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What is harm reduction?
Harm reduction can be defined as ‘policies, programmes and practices that aim primarily to reduce the adverse health, social and economic consequences of the use of legal and illegal psychoactive drugs without necessarily reducing drug consumption. Harm reduction benefits drug users, their families and the community’.
One of the basic principles underlying this approach is that people have always used drugs, and will use drugs, and as such there will never be a drug-free society. Harm reduction accepts that some people who use drugs are often unable or unwilling to stop, and seeks to provide care, support and resources in a non-judgmental environment. The most humane, compassionate and effective approach is therefore to attempt to alleviate the worst of the harms associated with drug use.
Harm reduction promotes safer use and options that help to minimise the risks from drug use and of causing harm to themselves or others, without requiring the cessation of use. It is a pragmatic approach that is based in public health and human rights.There is a large and ever growing body of evidence that demonstrates harm reduction as an effective approach for preventing drug related harms including HIV, Hepatitis C, and overdose. In addition to individual benefits, harm reduction interventions also benefit the community, for example by reducing crime.
- Information: providing honest, non-judgemental information on how to reduce risk of harms associated with drug use.
- Needle exchange programmes: providing sterile needles and other injecting equipment to people who inject drugs.
- Opioid Substitution Therapy (OST): the administration of a prescribed daily dosage of opioid medicines under medical supervision.
- Pill testing: screening drugs for dangerous adulterants and thus reducing the risks of accidently ingesting these substances.
- Overdose prevention: Including information on overdose causes, recognising, and what to do, and distribution of naloxone, an emergency antidote for people who overdose on opioids.
- Safer crack kits: Include materials to prevent the harms associated with smoking crack, in particular to reduce the risk of burned or cracked lips and the associated risk of becoming infected with blood-borne viruses such as HCV and HIV.
- Age restrictions: in many countries worldwide where harm reduction services exist, arbitrary age restrictions do not allow young people under the age of 18 to access these services.
- Lack of youth friendly services: Harm reduction services do not cater to young people’s specific needs and situations. In addition, young people are not involved in service design, implementation and evaluation, which severely compromises the service’s effectiveness, accessibility and appropriateness.
- Untrained services providers: Young people who access services are often faced with hostile and untrained services providers, who are ill-equipped to deal with the needs and realities of young people who use drugs. Unclear laws also result in hesitation among service providers to provide young people with harm reduction services and support.
- Non-supportive legal environment and law enforcement practices: In countries where punitive approaches dominate the response to drug use, young people are deterred from accessing harm reduction services out of fear of arrest.