HARM REDUCTION—AN ETHICAL IMPERATIVE

Abstract

but seems unlikely to me.I feel much the same way about the use of the term 'entheogen' as a replacement for 'psychedelic'; the old term accumulated a great deal of baggage, but it is only a minor cognitive operation to transfer those bags to the new cart, and the new term asserts what ought to be an open question about these drugs' properties.Also, it seems likely that opponents dislike the harm reduction label in part because it is such a good one; it highlights a worthy goal that is neglected by the near exclusive emphasis on abstinence and deterrence in our mainstream policies [2].With respect to clear thinking, harm reduction is an excellent label to be used without apology, as long as it is used as a goal or strategy rather than a program.It is true that not all harms can be quantified or compared (see [3] for a detailed taxonomy and discussion); but the same can be said of love, dignity, respect, passion, creativity, pettiness, cruelty, arrogance, obnoxiousness and many other criteria we seek to monitor and influence in human life.All our interventions affect harms, the intensity of drug use and the prevalence of drug use, whether or not the effects are intended and are beneficial or not.Because total drug-related harm is the product of prevalence of use, intensity of use and harm per unit dose, we should recognize explicitly three criteria-prevalence reduction, quantity reduction and average harm reduction [4]-for any drug program, no matter how it might be labeled. Declaration of interestNone.