Harm Reduction Interventions

Abstract

The goal of harm reduction is to reduce both the individual and societal harms of drug use through knowledge-based interventions that change risk behaviors and risk settings. Chapter 84, “Harm Reduction Policies, Settings, and Challenges” in this textbook gives an overview of harm reduction as a public health policy. This chapter describes the main harm reduction interventions implemented in many countries around the world, synthesizes evidence on their effectiveness and risks, and summarizes key lessons learned. The focus is on illegal drugs, especially opioids and central nervous system stimulants. The interventions covered are opioid substitution treatment; needle and syringe programs; supervised drug consumption facilities; drug overdose prevention; outreach, peer education, and health promotion; testing, vaccination, and treatment of drug-related infectious diseases; interventions for stimulant users; and drug-related sexual risk reduction. Key themes stressed include the following: that harm reduction does not replace the need for treatment but adds to the capacity to respond effectively to the wide range of health and social challenges raised by drug use; that the scientific evidence shows that harm reduction interventions are effective in terms of their stated goals, as long as they are implemented appropriately within their contextual settings; and that single interventions are far more effective when implemented together as part of a broader public health policy, including steps to facilitate healthier living and safer social environments.