HARM REDUCTION - COME AS YOU ARE

The purpose of this paper is to describe what harm reduction is, how i t developed, how it works, and why it is becoming a major approach in the addictive behaviors field. Based on principles of public health, h arm reduction offers a pragmatic yet compassionate set of strategies d esigned to reduce the harmful consequences of addictive behavior for b oth drug consumers and the communities in which they live. To illustra te how harm reduction has been applied to both the prevention and trea tment of addiction problems, highlights of a national conference on ha rm reduction are presented. The historical roots of harm reduction pro grams in Europe (Netherlands and the United Kingdom) are described. Th e paper concludes with a discussion of four basic assumptions central to harm reduction: (a) harm reduction is a public health alternative t o the moral/criminal and disease models of drug use and addiction; (b) it recognizes abstinence as an ideal outcome but accepts alternatives that reduce harm; (c) it has emerged primarily as a ''bottom-up'' app roach based on addict advocacy, rather than a ''top-down'' policy esta blished by addiction professionals; and (d) it promotes low threshold access to services as an alternative to traditional high threshold app roaches.