Harm reduction approach to addictions : where do we stand in this regard in Malta? : and how this compares to other countries where this approach guides

Abstract

Harm reduction (HR) is a practice used in the realm of addictions, amongst other areas, that aims at reducing the harm of drugs while educating the user to make conscious decisions to secure their safety when using. The meaning of harm reduction is diverse, as key players in the field of addictions have portrayed a different understanding as to why harm reduction should be used and towards which goal. Harm reduction has been discussed widely internationally for the past thirty years and thus, a wide array of literature can be found on the foundation of harm reduction. Whilst harm reduction is present and researched in foreign countries, local research about the policies and practices within the Maltese context are lacking. This qualitative study aims to explore the ideas of key national stakeholders in the field of addiction to grasp an understanding of where Malta lies with regard to the best harm reduction policies and practices applied by foreign counterparts. Semi-structured interviews were conducted and analysed using a content analysis. Key findings highlight that there is an element of convergence on some of the current practices of harm reduction, however, some of the recent amendments to legislation with regards to responsible drug use were met with mixed views. As previously mentioned, even locally it seems that the term harm reduction is understood and perceived by different stakeholders as a means to very different ends. This brings forward another element that this study has shed light on, the notion of discussion between said stakeholders, which is crucial to establish a common understanding of harm reduction in the local context. The varied understandings and perceptions, along with the lack of strong activism for people who use drugs (PWUD), may be hindering the community from implementing certain practices and achieving some goals which have been obtained in foreign countries over the past years.