Contemporary and effective youth AOD services are committed philosophically to harm reduction which is has been an integral feature of Australia’s National Drug strategy since 1985. As part of a broader Harm Minimisation framework, harm also has practical application for youth AOD Services and practitioners.
Harm reduction focuses on limiting or minimising the negative effects of substance use without necessarily seeking abstinence or a reduction in use. Applied to young people with multiple and complex needs, harm reduction also embraces interventions to reduce the harmful impacts of problems in other domains of life such as mental health problems, homelessness, or involvement in the justice system. The harms of concern include harms to the development and wellbeing of the young person, as well as to their families, peers and communities.
As a philosophical approach, harm reduction rests on other higher order values. Young people have a human right to receive services whether or not they choose to abstain from or reduce their substance use. Respect is needed for a young person’s right to be protected, particularly those who are minors and their right make decisions for themselves about how to manage their life (including decisions that might possibly contribute to harmful outcomes).
Further to consideration of these foundational values, there is also evidence that an abstinence-based or zero-tolerance approach to service provision is ineffective for adolescents (Toumbourou et al., 2007). Based on the findings of their review of strategies for reducing the harms associated with substance use, Toumbourou et al. concluded that abstinence-only approaches ‘functionally deny services to those unwilling to completely eliminate use’. Given that ongoing substance use is almost ubiquitous in the sub-cultures of young people using AOD services, insistence on abstinence before granting access to services would likely result in further exclusion of this marginalised population.