Harm reduction and harm minimisation
Harm minimisation and harm reduction are terms frequently misunderstood outside of the public health field, despite being cornerstones of Australian drug policy for over a decade.
This reading list looks at definitions, histories, policy implications, and developments, rather than specific harm reduction programs such as methadone, needle exchange, alcohol taxation and the myriad other devices used to reduce drug-related harms. Harm reduction for alcohol, Indigenous communities and school drug education are listed in separate reading lists.
The following books, reports and journal articles are currently held in the DrugInfo resource centre.
Books and reports
Rhodes T & Hedrich D (eds.) 2010 Harm reduction: evidence, impacts and challenges, Lisbon: European Monitoring Centre for Drugs and Drug Addiction (EMCDDA)
Cook C, Lines R, Stimson G, & Bridge J 2009 Harm reduction and human rights : the global response to drug-related HIV epidemics [PDF: 957KB](new window), London: International Harm Reduction Association
Cook C & Kanaef N 2008 Global state of harm reduction 2008: mapping the response to drug-related HIV and hepatitis C epidemics, London: International Harm Reduction Association
International Harm Reduction Association 2006 17th International Conference on the reduction of drug related harm April 30–May 4, 2006, held Vancouver, Canada, London: International Harm Reduction Association
DrugInfo resource centre no. ref JB22 IHRA
Roberts M, Bewley-Taylor D & Trace M 2006 Monitoring drug policy outcomes: The measurement of drug related harm, Report no 9, Surrey: The Beckely Foundation Drug Policy Programme
Ryder D, Walker N & Salmon A 2006 Drug use and drug-related harm, 2nd ed., Melbourne: IP Communications
First published in 2001, this book discusses the fundamental concepts which allow people to make judgements about drug use, drug related harms and what can be done to minimise harms.
DrugInfo resource centre no. adf JB22 RYD
Commonwealth Department of Health and Ageing for National Drug Strategy 2005 Intergovernmental Committee on Drugs. National Drug Strategic Framework. Annual Report 2003–2004 to the Ministerial Council on Drug Strategy, Canberra: CDHA
Ritter A & Cameron J 2005 A systematic review of harm reduction [PDF: 377KB](new window), Fitzroy: Turning Point
DrugInfo resource centre no. ref MP20 TURN
Stockwell T, Gruenewald P, Toumbourou JW & Loxley W 2005 Preventing harmful substance use; the evidence base for policy and practice, Milton: Wiley
DrugInfo resource centre no. JB20 STO
Denning P, Little J & Glickman A 2004 Over the influence; the harm reduction guide for managing drugs and alcohol, New York: Guilford
This book aims to teach harm reduction techniques to drug and alcohol users, to assist them in taking control of their lives. It includes many real life personal experiences.
DrugInfo resource centre no. JB22 DEN
Drug Policy Expert Committee 2004 A harm minimisation policy framework for the Department of Human Services; Final report, Victoria Department of Human Services. Melbourne: Department of Human Services
DrugInfo resource centre no. JB22 DHS
King T & Richards J 2004 Australian local government: alcohol harm minimisation projects: good practice guide, Melbourne: Turning Point
DrugInfo resource centre no. JF24 TRE
Mendes P & Rowe J (eds.) 2004 Harm minimisation; zero tolerance and beyond; the politics of illicit drugs in Australia, Frenchs Forest: Pearson
DrugInfo resource centre no. JB22 MEN
Spooner C, McPherson M & Hall W 2004 The role of police in preventing and minimising illicit drug use and its harms, Sydney: National Drug and Alcohol Research Centre
DrugInfo resource centre no. MO28 SPO
Hunt N 2003 A review of the evidence-base for harm reduction approaches to drug use, London: International Harm Reduction Association (IHRA)
Duff C 2010 "Enabling places and enabling resources : new directions for harm reduction research and practice", Drug and Alcohol Review 29:3, pp. 337–344
This harm reduction digest argues that we need to look beyond the everyday tools of harm reduction like needle and syringe programs and peer education to 'enabling places' and 'enabling resources', areas where public policy makers and social planners can ensure the delivery of more innovative harm reduction policies and programs.
Islam MM, Day CA & Conigrave KM 2010 "Harm reduction healthcare : from an alternative to the mainstream platform?" The International Journal of Drug Policy 21:2, pp. 131-133
This commentary provides insights on advantages and disadvantages to mainstreaming harm reduction healthcare centres, and approaches and barriers to achieving this.
