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It is our proposal that it is absolutely essential to move beyond the limitations of harm reduction and clarify definitions of peers if we are going to stand a chance of actually supporting the health and well-being of people who use drugs The term harm reduction itself is negative and in practise it is often unclear as to whether it is the potential harm of dug use that is being prevented or the many harms of prohibition For many of us who have spent some time working in the harm reduction field the constant need to respond to crisis after crisis often feel like bandaging soldiers and sending them back to the front lines For those of us who are both professionals in the field as well as drug users self-respect and gut feelings demand something more Some of us have spent some time working with peer-based drug user organisations sometimes as paid professionals and sometimes as unpaid activists While it is undoubtably the existence of such groups that has assisted many people who use drugs to find a sense of self-respect and dignity unfortunately the word peer has been rendered about as meaningless as harm reduction where even a panel that involves a drug user representative may get called peer education There are also many people who use drugs working in other harm reduction organisations where most of them are required to keep their substance use secret While harm reduction theory may be about moving beyond the criminalisation of drug use in practise the pathologisation of users can hardly claim to be an improvement in many cases Slogans such as drug use is a disease not a crime coming from the mouths of drug users is a sure indication for the need for something else We are not interested in arguing with or apologising to those with an enforcement or treatment agenda In our view both systems support
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