What is Harm Reduction?

Harm reduction refers to policies, programs and practices that aim to reduce the harms associated with the use of psychoactive drugs in people unable or unwilling to stop. ​

The defining features are the focus on the prevention of harm, rather than on the prevention of drug use itself, and the focus on people who continue to use drugs (Source: Harm Reduction International: www.ihra.net).


"Harm Reduction" refers to policies, programs 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 people who use drugs, their families and the community.  


The harm reduction approach to drugs is based on a strong commitment to public health and human rights.  

Target at Risks and Harms

Harm reduction targets the causes of risks and harms. The identification of specific harms, their causes, and decisions about appropriate interventions requires proper assessment of the problem and the actions needed. The tailoring of harm reduction interventions to address the specific risks and harms must also take into account factors which may render people who use drugs particularly vulnerable, such as age, gender andincarceration.  

Evidence based and cost

Harm reduction approaches are practical, feasible, effective, safe and cost-effective. Harm reduction has a commitment to basing policy and practice on the strongest evidence available. Most harm reduction approaches are inexpensive, easy to implement and have a high impact on individual and community health. In a world where there will never be sufficient resources, benefit is maximized when low-cost/high- impact interventions are preferred over high-cost/low- impact interventions.


Harm reduction practitioners acknowledge the significance of any positive change that individuals make in their lives. Harm reduction interventions are facilitative rather than coercive, and are grounded in the needs of individuals. As such, harm reduction services are designed to meet people’s needs where they currently are in their lives. Small gains for many people have more benefit for a community than heroic gains achieved for a select few. People are much more likely to take multiple tiny steps rather than one or two huge steps.

Dignity and compassion

Harm reduction practitioners accept people as they are and avoid being judgmental. People who use drugs are always somebody’s son or daughter, sister or brother or father or mother. This compassion extends to the families of people with drug problems and their communities. Harm reduction practitioners oppose the deliberate stigmatization of people who use drugs. Describing people using language such as ‘drug abusers’, ‘a scourge’, ‘bingers’, ‘junkies’, ‘misusers’, or a ‘social evil’ perpetuates stereotypes, marginalizes and creates barriers to helping people who use drugs. Terminology and language should always convey respect and tolerance.

Transparency, accountability and participation

Practitioners and decision makers are accountable for their interventions and decisions, and for their successes and failures. Harm reduction principles encourage open dialogue, consultation and debate. A wide range of stakeholders must be meaningfully involved in policy development and programe implementation, delivery and evaluation. In particular, people who use drugs and other affected communities should be involved in decisions that affect them.

Universality and interdependence of rights

Human rights apply to everyone. People who use drugs do not forfeit their human rights, including the right to the highest attainable standard of health, to social services, to work, to benefit from scientific progress, to freedom from arbitrary detention and freedom from cruel inhuman and degrading treatment. Harm reduction opposes the deliberate hurts and harms inflicted on people who use drugs in the name of drug control and drug prevention, and promotes responses to drug use that respect and protect fundamental human rights. ​

Challenging policies and practices that maximize harm

Many factors contribute to drug-related risks and harms including the behavior and choices of individuals, the environment in which they use drugs, and the laws and policies designed to control drug use. Many policies and practices intentionally or unintentionally create and exacerbate risks and harms for drug users. These include: the criminalization of drug use, discrimination, abusive and corrupt policing practices, restrictive and punitive laws and policies, the denial of life-saving medical care and harm reduction services, and social inequities. Harm reduction policies and practice must support individuals in changing their behavior. But it is also essential to challenge the international and national laws and policies that create risky drug using environments and contribute to drug related harms. ​

Suggested Reading

  • Harm Reduction International - The Global State of Harm Reduction
  • Institute of Medicine (2006) Preventing HIV Infection among Injecting Drug Users in High Risk Countries
  • International Federation of Red Cross and Red Crescent Societies (2003) Spreading the Light of Science: Guidelines on Harm Reduction Related to Injecting Drug Use
  • Neil Hunt et al (2003) Review of the Evidence-Base for Harm Reduction Approaches to Drug Use
  • Links: HRC: http://harmreduction.org; North Carolina Harm Reduction Coalition: http://www.nchrc.org