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Models to Reduce the Harmful Consequences of Substance Use Disorder

Models to reduce the harmful consequences of substance use disorder (SUD), also known as harm reduction models, seek to decrease morbidity and mortality associated with substance misuse for those for whom abstinence is not an immediate or feasible goal. The goal of harm reduction models is to reduce at-risk, moderate, and high-risk behaviors often associated with substance use disorders.

The Harm Reduction Coalition has established eight key principles to harm reduction practice:

  1. “Accepts, for better or worse, that licit and illicit drug use is part of our world and chooses to work to minimize its harmful effects rather than simply ignore or condemn them.
  2. Understands drug use as a complex, multi-faceted phenomenon that encompasses a continuum of behaviors from severe substance abuse to total abstinence, and acknowledges that some ways of using drugs are clearly safer than others.
  3. Establishes quality of individual and community life and well-being — not necessarily cessation of all drug use — as the criteria for successful interventions and policies.
  4. Calls for the non-judgmental, non-coercive provision of services and resources to people who use drugs and the communities in which they live in order to assist them in reducing attendant harm.
  5. Ensures that drug users and those with a history of drug use routinely have a real voice in the creation of programs and policies designed to serve them.
  6. Affirms people who use drugs (PWUD) themselves as the primary agents of reducing the harms of their drug use, and seeks to empower PWUD to share information and support each other in strategies which meet their actual conditions of use.
  7. Recognizes that the realities of poverty, class, racism, social isolation, past trauma, sex-based discrimination and other social inequalities affect both people's vulnerability to and capacity for effectively dealing with drug-related harm.
  8. Does not attempt to minimize or ignore the real and tragic harm and danger associated with licit and illicit drug use.”

Evidence-based Models

Promising Approaches