Sam Shirley-Beavan recently submitted his PhD in Social Policy at the University of Kent. His doctoral project focused on the interaction of cocaine, harm and violence in Bogotá, Colombia. He was previously a researcher at Harm Reduction International and is now an independent research consultant based in Maputo, Mozambique.

Historically, harm reduction has focused on injection, opioids and bio-behavioural interventions to reduce health harms. This has overlooked people who use drugs but neither inject nor use opioids. Equally, research on the interaction between drugs, violence and armed conflict has focused on the supply chain, rather than the experiences of people who use drugs. These gaps have special relevance in Colombia where the primary drug of social concern is smokeable cocaine (basuco) and where the violence of the War on Drugs – including as experienced by people who use drugs – has been profound.

Through eleven months of ethnographic research with street-based people who use basuco in Bogotá, this study sought to understand violence, harm and harm reduction in this context.

It found that people who use basuco are subject to compounded violence at the intersection of the Colombian internal conflict and the global War on Drugs. A cycle of direct, structural and cultural violence produces harms broader than those addressed by bio-behavioural harm reduction interventions, occurring across four interdependent ‘zemiological’ categories of physical, economic, emotional and cultural harm. Common contributors to the generation of harm across these categories include stigma and marginalisation, criminalisation and criminal violence, abstinence-dominated norms around drug use, a constraining global political economy, and the legacy and continued impact of the internal conflict.

Reducing harm requires reducing the violence that produces it. It requires building peace. This study argues for a more inclusive, context-aware and socially transformative form of harm reduction, which could contribute to a peace process in the War on Drugs. Developments in Colombia since 2022, under the Petro administration’s banner of ‘Total Peace’, have begun to address the violence and harms faced by people who use basuco. Broadening attention could lead to new frontiers in both harm reduction and the peace process.