Harm reduction: roads less travelled to the Holy Grail (1997)

FRANÇAIS :
La réduction des risques a changé de manière dramatique l'orientation générale de nombreuses approches au niveau des services sanitaires et sociaux. Ce document examine les mérites, les limites et les pièges de l'application de ce concept (par exemple : où positionner le non-usage de drogue ?), présenté par quelques praticiens comme une panacée. Si nous n'explorons pas tous les chemins possibles, le progrès vers notre Saint Graal (minimiser les risques et maximiser les bénéfices potentiels de l'usage de drogues) est entravé. Un modèle complet, exposé ici dans ses lignes générales, ouvre la perspective d'une compréhension plus large et plus appropriée du problème de l'alcool et des drogues, pour les décideurs, les politiciens et pour l'ensemble de la communauté.
ENGLISH :
In recent years, a number of countries have embraced harm reduction as their principal philosophical stance and policy platform on alcohol and other drug-related problems. Harm reduction, while argued by some as not being a new concept, has dramatically changed the overall orientation of many health and human service approaches. We argue that as a result many important considerations have been overlooked. This paper explores the merits of harm reduction and examines the limitations and potential pitfalls that may exist in its application in the real world. For instance, where do we position non-drug-use? Such questions are raised in light of the impression perpetuated by some leading practitioners in this field that harm reduction is a global panacea for alcohol and drug problems. Without exploring all possible paths, progress toward our holy grail of minimising the harms and maximising the potential benefits of drug use will be hampered. An integrated model is discussed, which we believe provides an opportunity for wider acceptance and ownership by alcohol and drug stakeholders, politicians and the community.