Harm Reduction for Injection Drug Users

Abstract

Harm reduction for injection drug users (IDUs) refers to programs designed to reduce or minimize negative health consequences related to substance use among IDUs without the expectation of substance use abstinence. Harm reduction arose as a response to emerging HIVepidemics driven by injection drug use in the midto late 1980s. The goal of harm reduction is to reduce individualand societal-level harms that can result from drug use rather than focusing on stopping drug use altogether. Some harm reduction programs focus on reducing the amount and frequency of drugs used with the eventual goal of abstinence. However, the vast majority of harm reduction programming focuses on the reduction of physical harm to the individual injector, their immediate social network, and the public as a whole, particularly in reducing the transmission of HIV and other infectious diseases. Because the harm reduction approach in dealing with substance use is nontraditional, implementation of harm reduction programs can be controversial and politicized. Despite this, harm reduction strategies have been implemented widely both globally and in the United States. Common harm reduction programs include needle or syringe exchange programs (NEPs or SEPs), supervised injection facilities (SIFs), drug treatment, and provision of condoms and education about sexual transmission of HIV.