Understanding and Working with Substance Misusers explores the complex nature of addiction and the challenges involved in responding effectively through policy and practice. It examines the biopyschosocial elements of addiction to substances (including alcohol) and, draws together key research findings from these fields to present a new framework for integrating theory and practice. This book fills the need for a text which makes the complex issues surrounding substance misuse accessible to both students and practitioners.

Harm Reduction Approaches

Harm reduction approaches

The aims of this chapter are to:

  • explain the concept of ‘harm reduction’ and the context in which it has arisen
  • outline the main approaches to harm reduction including needle exchange and substitute prescribing
  • discuss some of the tensions inherent within this approach.

A ‘harm reduction’ agenda sits within a public health approach, which seeks to develop policy and practice based upon ‘scientific’ evidence to both prevent problems and, where problems do arise, to intervene in the most effective way. In practice policies exist aimed at, firstly, universal prevention (Robson and Marlatt, 2006), which are the basis of the UN conventions, and the domestic legislation of the signatories to those conventions (in the UK the Misuse of Drugs Act (1971)) and, secondly, drug education ...

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