Helping People Help Themselves? The Role of Institutionalized Peer Involvement in European Harm Reduction Organizations from a Prefigurative Politics Perspective

Abstract

Introduction: Harm Reduction started off as a movement based in prefigurative principles in response to the AIDS/HIV crisis. It sought to reduce harm experienced by people who use drugs by addressing root societal causes of drug use. However, Harm Reduction has since been overshadowed by its institutionalized branch, causing displacement of people who use drugs (peers) from caring for their own communities. There is a distinct lack of prefiguration-centric and European studies regarding peer involvement in institutionalized harm reduction, which the present study is trying to address. Research Questions: In present-day European contexts of institutionalized harm reduction, how does peer involvement show up, if at all? What does such (non)involvement prefigure? Framework & Methodology: By using Törnberg’s (2021) typology of five transition pathways to prefigurative social change, the present research abductively analyzes 25 semi-structured interview excerpts from 2022 where representatives of local harm reduction organizations discuss peer involvement. Results: A wide range of themes concerning modes of peer (1) involvement, (2) work, (3) self-organization was found along with (4) a political-cultural-financial nexus and (5) social network dynamics that further inform the context for peer engagements. Respectively, instances of (1a) tokenized involvement, (2a) employment conditional on appearing functional, (3a) lacking means to organize, (4a) punitive “harm reduction” services accordingly prefigure futures that do not take peers seriously. On the other hand, correspondingly, instances of (1b) meaningful empowered involvement, (2b) workplace accommodations for peer needs, (3b) thriving peer-led organization, (4b) refusal of inadequate funding schemes, and (5b) non-peer organizations helping establish peer-led initiatives all prefigure futures that take peers seriously. The latter set has the potential to spur change in the harm reduction landscape given sufficient development and an inciting landscape change, as per Törnberg’s theory. Conclusion: Five themes arose from the analysis with different instances manifesting through individual codes, ranging from practices that suggest peers are taken seriously to not at all. Theoretical limits meant that despite novel contributions, further theoretical syntheses were needed to better understand the subject matter. Prefigurative practices and their spread in harm reduction remain an open question.