Harm Reduction

Harm reduction is a concept that incorporates a spectrum of strategies, including safer use, managed use, and abstinence. With this approach, therapists meet substance users where they are and address the conditions of use along with the use itself. Harm reduction demands that treatment interventions and policies designed to serve substance users reflect the specific needs of the individual. Although there is no universal definition for harm reduction or a structured formula for implementing it, the approach has several key principles that we find useful in working with people using both legal and illicit substances.

• Accepts that legal and illicit substance use is part of our world
• Works to minimize the harmful effects of legal and illicit substance use rather than ignoring or condemning use
• Understands substance use as a complex, multi-faceted phenomenon that encompasses a continuum of behaviors from moderate use, misuse, abuse, and dependence to total abstinence, and acknowledges that some ways of using substances are clearly safer than others
• Establishes quality of individual and community life and well-being—not necessarily cessation of all substance use—as the criteria for successful interventions and policies
• Calls for the non-judgmental, non-coercive provision of services and resources to individuals who use substances and the communities in which they live in order to assist them in reducing attendant harm
• Advocates that substance users and those with a history of substance use routinely have a real voice in the creation of programs and policies designed to serve them
• Affirms substance users themselves as the primary agents of reducing the harms of their substance use, and seeks to empower users to share information and support each other in strategies which meet their actual conditions of use
• Recognizes that the realities of poverty, class, racism, social isolation, past trauma, sex-based discrimination, and other social inequalities affect both people’s vulnerability and capacity for effectively dealing with drug-related harm
• Does not attempt to minimize or ignore the real and tragic harm and danger associated with licit and illicit substance use