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Harm Reduction: Concepts and Practice; A Policy Discussion Paper

NCJ Number
178167
Journal
Substance Use and Misuse Volume: 34 Issue: 1 Dated: 1999 Pages: 9-24
Author(s)
D. Riley; E. Sawka; P. Conley; D. Hewitt; W. Mitic; C. Poulin; R. Room; E. Single; J. Topp
Date Published
1999
Length
16 pages
Annotation
This paper provides an overview of the context, definition, and key features of the harm-reduction approach to drug abuse and provides several examples of current programs in various countries; some of the critical issues and the strategies needed to advance harm reduction are discussed.
Abstract
The authors suggest the following definition of "harm- reduction" strategies: "A policy or program directed toward decreasing the adverse health, social, and economic consequences of drug use without requiring abstinence from drug use." Harm- reduction approaches in various countries include the use of drug-education materials with a harm-reduction focus that targets high-risk populations; police support for a public health drug strategy that emphasizes referral to treatment and syringe exchange; flexible drug-prescription regimes that range from short-term detoxification to long-term maintenance; and the use of "tolerance zones," where drug users can gather to obtain clean injection equipment, condoms, advice, and/or medical attention. In moving toward a harm-reduction approach, addictions agencies and practitioners should decide whether to adopt harm reduction as an agency goal or as a program strategy; determine the place of harm-reduction objectives within their broader hierarchy of goals; consider the views and roles of key partners and stakeholders in program planning and delivery; and provide staff with programming direction, training, and support for planned harm-reduction initiatives. The authors recommend continued innovation and development of harm-reduction policies and programs in the areas of syringe exchange and availability, methadone programs, education and outreach programs, and law enforcement policies. Research and evaluation needs are also outlined.