Colombian researcher, activist, and analyst specializing in drug policy and harm reduction through a Critical Medical Anthropology lens. With extensive experience in ethnographic research and advocacy, has collaborated with NGOs and community-based organizations on harm reduction, HIV and intercultural health systems in Colombia, emphasizing community-driven research and policy development.

espite advances in harm reduction, increasing medicalization and professionalization have shifted its focus away from community and counter-hegemonic roots. Although services provided by health professionals are valuable, they tend to focus on individual perspectives, ignoring the complexity of the concept of harm. A dialogue between harm reduction and Buen Vivir, an epistemology of Latin American indigenous communities, can broaden the understanding of harm and challenge structural injustices.

Buen Vivir offers a holistic vision that promotes harmony between humans, nature and the cosmos as an alternative to Western models of development. Integrating this perspective into harm reduction extends the focus to social, environmental and cultural justice, revealing how drug policies are deeply rooted in oppressive systems derived from colonialism and maintained by neoliberalism.

Buen Vivir could provide concrete insights into addressing specific contemporary challenges. For example, the opioid crisis in the United States is often approached from an individualistic, medicalized perspective, which fails to address the deeper socio-political and economic factors perpetuating addiction and marginalization. Similarly, the environmental harm caused by vaporizer waste and the ecological footprint of indoor cannabis cultivation are rarely considered in traditional harm reduction frameworks. Buen Vivir’s emphasis on harmony with nature invites us to rethink these practices by promoting sustainable, community-led alternatives that consider the interconnectedness of human health and the environment

Buen Vivir proposes a collective governance that recognizes the complexity of the interrelationships between humans, nature and society. It promotes equitable participation and respect for the diversity of knowledge, avoiding hierarchies and prioritizing collective well-being over extractivist interests.

To be truly transformative, drug policies should not be limited to legalizing substances or eliminating sanctions and stigmas. We must ask ourselves: how can we relate more harmoniously and without causing harm with substances, and the territories, ecosystems and knowledge behind them?