Harm reduction and the use of current illegal drugs: Some assumptions and dilemmas

Abstract

The assumptions underlying harm reduction approaches, and some of the difficulties encountered when trying to implement them, are discussed. The issues considered include widespread moral opposition to harm reduction; a lack of political will; disputes about what works; harm reduction strategies that have sometimes caused harm; the fact that many effective interventions are simply not implemented; and the fact that drug users are themselves sometimes resistant to, and are careless, or casual, about harm reduction. It is concluded that pursuing harm reduction approaches, despite the many barriers to their effective implementation, continues to be worthwhile.