Binti Md Isa, Yusramizza and Donoghue, Jane and Kibble, Neil (2015) Harm reduction in the context of drug use in Malaysia, a critical analysis of its justification and its compatibility with the criminal justice approach. PhD thesis, Lancaster University.
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Abstract
The emergence of a harm reduction approach for drug users has prompted extensive debate in many countries. However, in Malaysia the pertinent issues regarding the bases of such an approach and its consonance with the criminal justice approach have received little attention. This thesis examines the justifications for the harm reduction approach in Malaysia, its compatibility with the existing criminal justice approach and ways of reconciling both approaches in the event of conflicts between them within a socio-legal sphere of analysis. Building on philosophical and scientific judgements, this thesis argues that Malaysia should implement the harm reduction approach and argues that it is congruent with public health ethics, utilitarianism, human rights protection and the Islamic principles of ‘hajiyyat’ (needs), ‘darurah’ (necessity) and ‘al-∂arar al-ashaddyuzalu bi’l-∂arar al-akhaff’(tolerating a lesser harm to eliminate a greater one). The approach also fits in with the abstinence orientation adopted within drug prohibition policy and the confines of the international drug control conventions. The Methadone Maintenance Therapy (MMT) and Needle and Syringe Exchange Programme (NSEP) harm reduction measures are further justified by their efficacy and cost-effectiveness in decreasing drug use and HIV pathogen transmission. This thesis also argues that any alleged unintended adverse consequences of harm reduction are limited or absental together. Moreover, with regard to the issue of compatibility between the harm reduction and criminal justice approaches, this thesis emphasises that there are significant theoretical and practical conflicts between the two approaches as they are currently understood and practised in Malaysia. The tensions arises principally from law enforcement practices, predominantly the street-level policing activities, reflecting the lack of commitment of criminal justice actors to the harm reduction strategy, despite the existence of government initiatives to support harm reduction. The thesis suggests important options for reconciling both approaches, particularly at a conceptual level.Finally, this thesis argues for incorporating the harm reduction approach as an important component of overall drug policy under a sustained prohibitionist framework.