Noting that no single, widely embraced definition of harm reduction exists, the International Harm Reduction Association (IHRA) proposes that harm reduction be defined as ‘policies and programs which attempt primarily to reduce the adverse health, social, and economic consequences of mood-altering substances to individual drug users, their families, and their communities’ (IHRA, n.d., x 14). Examples of mood-altering substances include heroin, cocaine, methamphetamine, alcohol, and tobacco. Because individuals who use mood-altering substances have engaged in collective efforts to reduce the harm of their substance use independently of programs and policies (and, in fact, these efforts have at times predated, and given rise to, programs and policies), IHRA's harm reduction definition should perhaps be extended to explicitly encompass user-initiated actions, undertaken collectively, that are designed to ...

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