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ID: HR23-929
Presenting author: Goro Koto

Presenting author biography:

Harm Reduction Activist Founder and Co-Chair of Harm Reduction Tokyo Director of Japan Advocacy Network for Drug Policy (NYAN)

Genesis of Japan's Harm Reduction: In the face of fierce backwinds

Goro Koto
There was no harm reduction in Japan. The national government opposes harm reduction. Japan is said to have low drug problems. Almost all people consider this to be a good result of the punitive drug policy, which is driven by the Ministry of Health. The MOH administrates narcotic police.

However, we know people use drugs. Women and young children are very common. Popular substances are a variety of prescription and over-the-counter drugs. They are usually mixed and consumed in large quantities. Of course, there is also the use of controlled substances such as marijuana and methamphetamine.

Almost all people don’t know anything about harm reduction, seeing drug use is vice/crime. Health-care workers only help for abstinence. When it’s a controlled substance, health-care workers report to the police without clients’ consents. PUDs are extremely stigmatized and marginalized.

That is why we established Harm Reduction Tokyo. It’s a grassroots effort with peers. There is no funding from anywhere. But we still had to start. The stigma is so strong that it’s taking the lives of PUDs.

We’ve started an online outreach in the form of chat service that provides psychosocial support based on harm reduction. We started in June 2021 and had over 1800 chats with over 300 people in the first 10 months. More than 90% of these were with PUDs. Most people are in situations where they are isolated. We’ve received lots of messages saying, “I never thought I could talk to anyone about this”. This is the place where you can feel safe to talk about safer use or any other issues you want to chat about. In Japanese society, sadly, there are virtually no other resources to connect to. We are open and welcoming four days a week. And we are working towards becoming peer-led in the future.