Harm reduction

Harm reduction, or harm minimization, refers to a range of intentional practices and public health policies designed to lessen the negative social and/or physical consequences associated with various human behaviors, both legal and illegal.^[1] Harm reduction is used to decrease negative consequences of recreational drug use and sexual activity without requiring abstinence, recognizing that those unable or unwilling to stop can still make positive change to protect themselves and others.^[2][3]

Harm reduction is most commonly applied to approaches that reduce adverse consequences from drug use, and harm reduction programs now operate across a range of services and in different regions of the world. As of 2020, some 86 countries had one or more programs using a harm reduction approach to substance use, primarily aimed at reducing blood-borne infections resulting from use of contaminated injecting equipment.^[4]

Needle-exchange programmes reduce the likelihood of people who use heroin and other substances sharing the syringes and using them more than once. Syringe-sharing often leads to the spread of infections such as HIV or hepatitis C, which can easily spread from person to person through the reuse of syringes contaminated with infected blood. Needle and syringe programmes (NSP) and Opioid Agonist Therapy (OAT) outlets in some settings offer basic primary health care. Supervised injection sites are legally sanctioned, medically supervised facilities designed to provide a safe, hygienic, and stress-free environment for people who use substances. The facilities provide sterile injection equipment, information about substances and basic health care, treatment referrals, and access to medical staff.

Opioid agonist therapy (OAT) is the medical procedure of using a harm-reducing opioid that produces significantly less euphoria, such as methadone or buprenorphine to reduce opioid cravings in people who use illegal opioids, such as heroin; buprenorphine and methadone are taken under medical supervision. Another approach is heroin assisted treatment, in which medical prescriptions for pharmaceutical heroin (diacetylmorphine) are provided to people who are dependent on heroin.

Media campaigns inform drivers of the dangers of driving drunk. Most people who recreationally consume alcohol are now aware of these dangers and safe ride techniques like 'designated drivers' and free taxicab programmes are reducing the number of drunk-driving crashes. Many schools now provide safer sex education to teen and pre-teen students, who may engage in sexual activity. Since some adolescents are going to have sex, a harm-reductionist approach supports a sexual education which emphasizes the use of protective devices like condoms and dental dams to protect against unwanted pregnancy and the transmission of STIs. Since 1999, some countries have legalized or decriminalized prostitution, such as Germany (2002) and New Zealand (2003).

Many street-level harm-reduction strategies have succeeded in reducing HIV transmission in people who inject substances and sex-workers.^[5] HIV education, HIV testing, condom use, and safer-sex negotiation greatly decreases the risk of acquiring and transmitting the HIV virus.^[5]