Vincent van Gogh, Skull with Burning Cigarette (c. 1885)
Harm reduction has long been the mantra of the British approach to the problem of drug addiction, particularly to heroin. The argument in favour of this approach is as follows:
Certain people will continue to take drugs whatever prohibitive or restrictive measures are taken to interdict supply, and whatever therapeutic means are employed to encourage them to stop.
These people are a hazard to themselves and to others, for example by taking variable quantities of the drug, thus risking dangerous overdose, and by sharing needles so that they spread blood-borne viruses which, by means of sexual contact, can enter the general population.
Moreover, these people who will take drugs irrespective of anything else generally find it difficult or impossible to meet the economic costs of continuing by legal means, and therefore resort to crime to ‘feed their habit,’ thus causing much misery to the rest of the population.
In view of the intractability of their addiction, then, it is best to supply them with drugs and injecting equipment that will reduce, though not entirely eliminate, the harm they do to themselves and others.
It is not my purpose here to argue whether harm reduction works or not, a question of formidable complexity and indeed moral import. I wish merely to point out an interesting contradiction, of some cultural significance, in the British Medical Journal, which has in the past published a large number of articles in favour of harm reduction.
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