After the concept of "harm reduction" spread from European pioneers to American activists in the 1980s and '90s, journalist Maia Szalavitz notes in her new history of the movement, it "terrified drug warriors." With good reason: "If the drug war was to be judged on its capacity to reduce harm, rather than on the number of arrests and drug seizures, it would almost certainly have to be declared lost."
As a rejoinder to "Just Say No" and "zero tolerance," harm reduction is readily understandable, intuitively appealing, and ultimately devastating to the prohibitionist cause. It refocuses attention from drugs to drug-related harm, distinguishes between the damage done by drug use and the damage done by drug laws, and requires weighing the costs of those laws along with their purported benefits. As Szalavitz shows in Undoing Drugs: The Untold Story of Harm Reduction and the Future of Addiction, that's a powerful combination.
Harm reduction opens the door to relatively modest but previously unthinkable programs such as needle exchange, heroin maintenance, and supervised consumption facilities, each of which can be defended as an improvement on the status quo. At the same time, harm reduction invites a radical reconsideration of the way the government deals with politically disfavored intoxicants.
Szalavitz illustrates the subversive potential of harm reduction by describing how the views of its leading promoters evolved as they accepted the idea and tried to apply it consistently. People who initially thought abstinence was the only viable alternative to life-destroying addiction became more tolerant of other approaches, based on the premise that "any positive change" should be welcomed. People who initially accepted prohibition or tinkered around its edges became full-throated abolitionists. The movement's final fruition will depend on whether politicians are capable of similar reflection.