Background
Cultural violence refers to those phenomena that justify or legitimate the existence of structural and direct violence. The concept has rarely been applied to harm reduction, where it can contribute to understanding why harm-producing structural and direct violence against people who use drugs persists. Building on research presented at ISSDP 2024, this paper is a deep-dive into the role of cultural violence in the production of drug-related harm among people who use basuco, a form of smokeable cocaine.

Methods
The research is based on ten months of ethnographic fieldwork with street-based people who use basuco in central Bogotá from May 2022 to April 2023, including 41 semi-structured interviews with a purposive, stratified sample designed to include diversity of gender, age, race, displacement status, and drug use history.

Findings and implications
It finds that three ‘violent ideas’ are particularly prevalent in legitimising violence against people who use basuco: ‘Drug use is bad’; ‘Drug use is a disease,’ and ‘Harm reduction is for people who inject drugs’. These ideas, present among service providers and people who use basuco, justified violence by presenting people who used basuco as deserving of punishment, incapable of autonomy, and/or subject to forms of harm ‘irrelevant’ to harm reduction. This cultural violence not only legitimated other forms of violence but was also produced by them. It sits in a self-reinforcing cycle of violence and harm production. As such, harm reduction in this context requires not only challenging these violent ideas (e.g. through anti-stigma, social inclusion and decolonisation) but simultaneously addressing the structural and direct violence faced by people who use basuco.