1. A pragmatic approach to public health that aims to limit the risk of unsafe behaviors rather than prohibit them
Why is harm reduction needed?
Because when it comes to risky behaviors, such as drug use, teenage sex and socializing during a pandemic, the “just say no” approach has been proven not to work. As millions of adults who suffered through the in-school D.A.R.E. program know, bombarding kids about the dangers of drugs and alcohol does not actually make them less likely to start using. Abstinence-only sex education, which the federal government has funded with about $2 billion over the past 20 years, has not changed the age people first have sex — but has often meant they lack information about diseases and pregnancy prevention when they do.
There is rarely a one-size-fits-all prescription for healthy behavior. Even when there is, attempting to scare or coerce people into compliance is less effective than making the behavior as safe as it can be.
What does harm reduction look like?
Needle exchanges for IV drug users are a hugely successful case study. In the 1990s, for example, drug users in New York were three times more likely to contract HIV if they did not use a needle exchange. Other examples include designated sites for drug use and providing free contraceptives for sex workers. Replacing the criminalization of dangerous behaviors with non-judgmental, public health-based approaches can help address root causes and provide better social outcomes.
“Dangerous behaviors” like going to house parties or crowded bars?
Yes! Many public health experts believe that as the pandemic drags on, we need to adopt a harm reduction approach to social contact, especially considering that ongoing quarantine is simply not possible for some people. Rather than continue to advise that people not see anyone outside their households, even while we know that many are going to bars, “safer socializing” might include, for example, gathering in parks where distance can be maintained, masks are required and hand sanitizer is plentiful.
It’s not an accident that this sounds a bit like classic American sex education. Decades-long public health campaigns to educate about HIV/AIDS prevention and normalize condom use have a lot of lessons for the current moment. We just need to move much, much faster to ward off catastrophe.
This is part of “The Big Idea,” a monthly series offering brief introductions to progressive theories, policies, tools and strategies that can help us envision a world beyond capitalism. For recent In These Times coverage of harm reduction, see “Don’t Shame Protesters and Park-Goers Over Covid-19 Spreading — Shame Corporations and the State,” “Harm Reduction: The Anti-Drug” and “Should HIV-Positive Workers Be Allowed in the Sex Industry? Some Advocates Say Yes.”