Drugs, Communities, and “Harm Reduction” in Germany: The New Relevance of “Public Health” Principles in Local Responses
Drugs, Communities, and “Harm Reduction” in Germany: The New Relevance of “Public Health” Principles in Local Responses
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德国的毒品、社区和“减少危害”：“公共卫生”原则在当地应对措施中的新意义
DOI：
10.2307/3342618
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发表时间：
1995
影响因子：
3.8
通讯作者：
B. Fischer
中科院分区：
文献类型：
--
作者：
B. Fischer
德国的毒品政策目前正在经历戏剧性的变化，不再以镇压和强硬禁令为主导。然而，最近的举措(非刑事化、“低门槛”社会服务、针头交换、鸦片替代方案等)的一个关键部分。界定公共系统和吸毒者之间新的互动的政策并没有通过主要国家政策文书的任何决定性变化而发生。例如，德国宪法法院最近关于德国麻醉品管制法合宪性的裁决明确否认了可能的法律转变。相反，这些举措是直接面对毒品使用和由此产生的问题的社区第一线采取务实、合作行动的结果。这篇文章着眼于几个德国城市毒品政策的新“现实”，这些城市在接受进步的、基于“减少伤害”的方法来解决其社区的毒品问题方面一直处于领先地位，尽管来自其他政治层面的主要冷漠或抵制。概述了参与执行一线毒品政策的不同行为者--警察、社会服务机构、卫生机构--如何改变其做法，以便切实地“减少”对吸毒者及其社区的伤害。通过改变与毒品有关的伤害的指标，例如与毒品有关的死亡的流行率、健康问题、提供社会服务、替代方案的影响和与毒品有关的犯罪率，来评估公众对毒品行动的这一重大转变的影响。
Drug policy in Germany currently is subject to dramatic changes away from the dominance of repression and hard-line prohibition. However, a crucial share of the recent initiatives (decriminalization, “low threshold” social services, needle exchanges, opiate substitution programs etc.) that define the new interaction between the public system and the drug user have not occurred through any decisive change in the main state-policy instruments. A possible legal shift was, for example, explicitly denied in the recent decision of the German Constitutional Court on the constitutionality of the German narcotics control law. Rather, these moves are the result of pragmatic, cooperative action at the front-line of communities directly confronted with drug use and the resulting problems. This paper looks at the new “reality” of drug policy in a few German cities that have been leaders in embracing progressive, “harm reduction”-based approaches for their communities' drug problem despite predominant indifference or resistance from other political levels. An overview is given of how the different actors involved in implementing front-line drug policy—police, social services, health agencies—have changed their approach in order to pragmatically “reduce harm” to drug users and their communities. As assessment of the effects of this substantial shift in public action towards drugs is suggested through changes in indicators of drug-related harm, e.g., the prevalence of drug-related deaths, health problems, provision of social services, effects of substitution programs, and drug-related crime rates.