HARM REDUCTION - PERSPECTIVES AND POLICY STATEMENT

Harm reduction is an important but diffuse concept that requires clarification. Not all people who have addictive disorders are amenable to an abstinence-based recovery at any given time. Therefore, it is essential that intervention(s) be provided to reduce the harm associated with continued drug use and/or engagement in addictive behaviour.

Addiction is a primary, chronic disease, characterised by impaired control over the use of a psychoactive substance and/or behaviour. Decreasing the negative, harmful consequences of drug use, to the user, those around him/her and society, is much harder to achieve in the face of continuing drug use.

Harm reduction and abstinence-based treatment must not be viewed as polarised concepts. Rather, interventions need to be viewed on a continuum, where containment and amelioration of drug-related harms are appreciated as an early, necessary step, where cessation of drug use is not feasible and/or acceptable to the affected person. Abstinence-based treatment must be made readily available taking individual needs into account. A spectrum of interventions needs to be provided after proper assessment for problems related to drug use and other addictive disorders.

Hence, the Canadian Society of Addiction Medicine Harm Reduction Policy Statement is:

Health promotion, prevention, assessment and intervention options that aim to decrease the health and socio-economic consequences of drug use and addictive behaviour, without necessarily requiring abstinence, must be made readily available to all people. Abstinence-based strategies are an integral component of a comprehensive harm reduction policy.

The implications of this policy would be:
(a) As a prevention activity, there needs to be more emphasis on educating all members of our society about harms resulting from drug use, abuse and addictive behaviours;
(b) Education of health care providers to utilise harm reduction and abstinence-based treatment as complementary strategies;
(c) Provision of a spectrum of prevention, intervention and treatment resources for individuals, families and communities to minimise addiction-related harm, including comprehensive addiction treatment when needed;
(d) Commitment to research and utilisation of evidence-based practice to clarify and validate the various approaches to harm reduction; and
(e) Co-operation with law enforcement and legislators to implement and
monitor changes resulting from harm reduction policies.

Adopted 1999 October 16