Harm minimisation is an approach focused on reducing the negative health, social and economic consequences of alcohol and other drug use on both individuals and the community as a whole.

Harm minimisation is the basis of World Health Organisation’s policy in relation to alcohol and other drugs and has guided Australia’s National Drug Strategy since its inception in 1985. As such, credible youth AOD services in Australia incorporate adopt a harm minimisation approach.

The aim of Australia’s National Drug Strategy (NDS) 2010–2015 is to build safe and healthy communities by minimising alcohol, tobacco and other drug-related health, social and economic harms among individuals, families and communities.

Alcohol and other drug use, both licit and illicit, is accepted as an inevitable part of society. Eradication of alcohol, tobacco and other drug use has been demonstrated to be impossible and in fact continued attempts at eradication may well result in increasing harm to society. 

The three pillars of harm minimisation

  1. Demand reduction to prevent the uptake and/or delay the onset of use of alcohol, tobacco and other drugs; reduce the misuse of alcohol and the use of tobacco and other drugs in the community; and support people to recover from dependence and reintegrate with the community
  2. Supply reduction to prevent, stop, disrupt or otherwise reduce the production and supply of illegal drugs; and control, manage and/or regulate the availability of legal drugs
  3. Harm reduction to reduce the adverse health, social and economic consequences of the use of alcohol, tobacco and other drugs.

Source: National Drug Strategy 2010– 2015 

The NDS 2010-2015 requires all harm minimisation strategies to be applied with sensitivity to age and stage of life, disadvantaged populations, and settings of use and intervention. Previous National Drug Strategies in Australia have specified the following principles to which all harm minimisation strategies should adhere:

  • First, do no harm
  • Focus on the harms used by drug use rather than use per se
  • Maximise intervention options
  • Choose appropriate outcome goals, giving priority to those that are practical and realizable
  • Respect the rights of persons with drug-related problems

Harm minimisation informed goals and strategies are wide ranging and for individuals can include safer drug use, controlled use and abstinence. All strategies, whether they be focused reducing the supply, the demand or the harms associated with drug use are unified under harm minimisation by the necessity to bring about a “net reduction” in harm.  If a strategy is implemented and it can be demonstrated to cause or contribute to more harm it ceases to be harm minimisation. Genuine harm minimisation strategies stem from pragmatic decisions made without prejudice made based on the facts generated from review and evaluation.  

Strategies that have been devised with the best intentions can inadvertently bring harmful outcomes for individuals and communities that are unforeseen. This highlights the necessity for continual evaluation. When harm is increased a reorientation of the strategy is required as is further evaluation. This is not as simple as it seems as there is often disagreement as to what constitutes risk or harm and the best method for reducing it. There are also variations in how evaluation is conducted. One strategy can have differing impacts for individuals, groups and communities and at times there can be competing interests at play. The needs of all groups should be considered but at times a difficult decisions need to be made. 

From more information about harm minimisation and Australia’s current National Drug Strategy see the link provided and the PDF attached.

A module on harm reduction is included within this toolbox.