Harm reduction is a philosophy based in the idea that drug use cannot be eliminated immediately, and probably will never be eliminated completely, but that the negative effects of drug use can be meaningfully reduced. Harm reduction can be tactical, such as enabling injection-drug users to exchange clean needles for dirty ones, to prevent the spread of disease and keep hazardous waste out of the streets. It can also be strategic, such as adopting public policy that frames addiction as a public health problem rather than a criminal justice problem. Harm reduction practices may address drug use itself, as when emergency personnel are provided with medications to reverse overdose. They may also address related issues, as when a public transit system adds additional service on New Year’s Eve to get drinkers home safely.

What does harm reduction have to do with the Haight Ashbury and the free clinic movement? Because casual drug use of illicit drugs gained some degree of acceptance among middle-class young people during the late 1960s in the Haight, and media attention made that use visible to the nation and the world. Much of the Haight Ashbury Free Clinics’ work fell to helping people with drug issues find their way to recovery. The clinical staff and counselors, at the Detox program particularly, explored new ways to address the addictions carried by their patients.

Over 50 years, we’ve seen law enforcement and societal shifts lurch from “put them in jail” to “just say no” to “addiction is a chronic brain disease.” Harm reduction acknowledges another old adage, that “you can lead a horse to water, but you can’t make him drink.” Some people WILL use drugs and/or alcohol, and all the treatment opportunities in the world won’t/can’t/don’t keep them clean and sober.

Economics offers another reason to consider harm reduction. It’s usually cheaper to provide a safe place than incur repeated emergency room visits. More than one study has shown that every dollar spent on treatment saves $5-10 in medical, law enforcement, criminal justice and other societal costs. Providing a secure environment may provide opportunities for the addict to discuss treatment, and may reduce his/her consumption. Additionally, facets of harm reduction can reduce infectious disease transmission.

International Harm Reduction Association

“‘Harm Reduction’ refers to policies, programmes and practices that aim primarily to reduce the adverse health, social and economic consequences of the use of legal and illegal psychoactive drugs without necessarily reducing drug consumption. Harm reduction benefits people who use drugs, their families and the community, based on a strong commitment to public health and human rights.”

Harm Reduction Coalition

“Harm reduction is a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use. Harm Reduction is also a movement for social justice built on a belief in, and respect for, the rights of people who use drugs.

“Harm reduction incorporates a spectrum of strategies from safer use, to managed use to abstinence to meet drug users “where they’re at,” addressing conditions of use along with the use itself. Because harm reduction demands that interventions and policies designed to serve drug users reflect specific individual and community needs, there is no universal definition of or formula for implementing harm reduction.”

“Harm reduction: An approach to reducing risky health behaviours in adolescents.” Canadian Paediataric Society. Paediatric Child Health. 2008 Jan; 13(1): 53–56.

Background and definition of Harm Reduction as a public health policy to aid those working with young people in reducing the risks of typical adolescents.