The Principles of Harm Reduction
Harm reduction is a set of practical
strategies that reduce negative consequences of drug use, incorporating a
spectrum of strategies from safer use, to managed use to abstinence. Harm
reduction strategies meet drug users "where they're at," addressing
conditions of use along with the use itself.
Because harm reduction demands that
interventions and policies designed to serve drug users reflect specific
individual and community needs, there is no universal definition of or
formula for implementing harm reduction. However, HRC considers the
following principles central to harm reduction practice.
- Accepts, for better and for worse, that licit and illicit drug use
is part of our world and chooses to work to minimize its harmful effects
rather than simply ignore or condemn them.
- Understands drug use as a complex, multi-faceted phenomenon that
encompasses a continuum of behaviors from severe abuse to total
abstinence, and acknowledges that some ways of using drugs are clearly
safer than others.
- Establishes quality of individual and community life and
well-being--not necessarily cessation of all drug use--as the criteria
for successful interventions and policies.
- Calls for the non-judgmental, non-coercive provision of services and
resources to people who use drugs and the communities in which they live
in order to assist them in reducing attendant harm.
- Ensures that drug users and those with a history of drug use
routinely have a real voice in the creation of programs and policies
designed to serve them.
- Affirms drugs users themselves as the primary agents of reducing the
harms of their drug use, and seeks to empower users to share information
and support each other in strategies which meet their actual conditions
- Recognizes that the realities of poverty, class, racism, social
isolation, past trauma, sex-based discrimination and other social
inequalities affect both people's vulnerability to and capacity for
effectively dealing with drug-related harm.
- Does not attempt to minimize or ignore the real and tragic harm and
danger associated with licit and illicit drug use.
The Need for Harm Reduction
With American drug treatment and prevention
policy rooted in criminal law enforcement and incarceration, most approaches
to drug-related problems help only a tiny fraction of the people who use
illicit drugs. We recognize that families and communities (especially
communities of color) are frequently devastated not only by addiction, but
also by arrest and incarceration, the lack of available drug treatment,
infectious disease, poor housing, unemployment, etc. Drug related problems
continue to baffle communities across the country, leaving them frustrated
and hopeless in their inability to respond to the harms they experience. The
harm reduction movement grows from the need for a conscientious response to
drug use that is less damaging to the fabric of our nation's diverse
communities. Harm reduction works to redress the following injustices, among
- There is a shocking lack of the basic
services that help reduce drug-related harm. Most areas in the United States
still have neither needle exchange programs, nor over-the-counter sale of
syringes, as HIV prevention measures. Drug treatment is not available at all
in some states, and there are no methadone maintenance treatment programs in
nearly one-fifth of them. Where treatment is available, it is not funded to
meet the level of demand.
- The lack of universal health care and the
movement toward privatization and managed care threaten to reduce or
eliminate some the few therapeutic services that currently exist for illicit
drug users particularly drug treatment.
- While personal difficulty in maintaining
housing, family, employment and health may be worsened by chronic drug
abuse, the problems are equally worsened by policies that create obstacles
to housing, family, employment and health care for drug usees.
- Most therapeutic services for drug users,
including drug treatment, are designed to serve the priorities of providers
instead of the needs of consumers. Drug education and prevention campaigns
are largely ineffective, attempting to scare people away from using drugs
instead of equipping them with accurate information about drugs and drug
use, including their adverse and harmful effects.
- Current drug control strategies criminalize
a huge proportion of the country's population. Since 1980, the number of
adults incarcerated in state and federal prisons, local jails, and on
probation or parole has more than tripled, with one-third of this expansion
due to an increase in the number of drug law violators put behind bars.
Women, African-Americans, and Latino/as have been disproportionately
- A struggle exists between law enforcement
and medical providers to define drug users as either criminals or medical
patients, with communities and families left out of the debate and unable to
define users as community and family members. Effective community planning
for drug treatment and post-incarceration support for drug users have no
priority in the allocation of drug intervention funding.
- The HIV epidemic has killed hundreds of
thousands of people in the United States and continues to rage on. Swift
public policy changes and the implementation of critical services could have
prevented an untold number of deaths and HIV infections among injection drug
users, their sexual partners, and children.