Intoxication and Harm Reduction

Abstract

Any use of substances to produce intoxication carries with it the potential for harm. However, intoxication is something that many people will experience in their lives, and for the majority, intoxication will carry with it both pleasure and pain: pleasure because intoxication can facilitate an enhanced sense of enjoyment, pain because often intoxication has ‘morning after’ impact where physical and emotional pain occurs. Harm, in these cases, is fleeting and relatively benign and is often outweighed by pleasure. However, there are people for whom intoxication is regular and is culpable in creating serious harms for the individual, their families and their communities. In those situations, many societies now offer services and interventions which are aimed at reducing substance-related harms. This chapter examines harm reduction, looking at the concept, development and focus of harm reduction from a number of perspectives. It looks at the manner in which harm reduction has evolved from a clinical intervention for intravenous drug users, branched out into advice on ‘safe use’ for recreational substance users and is increasingly being used as a political vehicle to begin to challenge some of the structural factors associated with problematic substance use at community level. It notes that increasingly harm reduction is in the vanguard of the decriminalisation and legalisation of formerly hitherto proscribed substances. It concludes by asking questions of how much further harm reduction will go in reshaping local, national and global drug policies.