Harm Reduction: A New Direction for Drug Policies and Programs

Ian W. Toal is a registered nurse in Barrie, Ontario.

“Harm reduction” is an emerging concept in the field of substance
use and misuse. In 1990, the First International Conference on the
Reduction of Drug Related Harm was held in Liverpool. The fifth
conference was held in Toronto in 1994, and the material presented there
forms the basis of this book.

Being a relatively new concept, harm reduction is a little tricky to
define, but essentially it takes substance use (both legal and illegal)
as a given, and concentrates on strategies to minimize the health risks
associated with such use. One author says that by “focusing on the
harm associated with substance use rather than solely on the use, both
the counselor and the client could consider a broad range of solutions,
of which abstinence is only one.” Initially applied to illegal drug
use, the concept has rightly been expanded to include alcohol use and
abuse.

The end result of the harm-reduction approach can be as varied as the
populations served. A mobile health clinic in Glasgow provides
genito-urinary exams and clean needles to prostitutes, while a lifestyle
enrichment program in Ottawa provides socialization for older adults
with the result that they need to drink less alcohol. Both programs
accomplish the same thing: the health of the clients are improved
without making their lifestyles the primary issue.

For this layperson, this is not an easy book to read. Aimed at
professionals in the field, the 26 chapters represent 26 distinct
studies into the use of substances, broadly divided into five major
topics: history, human rights, alcohol and public health, clinical
studies, and special populations. Recommended for the interested general
reader and for any professional who deals with substance users.