Caulkins JP, Tragler G & Wallner D 2009 "Optimal timing of use reduction vs. harm reduction in a drug epidemic model", The International Journal of Drug Policy 20:6, pp. 480–487
This article presents a stylised two-state, one-control policy simulation model of the use vs. harm reduction choice when initiation stems from susceptible non-users interacting with current users.
Rhodes T 2009 "Risk environments and drug harms : a social science for harm reduction approach", The International Journal of Drug Policy 20:3, pp. 193–201
A "risk environment" framework promotes an understanding of harm, and harm reduction, as a matter of ‘contingent causation’. Harm is contingent upon social context, comprising interactions between individuals and environments. There is a momentum of interest in understanding how the relations between individuals and environments impact on the production and reduction of drug harms, and this is reflected by broader debates in the social epidemiology, political economy, and sociology of health.
Weatherburn D 2009 "Dilemmas in harm minimization", Addiction 104:3, pp. 335–339
This paper discusses the dilemmas inherent in pursuing a philosophy of (drug) harm minimization. The dilemmas arise (i) because all drug control policies produce harms as well as benefits; (ii) because many of these harms and benefits cannot be measured; and (iii) because even when they can be measured, judgements about what harms matter the most are irreducibly political.
Christie T, Groarke L & Sweet W 2008 "Virtue ethics as an alternative to deontological and consequential reasoning in the harm reduction debate", International Journal of Drug Policy 19:1, pp. 52–58
This paper analyses objections to harm reduction in light of the ethical theories of John Stuart Mill, Immanuel Kant and Aristotle.
Kleinig J 2008 “The ethics of harm reduction”, Substance Use & Misuse, 43:1, pp. 1–16
The article attempts to set harm minimisation within drug settings into a larger framework of harm minimisation practices. It seeks to provide a plausible account of harm reduction and then explores four ethical challenges for harm reduction strategies.
Reece S 2008 “When harm minimization is not harm minimization: Australia as a case study”, Journal of Global Drug Policy and Practice 1:4
This paper is based on evidence given by the author to the Family and Human Services Committee, House of Representatives, Parliament of Australia, in 2007. The Committee undertook an enquiry into the impact of illicit drugs in Australia and particularly the impact of harm minimisation on Australian families. It released its final report on 13th August 2007 in which 31 recommendations were made.
Irwin K & Fry CL 2007 "Strengthening drug policy and practice through ethics engagement. An old challenge for a new harm reduction", International Journal of Drug Policy, Special edition, Harm Reduction Coming of Age, 18:2, March, pp. 75–83
The authors revisit the relationship between harm reduction and ethics and reframe ethics as a pragmatic concern for all of harm reduction. They argue that greater attention to the actual values and beliefs underpinning harm reduction can help to frame policy and practice. This issue contains several articles on harm reduction.
Milne S, Greenaway S, Conway K & Henwood W 2007 “What next? Sustaining a successful small-scale alcohol consumption harm minimisation project”, Substance Use & Misuse 42:12-13, pp. 1933–1944
Engaging communities in alcohol consumption-related action projects requires the application of a range of flexible and responsive evidence-based methods. These include: establishing collaborative relationships, implementing strategies to improve age verification practices, encouraging organizational change, and raising awareness of local alcohol issues. The focus of this article is the sustainability of an alcohol harm minimisation project for young people in Hawera (a small New Zealand town) that has produced some encouraging results.
Tammi T & Hurme T 2007 "How the harm reduction movement contrasts itself against punitive prohibition", International Journal of Drug Policy, Special edition, Harm Reduction Coming of Age, 18:2, March, 84–7
This paper reflects the movement's self-understanding in contrasting itself with the system of punitive prohibition and concludes that the principles of the harm reduction movement resonate extremely well with the moral sensibilities of our contemporary societies. This issue contains several articles on harm reduction.
McKeganey N 2006 “The lure and the loss of harm reduction in UK drug policy and practice”, Addiction Research and Theory, 14:6, pp. 557–588
This article looks at the extent to which drug use or HIV have had the greater impact on individual and public health within UK and the extent to which it has been possible to reduce drug related harm in the face of continuing drug use.
