entity based on how it is bounded (Paul, 2007). This is so in the same way that there are disciplinary conventions that determine and define, for example, the kinds of objects of study that are normatively considered to belong to one discipline rather than another and are investigated by means of methodologies established and legitimated within that discipline. While online communications are in reality fluid, dynamic, and indeterminately interlinked, there are nonetheless obvious candidates that can serve as relatively stable online settings. We therefore decided to focus on a set of web forums, “story sites,” and blogs that between them cover three relatively distinct typologies of drug use. These are “novel psychoactive substances” (NPS)/“legal highs,” ⁶ “addictive drug use,” and “non-medicinal use of prescription drugs.” ⁷

Conclusion: Harm Reduction as Phronesis or “Doing Drugs Well”

Across a broad spectrum of online drug scenes, our study revealed a culture of communicative sharing around illicit drug use that demonstrates a popular culture of “best practice” rooted in experience and know-how of illicit drug-taking. The manifest culture of caution, care, and responsibility, the management of risk and danger in relation to drug-taking, however questionable its “efficacy” may be from the perspective of various forms of “drugs expertise”—including harm reduction expertise—can be viewed, firstly, as evidence of a general and widespread “harm reduction ethos.”

To conclude, we return to how harm reduction practiced from below problematizes the conventional understanding of harm reduction, which we argued cannot escape the question of who or what has the authority to define harm reduction. We did not set out to empirically assess whether or not online drug culture contributes to (or undermines) harm reduction, as it is understood from within its various institutional settings and policy deployments. Nor did we attempt to measure the effectiveness or impact of the various kinds of co-created drug use knowledge and advice on the actual practices of drug users. Our study instead aimed to show how drug users, as evidenced in a variety of online drug cultural settings, are involved in working out for themselves how to get along better with the drugs they take—on their own terms. Every drug taker’s “terms” are arguably unique; drug use situations differ widely and no doubt partly determine how any particular drug use scenario turns out for those involved. But at least for the participants of online drug culture, their terms of engagement with drugs are also partly constituted and expressed by the online spaces in which this culture takes place and is shared. These are scenes in which best practice and the meaning of “best practice” are continuously worked out in conjunction with and within a multitude of drug-taking contexts. In conjunction, that is, with the wider dynamic ecology of drugs and drug use practices, which include informational practices such as publicity, communication, and dissemination. Some of these are institutional and scientific (including social scientific). Many are not. But they all directly or indirectly find their way into the online deliberations surrounding the drug use of online users by, literally, becoming part of the milieus of their drug use.

In many ways, it is only too easy to identify evidence of a harm reduction ethos in such cultural spaces, but doing so inevitably proceeds on the basis of a concept of harm reduction that has its normative roots in wholly other kinds of “institutional” cultural spaces. ¹² Its discursive power shapes the thinking of social drug use researchers and drug users alike—how could it not (for we authors as much as anyone else)? To a degree this is reflected also, as we have shown, in harm reduction talk in online drug culture settings. The practice of drug-taking, however, is aimed at performing drug use in such a way that it accomplishes something for the user—a particular high, a mood change, even oblivion—to make the next moments of life as it is lived “better” than the present. So while raising the issue of who has the power to define harm reduction is crucial, it is equally important to question the assumption that the “primary issue” for drug users (as individuals, as a group, or as a community) is that of potential harm (notwithstanding the day-to-day concerns that arise from impurities, the unidentifiability of powders and pills, the availability of clean drug paraphernalia, illegality of acquisition, and etc.—all of which are indisputably sources of potential harm.) For at least some people, their drug-taking practices are aimed at reducing the “harm” a life of sobriety inflicts on their projects of living well.

It is difficult not to think of the quest for a “healthier” relationship to drugs, on a personal or societal level, other than on the basis of health and well-being as defined by medical discourses (along with other juridical and political discourses surrounding acceptable behavior). It would then follow logically that the harm reductionist approach toward for instance addiction should seek its decriminalization and argue for its medicalization. After all, the underlying assumption is that drugs are first and foremost “medical substances” and that the pharmaco-medical management of their use and their users is ultimately what is propitious. But what is obscured or concealed by this dominant model of harm reduction—which with all good (moral) intentions aims to alleviate the perceived harms of drug-taking in anything less than “ideal circumstances”—is the presumption that lives lived “on drugs” have little or nothing to offer in terms of the account (logos) they might give of themselves. Our claim is that the online dimension of such “drug lives” is a dimension of culture, a space or place where, at least to a degree, this becomes possible.

What we have observed in such online settings is the working out of a multifarious range of relationships to drugs by users, relationships that reveal aspects of drug use aimed at getting along better with drugs. These are relationships in which drugs themselves, in a kind of symbiosis with life online and within a wider ecology of practices surrounding their use, aim for a kind of practical wisdom (phronesis) about drug use. While individuals may judge one another around what they consider to be correct or incorrect, good or bad advice, and with regard to who among them speaks with authority, judgment per se is less important than the collective quest of “getting it right” in practice and in situ.

It is this that warrants, we suggest, referring to scenes of practice as phronetic. While expert knowledge (episteme)—well or poorly appropriated—figures in these cultural scenes to a greater or lesser extent, and skill or craft (techne) with respect to drugs (handling, sourcing, preparing, injecting, and etc.) is highly valued, such forms of knowing are, for the drug user who has “just said yes” to their drug, subservient to the aim of “doing drugs well.” What doing drugs well means, however, cannot be generalized. It is possibly not only different for each individual but also for every single instance of use, because every situation is unique and always shaped by multiple variable parameters—the drug in question, the supposition of its purity, the current health status of the taker, the presence of friends, polydrug use, and so forth. But the meaning of the expression is, emphatically, neither the point nor directly the concern of practical wisdom: Phronesis refers to the practice or performance of life itself and, by definition, doing it well can only be learned from life itself.