Harm reduction philosophy

Harm reduction as a philosophy is more than 20 years old and has played a major role in drug treatment. This section describes what harm reduction is and how it benefits individuals as well as society.

The following definition is taken from United Kingdom harm reduction Association (UKHRA)

Principles of harm reduction:  

Definition of harm reduction: Harm reduction is a term that defines policies, programmes, services and actions that work to reduce the health, social and economic harms to individuals communities and society that are associated with the use of drugs (Newcombe 1992)1.

The principles of harm reduction:

The following principles of harm reduction are adapted from those set out by The Canadian Centre on Substance Abuse (CCSA 1996)2, and Lenton and Single (1998)3

Harm Reduction:

• Is pragmatic and accepts that the use of drugs is a common and enduring feature of human experience. It acknowledges that, while carrying risks, drug use provides the user with benefits that must be taken into account if responses to drug use are to be effective. Harm reduction recognises that containment and reduction of drug-related harms is a more feasible option than efforts to eliminate drug use entirely.

• Prioritises goals - harm reduction responses to drug use incorporate the notion of a hierarchy of goals, with the immediate focus on proactively engaging individuals, targeting groups, and communities to address their most compelling needs through the provision of accessible and user friendly services. Achieving the most immediate realistic goals is viewed as an essential first step toward risk-free use, or, if appropriate, abstinence. 

• Has humanist values - the drug user's decision to use drugs is accepted as fact. No moral judgment is made either to condemn or to support use of drugs. The dignity and rights of the drug user are respected, and services endeavour to be ‘user friendly’ in the way they operate. Harm reduction approaches also recognise that, for many, dependent drug use is a long-term feature of their lives and that responses to drug use have to accept this.

• Focuses on risks and harms - on the basis that by providing responses that reduce risk, harms can be reduced or avoided. The focus of risk reduction interventions are usually the drug taking behaviour of the drug user. However, harm reduction recognises that people’s ability to change behaviours is also influenced by the norms held in common by drug users, the attitudes and views of the wider community harm reduction interventions may therefore target individuals, communities and the wider society.

• Does not focus on abstinence - although harm reduction supports those who seek to moderate or reduce their drug use, it neither excludes nor presumes a treatment goal of abstinence. Harm reduction approaches recognise that short-term abstinence oriented treatments have low success rates, and, for opiate users, high post-treatment overdose rates. 

• Seeks to maximise the range of intervention options that are available, and engages in a process of identifying, measuring, and assessing the relative importance of drug-related harms and balancing costs and benefits in trying to reduce them.