Harm Reduction is a pragmatic approach that focuses on decreasing the negative consequences of drug use for communities and individuals. It recognizes that abstinence-based approaches are limited in dealing with a street-entrenched open drug scene and that the protection of communities and individuals is the primary goal of programs to tackle substance misuse. (MacPherson, 2001: 4)
This definition of Harm Reduction comes from a A Framework for Action: A Four Pillar Approach to Drug Problems in Vancouver. The four pillars included in the framework are prevention, treatment, enforcement and harm reduction. The report argues that each pillar should interact with each other and as well as other municipal initiatives “that aim to improve the overall well being of the community”, such as business development, community safety, health and housing initiatives. This policy document is linked to an agreement signed in 1999 by the City of Vancouver, the Province of British Columbia and the Government of Canada known as the Vancouver Agreement. The agreement
commits these government partners to work together, and with communities and business in Vancouver, on a coordinated strategy to promote and support sustainable economic, social and community development.(The Vancouver Agreement, 2000)
The initial focus of the agreement is Vancouver’s Downtown Eastside.
I have started this section with a definition from the Four Pillars Report because I think it helps to set the context for an exploration of how we can apply Harm Reduction principles to programs in Vancouver. Other literature on Harm Reduction provides lists of principles, such as one developed by the US-based Harm Reduction Coalition (Harm Reduction Coalition) — see Table 1) or descriptions of philosophy. The one here seems to be particularly congruent with adult literacy work, especially for those who use a learner-centred approach. Marlatt (1998) describes HR as
Viewing individuals as responsible for their own choices and as both agents and recipients of environmental influence is central to the harm reduction paradigm. Individuals must be engaged "where they are" and moved from there in small manageable steps to increasing levels of improved self-care, health, and well-being. (Marlatt, 1998: ix)