What is Harm Reduction?

With harm reduction being at the heart of everything we do as individuals and at service level when it comes to working with people who use drugs, we at Hep C U Later have been discussing harm reduction and the bigger picture.  Hep C U Later is in part, commissioned to support NHS Addiction Provider Alliance services reach the micro-elimination of Hepatitis C, while this is an essential element of harm reduction, the wider harm reduction agenda encompasses so much more.

With this in mind, Hep C U Later have decided to launch the “Harm Reduction Series” of blogs, podcasts and resources, including contributions from leaders in the field from across the sector.

In the first piece in the series we have invited three leaders from within the harm reduction field who are recognised locally and nationally for the work they do within their area of work.

We asked each of our guests “What is Harm Reduction?”

The first contributor has been at the cutting edge of harm reduction for over 15 years and has championed the harm reduction agenda at both local and national levels, including pioneering work to put Naloxone on the UK harm reduction map and being chair of the National Needle Exchange Forum.

Philippe Bonnet; Outreach and pharmacy testing manager Hepatitis C trust, Birmingham and West Midlands

“Harm Reduction is not new and has been all around us for decades, in one way or another. Think of seat belt wearing campaigns, various signage in our towns and roads, warning of potential danger, be it falling objects from a building site, speed limitation, dangerous road bends, slippery surfaces, it’s all around us!

When we talk about Harm Reduction in regard to drug use, it should be at the core of every service. Harm Reduction is about meeting people where they are at. Harm Reduction does not shame or judge people and does not expect them to cease using. It is about helping people “keep their heads above the water” until they are ready, and willing to change. It is about making sure individuals are, first of all, alive; then, enabling them to make healthier choices, hopefully with all their limbs, without Blood Borne Viruses and without too many health complications. Harm Reduction is about love, compassion and preservation of life, without judgement. Harm Reduction needs to be embraced, promoted and valued.“

Our second guest contributor is very well know across drug and alcohol services nationally with impeccable knowledge of everything drug and alcohol related, Kevin has an extensive history of working in front line services as a practitioner but in later years is known for his excellent training packages that he delivers to drug and alcohol services across the sector.

Kevin Flemen; KFX Training and Consultancy Specialist (www.kfx.org.uk)

“Harm reduction is all that most people who use drugs need to keep them safe; it’s the knowledge and tools to help avoid inadvertently doing something dangerous.

Harm reduction may be an early step on a path for people not ready, able or seeking to stop using. Harm reduction can help keep people alive, because all lives matter.

Harm reduction helps reduce damage, so that lives can be lived more fully without reduction in capacity or ability.

Harm reduction is what we do with all other risky human activity and is the obvious intervention when you are no longer bound to ideological or moral positions about abstinence.”

Our third guest contribution to this blog is the Harm Reduction Lead for Inclusion in Hampshire. She studied Pharmacy at University of Manchester and has worked for Inclusion for 10 years. Claire has lived experience of using drugs and recovery.

Clare Hatherly; Harm Reduction Coordinator, Inclusion, Midlands Partnership NHS Trust

“Harm reduction is choice, pragmatism, social justice, empowerment, kindness, evidence based, builds community, reduces health inequality, human and gives life.

People will always want to take drugs. Prohibition has not prevented this. For some people their drug use will greatly impact on their health. Improving health is more effective than stigmatising or isolating populations when it comes to keeping people alive. Harm reduction is about meeting individuals where they are, without judgment, and supporting them on their unique paths to well-being.

We provide needle syringe programmes, the lifesaving drug Naloxone, we test and treat blood borne viruses (BBVs), provide basic wound care and health checks. We check in on the wellbeing of the most underserved populations and develop supportive relationships. We stay up to date and provide information on the ever-changing drug market.

Checking our own internalised stigma within drug services as well as challenging individuals and organisations that create barriers to wellbeing for people who use drugs is way to start correcting the injustice and stigma our clients face. The right to health is a human right.  It’s a holistic and empathetic approach that values human dignity above all.

What would I change about Harm Reduction?

The polarisation of the harm reduction vs recovery agenda has the propensity to push people down certain treatment pathways. Recovery and harm reduction are not mutually exclusive. Unity in our professional approach and a diverse range of treatment options to offer our clients is key.

There are some laws I would change to be able to provide crack pipes and other equipment that is needed. I would like further studies on safe consumption rooms. I would like substance use disorders to be recognised under the equalities act, discrimination against people who use drugs seems like one of the last walls of prejudice to be knocked down.

Most of all I would like to see changes in the provision of mental health and housing services for people who use drugs. It’s a constant frustration to support someone to keep themselves safe that does not have their basic needs of shelter and safety met.”

In summary, people may have varying perspectives on what harm reduction is, or means to them, but the core message remains the same, we work with people in a person centred and non-judgmental way, tailoring interventions to the needs of the individual.  Harm reduction is a wide approach, everything from advice to health to housing, and we do this to keep people safe from the harm that may be involved with using a substance.

All of our guest contributions have touched on the common theme of keeping people safe from harm, engaging with them non-judgmentally and empathically.


Tony Mullaney, High Intensity Engagement Coordinator, Hep C U Later