Harm reduction is a pragmatic and humanistic approach to diminishing the individual and social harms associated with drug use, especially the risk of HIV infection. It seeks to lessen the problems associated with drug use through methodologies that safeguard the dignity, humanity and human rights of people who use drugs.
This approach is based on the pragmatic acknowledgement that, despite years of trying, there are no known effective interventions for eliminating drug use or drug-related problems in any community, city, or country. In most cultures, adopting a harm reduction approach requires a shift in thinking away from deeply rooted, and understandable, long-term idealistic goals of eliminating drug use and getting all drug users to become drug free.
Harm reduction does not deny the value of helping people become drug free, or the desirability of abstinence as an eventual goal. It simply recognizes that for many drug users these are distant goals, and that services to reduce the risk in the interim are therefore essential if personal and public health disasters are to be avoided. Recognizing the reality of drug use, harm reduction programs measure success in terms of individual and community quality of life and health and not in relation to levels of drug use.
Harm reduction entails a prioritization of goals. Given the high individual and social costs associated with HIV/AIDS, measures to prevent the spread of HIV are at the forefront of harm reduction priorities.
Humanitarianism—Recognizes the intrinsic value and dignity of all human beings.
Pragmatism—Does not judge licit and illicit drug use as good or bad, rather it looks at people's relationship to drugs, and emphasizes the reduction of drug-related harm while encouraging safer drug use (non-judgemental, pro-choice, non-coercive).
Evidence-based—Research shows that users will change their behaviour in response to information about safer use, and that this change is greater if skills training as well as the means to ensure safety are provided.
Drug use is the norm—We are all drug users, all through history, across all cultures. Elimination is not realistic (or desirable).
Balanced—Drug use is associated with benefits and risks - harms (risks) can be reduced. Focused on health and safety.
Respect—for people's ability (and right) to set their own goals and make their own decisions (client-focused).
Holistic—People use drugs within a social, economic, political, physical and psychological context.
Advocacy—Criminalizing drug use (policies and laws) and prejudice towards illicit drug users (values and attitudes) creates harms.
Empowerment—Pro-actively values and appreciates program development inclusive of (or arising from) users and communities.
Harm reduction uses a range of services to achieve its goals. Needle exchanges and replacement therapy treatment are two effective interventions to reduce drug related harm. These are often complemented by other supportive services for drug users such as health and drug education, HIV and Sexually Transmitted Infection (STI) screening, psychological counselling, and medical referrals.
By providing accessible services that meet drug user needs, harm reduction programs often serve as a meaningful point of contact that can connect drug users with other community, medical, and social service resources.
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