Harm reduction is a set of policies and practices intended to reduce the negative effects of drug and alcohol use.
Harm reduction programs exist for several types of drugs, including opioids, alcohol, stimulants, Ecstasy, and marijuana. They range from needle exchange sites to managed alcohol programs to drug-testing kits at music festivals.
Studies have found many of these methods to be effective.
But critics see the programs as encouraging drug use and keeping people addicted to drugs.
Below is information on common programs, tips for safe use, and links to more resources.
Harm reduction is a broad term that applies to policies, programs, and practices that aim to minimize the health, social, and economic consequences of substance abuse.1 The idea behind harm reduction is not to necessarily eliminate substance abuse but to diminish its harmful effects.
Harm reduction acknowledges that many people will continue to abuse drugs and engage in other dangerous behaviors despite prevention efforts. It also accepts that many people are unwilling or unable to seek treatment. But while some people who use substances may not necessarily require treatment, it is helpful for them to be aware of resources that can help minimize harm from their drug use.1
The medications used in MAT are:7
Tips for safer drinking include:10
As with harm reduction for other substances, stimulant harm reduction efforts are aimed at meeting users where they are, proving education on drug use, and preventing harm associated with stimulant use, including dental problems, STDs, psychosis, and poor hygiene.15
Some tips for reducing harm based on the mode of use include:16
The aim of Ecstasy (MDMA) harm reduction is to prevent harms associated with Ecstasy use, which can include anxiety, trouble concentrating, fatigue, insomnia, depressed mood, hypersomnia, difficulty concentrating, decreased appetite, and dizziness.17
RollSafe is an organization that publishes online information about MDMA and how to safely use it. Their website includes research on side effects, ingredients, test kits, doses, tips for safe use, and more.
DanceSafe is a similar organization that provides education about Ecstasy and other drugs in the electronic music scene, as well as on-site pill purity testing at events. Other on-site services include ear plugs, free water, and safe sex tools.
Tips to reduce the harm caused by Ecstasy use include:18
Harm reduction for marijuana is designed to promote safety, health and well-being, and informed decision-making regarding use.19
In anticipation of Canada’s legalization of marijuana, the Canadian Nurses Association published a harm reduction guide for marijuana use.
Some of the methods they recommend for lowering the risks of marijuana use include:19
A number of studies on harm reduction for specific substances have demonstrated its effectiveness.
Critics argue that medication-assisted treatment drugs such as buprenorphine can themselves be addictive and are essentially keeping the person dependent on opioids (substituting one drug for another). They also point out that the drugs can be diverted and sold on the black market.22
Further, some have suggested that needle exchange programs lead to more dirty needles on the street and overdoses if the programs are not properly controlled.23 Another common criticism is that they encourage drug use and make it easier for addicts to remain addicted and continue to commit crimes.24
Similar claims have been made about supervised injection sites. And a recent study found that the available research on the sites was not well-conducted. The quality studies did not find any noticeable effect on overdose deaths or needle-sharing.25
Still, researchers who studied an injection site in Vancouver, Canada found that it led to significant increases in the number of people who sought methadone and other addiction treatments. Other reviews have found that injection sites improve health in users and do not increase drug trafficking or crime. The question is whether sites that open in other cities, like in the U.S., will see these same results.4,25