Harmminimization

Harm minimization, or harm reduction, is a public health approach aimed at reducing the health, social and legal harms associated with risky behaviors, most notably illicit drug use. It does not require cessation of the behavior but seeks to minimize negative outcomes such as overdose, infections, and unsafe practices.

Its core principles include acceptance of people who use drugs, nonjudgmental care, human rights, evidence-based practice, proportionality, and equity. It emphasizes meeting people where they are and integrating services within broader health and social supports rather than relying solely on punitive interventions.

Common interventions include needle and syringe programs, supervised consumption services, and opioid substitution therapy (for example, methadone or buprenorphine). Additional measures include take-home naloxone for overdose reversal, access to testing and vaccination for blood-borne infections, wound care, contraceptive and vaccination services, and drug-checking or education to reduce risky use.

Evidence suggests harm minimization can reduce transmission of HIV and hepatitis C, decrease overdose deaths, and increase engagement with health services. Its impact on reducing overall drug use is less consistent. Critics argue it may be perceived as enabling drug use and risks allocating resources away from treatment; proponents emphasize governance and integration.

It is implemented within various policy contexts worldwide and often faces political and legal barriers. When well designed and properly funded, harm minimization is considered a pragmatic component of comprehensive public health strategies for reducing substance-related harm.