What Is Harm Reduction? A Practical Public Health Approach

Harm reduction, while relatively new to health policy approaches, has long been a practice used in health and human behaviour to help people manage risk.

What is Harm Reduction:

Recognises the risk in certain behaviours and understands that while the ideal measure would be to avoid the risk altogether, this is not always possible.
Offers alternatives and adjustments to risky behavior that result in less harm.
Can be seen as a strategy for achieving a set of goals, and while the goal may be abstinence from the behaviour, harm reduction helps identify the steps in reaching abstinence or allows the individual to engage in the original behaviour with less associated harm.
Provides a realistic approach, allowing people to be effectively supported in all behaviours they choose to engage in.
For many, it provides a strategy for stopping an often unwanted addiction.

Everyday Example of Harm Reduction

While the most common example of harm reduction practices in healthcare tends to be around substance use, society engages in harm reduction behaviour daily as we encounter risk, for example, when choosing to drive a car. There will always be a risk of getting into an accident; however, harm reduction means there are steps in place to make sure we endure less harm due to the implementation of seatbelts, airbags, driving lessons, restrictions on driving under the influence of alcohol, and other safety measures that enable people to drive more safely and manage their risk.

Other Examples of Harm Reduction:

Access to clean needles for drug users: When considering drug policy and harm reduction, 108 countries include harm reduction in national policies, but stigma and resistance globally mean these kinds of programs continue to be massively underfunded.
Access to naloxone for heroin & opiate users: Needles and Syringe exchange programs (NSPs) along with access to opioid substitutes were found to lower risks of contracting Hepatitis C by 41% if individuals accessed needles from syringe programs and 59% if they used an opioid substitution. Similarly, certain countries have adopted harm reduction approaches in addressing tobacco-related harms.
Access to nicotine patches, pouches and other safer nicotine products for smokers: Access to safer nicotine products such as SNUS, have potential to reduce health harms caused by cigarettes, with SNUS causing only 5% of the harm of cigarettes. The positive effect this has on smoking cessation can be observed when comparing countries that have adopted this approach, such as Sweden, to countries that have not, such as Argentina in their journey to becoming smoke free.

Conclusion

Harm reduction understands that delivering effective care involves caring for people without judgement. As health professionals and a society whose ultimate goal is health and the prevention of illness, risk assessment is vital to supporting individuals who might be struggling with addiction or other risky behaviours. Harm reduction allows for a renewed focus on improvements and adjustments to risk, allowing for a more reflective risk assessment tool for certain behaviours.