ORGANIZATION OF AMERICAN STATES

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1 ORGANIZATION OF AMERICAN STATES INTER-AMERICAN DRUG ABUSE CONTROL COMMISSION FIRST INTER-REGIONAL FORUM OF EU-LAC CITIES: PUBLIC POLICIES IN DRUG TREATMENT April 2 5, 2008 Santo Domingo, Dominican Republic OEA/Ser.L/XIV.4 CICAD/EULAC/doc.24/08 30 March 2008 Original: English ABSTRACT TREATMENT AND HIV/AID. Harm Reduction MARCUS DAY Director of the Caribbean Drug and Alcohol Research Institute St. Lucia GENERAL SECRETARIAT OF THE ORGANIZATION OF AMERICAN STATES, WASHINGTON, D.C

2 PANEL 3.d. Tratamiento y SIDA. Reducción del Daño* Marcus Day, Director of the Caribbean Drug and Alcohol Research Institute, St. Lucia Harm Minimisation or Harm Reduction has had a controversial history in the Americas. Accepted in Europe as a pragmatic, public health based approach to reducing the medical and social consequences of drug use, harm reduction has been scientifically shown to be an effective intervention strategy for those drug users outside the reach of traditional, high threshold abstinent based services. Initially developed as a programme to reduce the HIV risk of injecting drug users, Harm reduction has grown into a set of practical strategies that allow intervention workers and service providers to make contact with drug users with the most chaotic lifestyles. These interventions work to help keep them alive while allowing them the time and space to make the lifestyle changes necessary to improve their lives. Harm reduction allows service providers to become a different mirror in which a drug user can reflect and see that there is a life outside of drugs that he can work toward at his own pace. Harm Reduction Harm reduction is a set of pragmatic, practical strategies that help reduce the negative medical and social consequences of drug use. Harm Reduction advocates a spectrum of intervention strategies often referred to as a continuum of care from street based, low threshold drop in centres that meet drug users "where they re at," through to high threshold residential rehabilitation centres that help a user to live a drug free live. Harm reduction strategies address both the conditions of use along with the use itself. Because harm reduction stress that interventions and policies reflect specific individual and community needs, there is no universal definition of or formula for implementing harm reduction. However, the Caribbean Harm Reduction Coalition considers the following principles central to harm reduction practice. Harm Reduction accepts, for better and for worse, that licit and illicit drug and alcohol use is a part of our world and chooses to work to minimize the harmful effects of their use rather than simply ignore them or condemn them.

3 Harm Reduction understands drug use as a complex, multi-faceted phenomenon that encompasses a continuum of behaviours from severe and chaotic drug use to total abstinence, and acknowledges that while no drug use is the goal some ways of using drugs are clearly safer than others. Harm Reduction measures the criteria for successful interventions and policies as the quality of life and well being for the individual and the community life. Success therefore is not only measured against the cessation of all drug use--. Harm Reduction is the non-judgmental, non-coercive provision of services and resources to people who use drugs and the communities in which they live in order to assist them in reducing the attendant harms. Harm Reduction sees drugs users themselves as the primary change agents in the goal of reducing the harms their drug use causes Harm Reduction seeks to empower drug users to share information and support each other by educating each other in strategies which reduce the consequences of their drug use. Harm Reduction recognizes that the realities of poverty, class, racism, social isolation, past trauma, sex-based discrimination and other social inequalities affect both people's vulnerability to and capacity for effectively dealing with drugrelated harm. Harm Reduction does not attempt to minimize or ignore the real and tragic harm and danger associated with licit and illicit drug use. Harm Reduction ensures that drug users and those with a history of drug use routinely have a real voice in the creation of programs and policies designed to serve them. Harm Reduction is not about the legalisation of drugs. For more information on establishing a harm reduction, street based intervention in your city please contact Dr Marcus Day Director Caribbean Drug & Alcohol Research Institute Box 1419 Castries, Saint Lucia marcus.p.day@gmail.com

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