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Policy from a harm reduction perspective

Lenton, Simon

Current Opinion in Psychiatry: May 2003 - Volume 16 - Issue 3 - p 271–277
doi: 10.1097/01.yco.0000069082.26384.4a

Clinical and research practitioners should use their influence to call for policy that facilitates interventions that have been shown to be effective in reducing drug-related harm.

Purpose of review The present review addresses recent literature on the effectiveness of reducing drug-related harm in a number of domains that might be promoted, facilitated, hindered or prohibited by drug policy.

Recent findings Increasingly, there is recognition among health professionals, the judiciary and the public that it is possible to design a system of drug control that has less of an emphasis on criminal law. However, for countries contemplating models of drug law other than strict prohibition, the three main international drug treaties limit the scope of changes to domestic laws. During the past 25 years alcohol policies have shifted from reducing the total population consumption to addressing risky drinking situations and patterns of use in order to reduce alcohol-related problems. With regard to drug use, the evidence supports needle and syringe provision schemes in the community; prison drug substitution treatment and needle exchange programmes; removal of criminal penalties for minor cannabis offences; and supervised injecting facilities in localized areas with open, public drug scenes and associated amenity problems. Schemes that divert drug offenders from the criminal justice system to treatment are increasingly common, but their effectiveness is yet to be demonstrated. Provision of naloxone hydrochloride to heroin users and their friends and family to aid in management of heroin overdose has promise, but more research is needed before widespread distribution can be advocated.

National Drug Research Institute, Curtin University, Perth, Western Australia, Australia

Correspondence to Simon Lenton, BPsych MPsych(clin), Senior Research Fellow, National Drug Research Institute, Curtin University, GPO Box U 1987, Perth, WA 6845, Australia Tel: +61 8 9426 4200; e-mail:

© 2003 Lippincott Williams & Wilkins, Inc.