Harm Reduction, Part One: Origins and Overview

The remarkable progress made this year towards ending our disastrous war on drugs make this an optimal time to define and discuss the concept of harm reduction*.

I was trained in and practice from a harm reduction perspective (see my services for more information), so I'd like to provide some background and information about what this means, as well as invite some conversation around alternative ways to approach alcohol and substance use.

So what IS harm reduction, and how did it begin?
​Though we can trace its roots back for several decades, harm reduction largely became visible in the 1980s as an international public health movement that recognized HIV as a larger health risk than drug use in and of itself, and aimed to reduce transmission via the distribution of condoms and clean needles.

The primary principles of this health movement are an acceptance of the reality that people DO engage in high-risk behaviors, and a commitment to helping them reduce the harm associated with those behaviors, without requiring that the behaviors
themselves stop.

Out of these principles grow many of our well-known public safety regulations and health education programs, such as seat belt and helmet laws, minimum drinking age requirements, nicotine replacements, safer sex practices, and designated driver programs.

General Philosophy
​Harm Reduction is a pragmatic stance, rather than one based in moral idealism, and is grounded in scientific research, human rights, compassion, and common sense.

It is consumer-oriented, maintaining a low threshold for participation; providers are committed to meeting people where they ARE, rather than requiring abstinence before treatment begins.

It is collaborative, rather than punitive; people are encouraged to participate in setting their own goals for treatment, and to work together with their providers towards those goals.

This stance represents a major shift in how we approach individuals with high-risk behaviors, opening the doors of treatment to many more people than ever before.


That's it for today--stay tuned for Part II: Moving from Away From the Moral and Disease Models! 


* Much of the information in these posts and my practice was gleaned not only from the excellent book Over the Influence: The Harm Reduction Guide for Managing Drugs and Alcohol, but also via live trainings with Patt Denning, Ph.D., one of the authors. For those seeking further reading in this topic, I can not recommend this book highly enough.
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