Needle exchange programs — in which drug users can exchange used syringes for new ones in order to stop the spread of disease — are probably the most well-known example of a “harm reduction” program.
The basic idea is that instead of trying to prevent problems like drug use, harm reduction aims at reducing the negative impacts of a behavior. These programs have become more and more widespread in the last few decades, but they remain controversial. Seattle, for example, is considering a measure that would stagger the times local bars would be forced to stop serving alcohol. Proponents feel this would help avoid a 2 AM rush on taxis (which potentially leads to drunk drivers), as well as limit noise pollution and binge drinking from those trying to fill up before a 2 AM cut-off.
One of the most controversial programs in North America is Vancouver, BC’s “supervised injection” site Insite. The facility allows addicts to inject drugs under the supervision of medical staff. Supporters say the facility has greatly reduced the risk of death by overdose for the drug-injecting community of Vancouver, and has done so without affecting the broader community. But opponents say that the facility helps to normalize drug use and encourages drug use by making it less dangerous.
What are the ethics of “harm reduction” programs? What are the values that should underlie our public health policies?
- Kathy Mulady: Public information officer for the Seattle City Attorney’s Office
- David Duncan: Clinical associate professor at Brown University
- Ron Joe: Coordinator for addiction services in inner city Vancouver
- Bertha Madras: Professor of Psychobiology at Harvard Medical School