Harm reduction programs accept the reality of drug use while attempting to reduce its harmful consequences to individuals and society. This term, coined about 15 years ago in the U.K., has become a policy paradigm increasingly explored throughout most of the industrialized world. An example of a harm reduction program is the widely accepted substitution of methadone for the more "harmful" heroin. Programs that divert drug-involved offenders into treatment are another example of the operationalization of harm reduction policies.

In these 10 original chapters, international contributors discuss the philosophical basis and history of harm reduction policies and examine their outcome. They also cover controversial topics related to harm reduction, especially conflicts between the public health system where most programs are located, and a worldwide criminal justice system that further marginalizes drug users. Included in this book are descriptions of programs in the United States, the United Kingdom, Canada, Brazil, the Netherlands, Switzerland, and Australia.

The editors provide the context with a substantive introductory chapter focusing on the nature of harm reduction. The first part contains five chapters presenting the American perspectives on harm reduction; Part II includes five chapters presenting international perspectives from countries with particularly innovative harm reduction programs and policies.