What is harm reduction?

Harm reduction refers to policies, strategies and programmes designed to reduce the harm associated with the use of psychoactive substances, including illicit drugs.

Harm reduction was originally conceptualised around providing clean needles to injecting drug populations. This process soon expanded to what became classified as needle exchange which involves exchanging used needles and syringes for new ones. Certain countries such as Britain, Australia, Holland and Hong Kong soon made it official policy, and were able to demonstrate manageable HIV prevalence rates linked to injecting drug use at less than 5 per cent, which is still currently the case.

Countries that had successfully managed HIV in injecting drug populations had Opiate Agonist Therapies in place prior to needle exchange programmes. In Opiate Agonist Therapies programmes, injecting drug users could opt for "replacement therapy" in the form of oral or even injectable opiates in controlled settings. This practice was already in place in the US, Europe and Asia (Hong Kong and Thailand), and become a natural part of what was known as harm reduction.

Examples of harm reduction approaches currently include:

• needle and syringe access to reduce opportunities for HIV transmission by removing the need to share injecting equipment;
• disposal programmes;
• drug substitution therapy providing orally administered drugs to reduce the need for injections; and
• information and advice on sexual and reproductive health.