Harm reduction: the least worst treatment of all
Charlotte Allan and Nat Wright explore the controversial option of harm reduction
“Harm reduction” is the theory and practice of reducing the negative consequences of drug use for the individual and for society as a whole.1 It covers a range of initiatives from government polices and programmes to providing services, such as needle exchanges and safer injecting advice. Those who advocate harm reduction do so because overcoming an addiction is extremely difficult, and it helps minimise damage in the meantime. For others, harm reduction where adverse consequences of drugs are reduced without necessarily reducing their consumption poses an ethical dilemma.2 How can health professionals be seen to advocate anything other than cessation when patients are taking illegal substances to the detriment of their own health?
A policy of harm reduction may be applicable to many aspects of health-for example, the promotion of drinking in moderation rather than becoming teetotal or promoting safer sex rather than abstinence. Debates around the ethics of harm