Harm Reduction as Best Practice

Harm reduction is focused on minimizing consequences without needing the activity to

stop. Harm reduction is a well-researched, evidence-based approach shown to be
effective in addressing substance related harms (minimizing death, disease, and injury).
Harm reduction is the only global drug policy response that has proven to save lives and
money at the same time as increasing quality of life (Stone & Sander, 2016).

Society actively embraces harm reduction in other areas where there is high risk for
death and injury. For example:

Seat belts, air bags, helmets for bicyclists and motorcyclists are all examples of
measures taken to reduce the severity of injuries in the event of collision or upset.
These measures neither prevent crashes nor attempt to reduce the high-risk behaviours
that lead to negative events. Once again, the primary goal is simply to reduce the
likelihood and severity of injury. Not only have such measures proven effective and
garnered widespread support, in many jurisdictions they have become legal
requirements (National Treatment Strategy Working Group, 2008).

In this context, harm reduction refers to an umbrella term for policies and practices
focused on reducing problematic effects of alcohol and other drug use (Erickson,
Butters, & Walko, 2002). Harm reduction can take place on the individual, community,
or societal level. Examples of familiar substance use harm reduction strategies include:
Smart Serve for bartenders, which decreases the potential for public drunkenness and
DUIs; needle exchange programs that reduce HIV transmission; no-smoking zones to
limit second-hand exposure to smoke (Erickson, Butters, & Walko, 2002). It is a non-
judgmental approach that opens up honest dialogue around drug (including alcohol) use
and decreases stigma around those whose substance use has become problematic.

Key principles include:

 Acceptance that there are benefits and consequences of alcohol and other drug use,
and that use has been around for thousands of years.
 Focus on decreasing more immediate harms vs. striving for a drug free society.
 Focus is on harms not the substance.
 Giving people choice and access to a broad range of options that help to keep
people safe and alive and healthy.
 Making an individual’s goals a priority and focusing on what they see is their most
immediate need.
 Small gains add up over time.
 Recognizing that people know what is best for them and are doing the best they can
with what they have.
 Myths Facts

Harm reduction is opposed to abstinence and Harm reduction is not at odds with abstinence; instead, harm re
therefore conflicts with traditional substance one possible goal across a continuum of possibilities that includ
abuse treatment. managed use.

Harm reduction encourages drug use.
Harm reduction is neither for, nor against, drug use. It does not
use, unless individuals make that their goal. Harm reduction foc
people’s efforts to reduce the harms created by drug use or oth
Numerous studies have demonstrated that harm reduction prog
increase substance use, nor do they increase the number of ne
studies have shown that harm reduction programs actually incre
treatment options.

In Canada, the trend has been that the vast majority of funds go
Harm reduction takes money away from other
current drug laws. Only a small fraction (~2%) goes toward harm
programs.
or services.

Making harm reduction equipment and information readily avail

commitment to the health of the overall community. It demonstr
By making condoms or safer drug use
individuals’ health and well-being, and creates opportunities to h
equipment available at program sites, programs
honest conversations about varying levels of risks associated w
will undermine policies that state that clients
There is no evidence that making these tools available leads to
cannot have sex or use drugs on the premises.
level of these activities either inside or outside programs. (Supe
Reduction Program)

Another way of looking at harm reduction is as secondary prevention. Primary

prevention focuses on preventing the high risk behaviour or disease in the first place,
secondary prevention focuses “on early detection and preventing progression and
threats to the health of the individual” (National Treatment Strategy Working Group,
2008). In the case of post-secondary students, reducing the harms they may experience
from the use of alcohol and other drugs, and identifying problematic use before it
progresses into an addiction would be examples of secondary prevention.