Harm Reduction between Knowledge Production and Political Disputes of Care

Abstract

This article offers a critical analysis of the trajectory of Harm Reduction (HR) in Brazil, from its origin as an epidemiological strategy to control transmissible diseases to its consolidation as an ethical-political guideline within the field of mental health. By challenging biomedical, punitive, and abstentionist models, HR emerges as a field of tension between institutional control and inventive care practices. The text explores the three "waves" of HR in Brazil, highlighting the emergence of expanded clinical care, the central role of users' knowledge, and the challenges of institutionalization within the Psychosocial Care Network (RAPS). This historical journey reveals a shift from abstinence-based logic to practices centered on autonomy, human rights, and the invention of singular ways of life.