What is Harm Reduction?
Harm reduction is multiple things at once. It is a movement, a philosophical approach to relationship-building, and a set of concrete strategies that can help reduce the potential health and social harms of certain behaviours, including substance use, gambling, sex work, and more.
Notably utilized in the context of substance use and addictions, harm reduction is best known as a movement for social justice built on a belief in, and respect for, the rights of people who use drugs (National Harm Reduction Coalition [NHRC], 2020).
As an interpersonal philosophy, harm reduction is an approach for building relationships of care and support—especially with people who use drugs or whose activities are otherwise marginalised, criminalised, and/or stigmatized (e.g. sex work). The core principles of harm reduction instruct us to meet others ‘where they are at’ with non-judgement, compassionate curiosity, and an understanding that people make choices for reasons that are often adaptive to their circumstances. That is, drug use and other potentially harmful behaviours often serve an important purpose for people.
Harm reduction is also a set of practical strategies about how to reduce the potentially negative or harmful consequences of certain behaviours without an expectation that the person abstains from those behaviours entirely. It is a “pragmatic yet compassionate set of principles and procedures” that recognizes that many people will continue to use drugs and engage in risky behaviours despite prevention efforts (Marlatt, 1996, p. 779). It also accepts that many people are unwilling or unable to seek and access treatment, and that others may not need treatment but would still benefit from harm reduction practices.
A harm reduction approach prioritizes education—about harms and potential options to reduce or eliminate them—and a respect for a person’s autonomy. In this framework, people are encouraged to set their own goals for health and wellness and are supported in taking “any steps in the right direction” to meet them (Logan & Marlatt, 2010, p. 201).
Finally, harm reduction emphasizes the need to address and focus on specific vulnerabilities among marginalized groups, recognizing that harm is often concentrated based on social determinants of health (income, racial background, gender and sexual identity, immigration status, and so on).
