From Policy to Practice: An Examination of Portuguese People Who Inject Drugs Navigating Harm Reduction

In 2001, Portugal was the first country to decriminalize all drugs under Law 30/2000. This decriminalization effort reflects a health-oriented and humanistic approach to substance misuse. Harm Reduction (HR) is a critical component of the 2001 law - this includes methadone maintenance treatment, drug consumption rooms, needle/syringe programs, and more. In this thesis, I seek to examine the experiences of people who inject drugs navigating Portuguese harm reduction - with an emphasis on the environment these organizations foster. I conducted fieldwork in Lisbon using participant observation and qualitative interviews with staff and service users. My findings reveal that the utilitarian approach to HR has some limitations, but overall, the HR principles of low-threshold care, deviation from moral assessments of substance use, and flexibility in "treatment" were significant for people who inject drugs and public health more broadly. Other salient themes included maintenance of privacy and reduction of surveillance in these treatment spaces. My<span style="font-weight: 400;"> findings are relevant in places and situations where there is a diverse and critical mass of people willing to pursue harm reduction for people who inject drugs.&nbsp;</span>