Despite recent advances in HIV prevention and treatment, high HIV incidence persists among people who inject drugs (PWID). Difficult legal and political environments and lack of services for PWID likely contribute to high HIV incidence. Some advocates question whether any HIV prevention research is ethically justified in settings where healthcare system fails to provide basic services to PWID a...

As the commercial success of electronic cigarettes offers the opportunity to study harm reduction by replacement therapy, the UK government steers in the opposite direction and plans to expand the 'war on drugs' with a blanket ban on all psychoactive substances. Michael Gross reports.

Canada has long contended with harms arising from injection drug use. In response to epidemics of HIV infection and overdose in Vancouver in the mid-1990s, a range of actors advocated for the creation of supervised injection facilities (SIFs), and after several unsanctioned SIFs operated briefly and closed, Canada's first sanctioned SIF opened in 2003. However, while a large body of evidence hi...

Tim Stockwell raises the question ‘...what exactly is the risk or the problem we are aiming to prevent – is it drug use? Is it risky drug use? Or is it harm?". He suggests that we should not focus solely on prevention of drug use, but incorporate the many opportunities for harm reduction in law enforcement, education and other arenas for prevention work. He suggests that the main yardsticks for...

Although moderation and harm reduction approaches to the treatment of alcohol problems are accepted in many parts of the world, they continue to be rare in the US. A major reason for this state of affairs has to do with the way alcohol treatment services in the US developed, and in particular the creation of a group of paraprofessional counselors many of whom attributed their recovery to the 12...

Harm reduction is a new paradigm that seeks to reduce the harmful consequences of substance use and other risky behaviors without requiring abstinence. This article discusses integrative harm reduction psychotherapy, one application of harm reduction principles to psychotherapy. Seven therapeutic tasks are described with attention to clinical process, skills, and strategies. A case is presented...

After working as Ron Davis’ deputy for the past seven years, I’m honoured and excited to have accepted the editor’s post now that Ron has moved on to become North American editor for the British Medical Journal. All who have followed the progress of Tobacco Control since its launch in 1992 will know what a unique journal it has become under his leadership. From its often riveting covers, throug...

Preliminary research has demonstrated reductions in alcohol-related harm associated with increased use of protective behavioral strategies (PBS) and higher levels of drinking refusal self-efficacy (DRSE). To extend research that has evaluated these protective factors independently of one another, the present study examined the interactive effects of PBS use and DRSE in predicting alcohol outcom...