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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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