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Harm reduction defined

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UKHRA
Definition of Harm Reduction

Introduction
Many responses to drug use have been defined at some time as ‘harm reduction’, and this has led to much some confusion as to what harm reduction actually is.

In order to clarify the situation, UKHRA – the UK’s leading organisation campaigning for a rational, harm reduction oriented response to drug use – has prepared a definition of harm reduction, and identified the core principles of harm reduction.

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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.

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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 19983:

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, targetting 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 endeavor 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

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1 Newcombe, R. (1992) The reduction of drug related harm: a conceptual framework for theory, practice and research. In, O'Hare et al (Eds.) The reduction of drug related harm. London Routledge.

2 CCSA (1996) Harm Reduction: Concepts and Practice: A Policy Discussion Paper, Canadian Centre on Substance Abuse (CCSA) National Working Group on Policy [ link ]

3 Lenton, S. and Single, E. The definition of harm reduction. Drug & Alcohol Review 17, 2: 213-220, 1998.


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