A harm reduction approach to health is one which accepts some human behaviours have harmful consequences, and so encourages practices which aim to reduce the harms associated with these behaviours. A well known example from Sexual Health is the use of condoms to prevent the spread of HIV.

Role of schools and family

It is up to a school or a family to make the decision whether to have a harm reduction or zero tolerance policy to using drugs, alcohol and tobacco. Some Harm Reduction messages are included in the Toolkit (for example, Crew2000 whose philosophy starts “We neither condemn nor condone drug use but believe there are ways to reduce harm for the significant numbers of our fellow citizens who decide to use them”).

Different messages for different substances

With alcohol, harm reduction messages include drinking alcohol slowly, and alternating soft drinks with alcoholic drinks to reduce overall consumption. For drugs, often a harm reduction message would be to take a small amount of a substance and wait one or two hours before taking more to ensure there are no unintended effects.

A specific example of the benefits of this comes from the similar appearance but hugely different effects of Ecstasy (MDMA) and PMA. PMA takes longer to have its effects than Ecstasy, and can kill at a much lower dose than Ecstasy. Frequently tablets have been sold as Ecstasy when they actually contain PMA. Street names of Ecstasy are often used for PMA. Typically, Ecstasy will take effect within half an hour. If someone thinks they have taken Ecstasy and feel no effect, they may take another tablet.

If these are in fact PMA (which takes longer to have an effect) by the time the effects kick in they are extreme (for example, increased temperature and dehydration), and may be at a dangerous level. By taking half a tablet and waiting two hours for the effects, the risk of overdose from taking a stronger drug than expected would be reduced. Underlying this is the message we are never sure what an uncontrolled drug or tablet has in it.