Harm Reduction

Harm reduction focuses on reducing the adverse consequences of psychoactive drug use and drug control policies. It is usually thought of having its roots in Dutch drug policy, which takes a public health or sociomedical approach in recognizing and responding to drug use and its consequences. A simplistic conceptualization posits that if users are unable or unwilling to refrain from drug use, then they should be assisted in reducing the harm caused to themselves and others. Harm reduction is pragmatic. It tries to minimize the damage that drug users do to themselves, to other people, and to society at large. Inherent in the conceptual fuzziness of harm reduction is deciding what constitutes harm, who is harmed, and how harms should be prioritized.

Harm-reduction advocates view a “drug-free” society as unachievable, since drug use has been a part of human societies since the dawn of mankind. Therefore, they give greater priority to reducing the harms to the drug user and others, instead of focusing on decreasing drug use itself. Although the official U.S. view tends to equate harm reduction with legalization, most advocates of harm reduction do not support legalization, on the grounds that it would increase drug use. Still, they recognize that prohibition not only does not stop drug use but creates crime and marginalizes drug users. Harm reduction interventions focus on integrating or reintegrating drug users into the community, taking care not to further isolate, demonize, or ostracize them. Priority is placed on maximizing the number of drug users in contact with public health and social services. Drug policies are evaluated in terms of their potential effects on minimizing the harms of drugs to the user and to the larger society.

Harm reduction advocates ask: How can we reduce the likelihood that drug users will engage in criminal and other undesirable activities? How can we reduce the overdoses and cases of HIV/AIDS and hepatitis B and C associated with the use of some drugs? How can we increase the chances that drug users will act responsibly toward others? How can we increase the likelihood of rehabilitation? and more generally, how do we ensure that drug control policies do not cause more harm to users and society than drug use itself?