Relational anonymity in reducing the harms of illicit drug use: accounts of users of dark web- and street-based services in Finland.

Background: Protecting individual anonymity is a common practice in harm reduction (HR), as it can mitigate the fears that may prevent people from accessing services. Protecting anonymity usually means applying for services with a pseudonym. However, anonymity protection practices have diversified in current HR environments, for example, on the streets or in the Tor network, which relies on technology to guarantee exceptionally strong anonymity. Despite its importance, the individual's need for anonymity when seeking help to reduce drug-related harm has been underexplored.

Methods: The research contexts included four street- and dark web-based HR services in Finland. The data consisted of service user interviews and naturally occurring conversations in the Tor network. We focused on service users' accounts of their need for anonymity and applied the concept of relational anonymity, acknowledging that wider contextual relations intertwine with situational needs for anonymity. We asked: What kinds of needs for anonymity do service users express when discussing seeking help to reduce drug-related harm? How do service users account for their need for anonymity when seeking such help? To which kinds of contextual relations are these accounts attached?

Results: We identified connections between the accounts of the need for anonymity and various contextual relations: (1) excusing the need for anonymity by referring to societal relations: blaming Finnish society for stigmatising attitudes and exclusionary practices; (2) excusing the need for anonymity by referring to service system relations: blaming the service system for the risk of negative consequences from recording the use of illicit drugs; (3) justifying and excusing the need for anonymity by referring to personal relations: appealing to personal situation, feelings and experiences.

Conclusions: The need for anonymity reflects problematic societal relations, in which the stigma towards drug use is strong. The service users' accounts were motivated by rational actions to avoid possible sanctions and the perceived abuse of power in Finnish society and services, which the service users deemed to have various negative consequences in their lives. Societies should promote cultural atmospheres and information sharing practices where anonymity is not needed, but services that protect anonymity are crucial in the current societal conditions.