Harm Reduction:

is a public health philosophy and intervention that seeks to reduce the harms associated with drug use and ineffective drug policies. A basic tenet of harm reduction is that there has never been, and will never be, a drug-free society.

The Drug Policy Alliance advocates reducing the harms of drug use through a lens of public health, using accurate, fact-based drug education, drug-related illness and injury prevention, and effective drug treatment for problematic use. We believe that every solution with the potential to promote public health and to mitigate harm should be considered. We continue to seek innovative health approaches to drug use, drug treatment, and drug policy that are based on science and research.



“Harm reduction” is nothing new. Just look around. It’s everywhere in our modern society. Harm reduction has become the health and safety standard for the 21st century.

Don’t believe me? The list of ways we’ve integrated harm reduction into our culture in the United States is endless. In fact, harm reduction is so common in our society we consider it normal. Are you surprised? Here are some examples from everyday life:

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• Wearing a helmet when riding a motorcycle
• Pasteurization of milk
• Sand around children’s playground equipment
• Seat belts
• Traffic lights and Stop signs
• Eating less fat, sugar, and salt
• Helmets when playing sports
• TSA screening at the airport
• Brushing your teeth
• Police patrols
• Condoms before sex
• Putting plywood over windows for hurricane protection

And the list goes on and on. With harm reduction so prevalent in our society, you’d think it would be the norm in the addiction industry. But it’s not. A few years ago, I submitted a proposal for a presentation on harm reduction to the American Psychological Association (APA). It was promptly rejected. The brain disease theory is still the most widely accepted concept of treatment in addiction. Because of this, harm reduction is rarely considered.

We disagree with that. At Alternatives, we offer modern addiction treatment programs. Our goal is to meet clients where they’re at. Why wait until they hit “rock bottom,” or all other forms of treatment have failed? That makes no sense.

For example, if an extremely overweight man comes into our office and tells us he wants to cut out 25% of the sugars and starches in his diet, but he intends to continue with his nightly “Twinkie fix,” we’re happy to help him achieve that goal. This is harm reduction. Yet many treatment facilities wouldn’t accept him as a client. They’d determine he’s in denial and not serious enough for treatment. Once again, we disagree.

Harm reduction is very successful in addiction treatment. Why? Because it’s so flexible. This approach can be the first step toward a goal of complete abstinence. Or it can be the end goal. At Alternatives, we leave that choice up to the client.

Like it or not, we live in a harm reduction society. If your goal requires more flexibility, maybe you should consider harm reduction as a treatment option. It works!

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A Harm Reduction-Principled Approach to Assisting the Relief of Drug-Related Problems.

Integrating the heart of harm reduction -- respecting work on any positive change as a person defines it for his/herself -- fashions a health sensitive alternative to the predominant practice of abstinence-only assistance for the relief of drug problems. This new approach is called Substance Use Management (SUM) as it no longer requires abstinence but instead focuses on a range of options for improvements while still including abstinence among the possible self-selected outcomes. SUM is suggested as a framework for change within the treatment system so as to maximize treatment's constructive impact, cost- effectiveness and maturation as a distinct discipline which can appropriately attract support and resources for making society healthier.  

Definition of Substance Use Management:  

"SUM is the practice of setting a new perspective on what constitutes help with drug problems and respectfully and collaboratively assisting the positive changes selected by the person seeking help. The role of the helper is to refocus the outcome on an individual's own view of success -- offering as wide a variety of options for improvement as possible -- and allowing the person the freedom to select the option(s) they choose to work on with the intensity they desire. Abstinence becomes a tool to achieve other ends versus being an end in and of itself. Most of all, SUM seeks to build a relationship with the respectful collaboration described here so as to have a basis with which to engage and continue SUM's work until the person is happier and healthier. SUM makes no condemnation about a person's choices in consumption but rather seeks to assist people in fulfilling their own desires for life improvement and satisfaction even when these desires include ongoing drug use. SUM recognizes that no matter how far into drug abuse a person is their basic humanity is never completely lost. Inherent in SUM's practice is the belief that the Human Spirit we all possess is more powerful than the Human Destructiveness we are all capable of demonstrating. Trust in this belief is necessary for SUM to be practiced in earnest." -Dan Bigg, CRADC
Chicago Recovery Alliance