Co-Production of Knowledge on Drug Use and Reduction of Epistemic Injustice

Drug use is usually considered from the perspective of both a legal and a biomedical framework. This double perspective produces classifications of people who use drugs through images of a delinquent and a sick person. Harm reduction policies have changed the representations and the place of people who use drugs in the policies intended for them by encouraging their agency to act in the process of reducing their exposure to the risks associated with drug use, and in particular with injection. Our socio-anthropological research includes a community-based participatory approach, carried out with Médecins du Monde. We studied the implementation of an injection education program (ERLI) on the basis of interviews with people who inject drugs, professionals and volunteers. We also conducted ethnographic observations of injection sessions. Our research highlights both the intimate and political dimensions of this public health programme. These dimensions give rise to an exchange and sharing of knowledge, affects and emotions as well as negotiations and tensions between people with lived experience, professionals and volunteers. This willingness to reduce epistemic inequities through the ERLI programme challenges the professional ethos of the volunteers and the harm reduction providers and reveals the way in which the exposure to risk of people who inject drugs is shaped by the risk environment.