Skip to main content

What is Harm Reduction?

By: Mia Dickinson

Definition of Harm Reduction

Harm reduction is an evidence-based approach that uses prevention, risk mitigation, and comprehensive health education to reduce negative outcomes associated with high-risk behaviors (National Harm Reduction Coalition, 2023). The harm reduction approach recognizes that complete elimination of certain behaviors or conditions may not always be feasible or realistic, and instead focuses on pragmatic strategies to minimize harm and improve overall well-being. Harm reduction has been applied across various fields to address a wide range of issues, including public health substance use disorders.

Harm reduction strategies have been used in public health for centuries. For example, laws and systemic changes surrounding seat belts in motor vehicles reduce the likelihood of injury when driving. These laws do not ‘discourage’ nor ‘enable’ driving, but rather minimize the risks associated with this behavior. Harm reduction principles are also applied in the context of sex work to promote the health, safety, and human rights of sex workers. Strategies used in this area include providing access to condoms and lubricants, offering regular health screenings, and advocating for the decriminalization of sex work to reduce violence and exploitation. Lastly, ​​harm reduction strategies are increasingly being incorporated into criminal justice policies to address issues such as substance use disorders and recidivism. Recidivism is to relapse into a previous condition or behavior, such as breaking the law. This might consist of offering diversion programs for nonviolent drug offenders, providing access to medication for addiction treatment in correctional facilities, and implementing harm reduction measures within the prison system, such as needle exchange programs.

In terms of substance use disorder (SUD), harm reduction serves as an empowering framework to help individuals make informed choices about their substance use (National Harm Reduction Coalition, 2023). By prioritizing the lived experiences of individuals, harm reduction strategies and practices are tailored to address their specific needs and circumstances. Some harm reduction strategies utilized in this space include testing drugs for contaminants, utilizing naloxone to reverse opioid overdoses, medications for substance use disorder, syringe service programs, and supervised consumption sites.

While traditional approaches to substance use often prioritize abstinence as the sole measure of success, harm reduction recognizes that addiction is a complex and multifaceted issue that requires a more comprehensive response. These harm reduction strategies are not mutually exclusive though and are often implemented in combination to address the complex needs of people who use drugs (PWUD).

Historical Background and Evolution of Harm Reduction

At the heart of harm reduction is a commitment to meeting people where they are, on their own terms (National Harm Reduction Coalition, 2023). This approach acknowledges the inherent value, dignity, and autonomy of PWUD by respecting their choices and lived experiences. Through engaging with PWUD in a non-judgmental and empathetic manner, harm reduction practitioners create an environment conducive to open dialogue and mutual trust.

The harm reduction movement emerged from social movements in the 1960s, 70s, and 80s in the United States. Among these movements was the Black Panther Party’s Free Breakfast for Children Program. Created because hunger and poverty made it difficult for many low-income black children to focus on school, the program fed more than 20,000 children nationally in its first year, 1969 (Pien, 2023).

Another innovative early harm reduction effort, implemented by the Young Lords Organization (YLO), a Puerto Rican activist group in the 1970s, was a community-based acupuncture program (Meng, 2021). Recognizing the heroin epidemic in East Harlem, New York City, the Young Lords sought alternative methods to address addiction after mainstream medical institutions failed to do so. They established the community acupuncture program, providing free acupuncture sessions to individuals struggling with opioid dependency. This initiative aimed to alleviate withdrawal symptoms, reduce dependency, and promote overall well-being among participants (Meng, 2021). The program not only offered practical support but also challenged mainstream perceptions of SUD and advocated for holistic approaches to public health issues. Acupuncture is still utilized in harm reduction programs to this day.

The emergence of the AIDS crisis in the 1980s also shaped harm reduction (National Harm Reduction Coalition, 2023). Faced with a rapidly spreading epidemic, activists and healthcare professionals mobilized to advocate for harm reduction strategies. These strategies included needle exchange programs, safer sex education, distribution of condoms, community outreach and support services, HIV testing and counseling, stigma reduction and advocacy, and access to Antiretroviral therapy (National Harm Reduction Coalition, 2023). These movements laid the groundwork for harm reduction principles of social justice and compassion, focusing on reducing harm from high-risk behaviors while prioritizing the needs of marginalized communities (National Harm Reduction Coalition, 2023).

Harm reduction strategies not only function as interventions, but they also often act as gateways to a variety of health and social services. For many individuals, harm reduction programs represent their first point of contact with healthcare systems or community support networks. Subsequently, they may be connected to additional resources such as mental health counseling, medication for SUD, housing assistance, or vocational training opportunities.

Conclusion

Throughout history and continuing today, the principles of harm reduction have evolved into ideals of social justice and compassion. Harm reduction principles acknowledge that health outcomes are shaped not only by individual behaviors but also by structural inequalities and systemic barriers. By providing education and practical tools to reduce harms associated with risky behaviors and listening to the needs of marginalized groups, harm reduction continues to be a force for positive change in public health dialogues. Learn about MATTERS’ harm reduction services by clicking here.

References

Meng, E. (2021, May). Use of acupuncture by 1970s revolutionaries of color: The South Bronx “Toolkit care” concept. American journal of public health. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8034021/

National Harm Reduction Coalition. (2023, December 1). Evolution of harm reduction. National Harm Reduction Coalition. https://harmreduction.org/movement/evolution/

Pien, D. (2023, March 6). Black Panther Party’s Free Breakfast Program (1969-1980). https://www.blackpast.org/african-american-history/black-panther-partys-free-breakfast-program-1969-1980/