Ritter A & Cameron J 2006 “A review of the efficacy and effectiveness of harm reduction strategies for alcohol, tobacco and illicit drugs”, Drug and Alcohol Review, 25:6, Nov., pp. 611–24
There is sufficient evidence to support the wide-spread adoption of harm reduction interventions and to use harm reduction as an overarching policy approach in relation to illicit drugs. The same cannot be concluded for alcohol or tobacco. Research at a broad policy level is required, especially in light of the failure by many policy makers to adopt cost-effective harm reduction interventions.
Fry CL, Treloar C & Maher L 2005 "Ethical challenges and responses in harm reduction research. Promoting applied communitarian ethics", Drug and Alcohol Review 24:5 Sep, pp. 449–59
It is argued that harm reduction research, in its focus on technical skills, evidence and innovation, has failed to articulate an agreed moral framework. The authors explain that crucial issues emerge at intersections between human rights, consumer engagement and applied communitarian ethics.
Moore D & Dietze P 2005 "Enabling environments and the reduction of drug-related harm: re-framing Australian policy and practice", Drug and Alcohol Review, 24:3, pp. 275–84
Moore and Dietze use data from their study of street-based injecting drug users and sex workers in the Melbourne suburb of St Kilda to challenge the dominant emphasis of drug policy in Australia.
Thom B 2005 "From alcoholism treatment to the alcohol harm reduction strategy for England. An overview of alcohol policy since 1950", American Journal on Addictions, 14:5, Oct–Dec, pp. 416–25
This paper argues that responses to policy statements—like the policies themselves—have to be examined within the political, economic, and cultural contexts of their time.
Dickson L, Derevensky JL & Gupta R 2004 "Youth gambling problems: A harm reduction prevention model", Addiction research and Theory, 12:4 Aug, Special Issue. Clinical Harm Reduction, pp. 305–16
A risk-protective factor model is used as a conceptual basis for designing a harm reduction prevention program. This framework points to the developmental appropriateness of the harm reduction approach for youth with gambling problems.
Beyers JM, Toumbourou JW, Catalano RF, Arthur M & Hawkins JD 2004 "A cross-national comparison of risk and protective factors for adolescent substance use. The United States and Australia", Journal of Adolescent Health, 35:3, pp. 3–16
The authors compare risk and protective factors that influence substance use in Australia and the US. They conclude that inter-country influences on youth substance use are generally similar despite different policy directions.
DrugInfo resource centre no. vf BEYERS04
Duff C 2004 "Drug use as a practice of the self. Is there any place for an ethics of moderation in contemporary drug policy?", International Journal of Drug Policy, 15, pp 385–93
Offers a series of critical interrogations of the principles and practice of harm minimisation. Suggests that Foucault's work on pleasure and ethics offers important new ways of understanding the changing setting and context in which drug use takes place.
McPherson M & Spooner C 2004 "Police contribution to illicit drug harm minimisation", Australian Police Journal, Sept., pp. 145–148
Police activities related to demand reduction include drug law enforcement, enforcing other laws that may relate to drug use, for example, loitering, and involvement in drug education, support of health campaigns and encouraging entry into treatment programs. Harm reduction includes reducing harm to the user, their families and others in the community.
DrugInfo no. vf MCPHERSON 04
Rogers SJ & Ruefli T 2004 "Does harm reduction programming make a difference in the lives of highly marginalised, at-risk drug users?", Harm Reduction Journal, 1:7, pp. Open access pages
Participatory research of harm reduction with 120 clients using nominal-group technique to develop culturally relevant outcomes to measure progress.
Tammi T 2004 "The harm reduction school of thought: three fractions", Contemporary Drug Problems, 13:3, Fall, pp. 381–99
After years of discussion and mobilisation, it has become generally recognised among the harm reductionists that there are many meanings of the term harm reduction.
Wellbourne-Wood D 1999 "Harm reduction in Australia: some problems putting policy into practice", International Journal of Drug Policy, 10:5, pp. 403–13.
The potential of Australia's national harm minimisation policy to guide intervention has been weakened by a number of forces. This paper examines these and other related obstacles to the implementation of harm reduction strategies. Some suggestions are made in relation to how Australia's harm minimisation policy could more effectively help guide both government and non-government intervention in the drug field.
Lenton S & Single E 1998 "The definition of harm reduction", Drug and Alcohol Review 17:2, pp. 213–20.
In this Australian article, the authors aim to critique some of the previous attempts at defining harm reduction and to offer what will hopefully be a practical set of criteria for policy.
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Last updated: 30 May 2013