The True Meaning of Harm Reduction

“Harm reduction” is a divisive term among treatment professionals working with drug users – it irritates many who believe that abstinence is the only legitimate goal of drug related interventions. Even if harm reduction programs, such as opiate substitution treatment or needle exchange gained great popularity and acceptance in the past decade in most countries of the world, there is still much confusion and debate about the theoretical and philosophical aspects. We interviewed several people in Vienna at the Global NGO Forum this June to learn about their opinions on harm reduction. We identified the following definitions of and approaches to harm reduction among the participants:

1)    There are still opponents of harm reduction who consequently reject harm reduction and label it as “harm promotion”, or the “Trojan horse of legalizers”. The opinion is hold mostly by the advocates of the War on Drugs in the U.S., where official documents never use the term.

2)    Some people (like Antonio Maria Costa, head of UNODC) try to define every anti-drug activities as harm reduction, including the eradication of drug crops in Afghanistan and interdiction efforts of the police. They argue that all these interventions aim to reduce the harms caused by illicit substance abuse .

3)    Others say harm reduction should not be a goal in itself but only a first step in the long way to abstinence. According to this approach harm reduction is only a subsidiary tool in the fight against drugs, with limited relevance, subordinated to abstinence-based treatment and primary prevention.

4)    Proponents of harm reduction define it as a theoretical and practical framework to deal with drug users, based on the respect of scientific evidence and human rights, pragmatism and compassion. They argue that abstinence should not be always an absolute goal but every interventions are legitimate that improve the health and well-being of people who use drugs.

Posted by Peter Sarosi