In her critique of the Four Pillars (discussed in more detail below) Erin Graham given the following explanation for HR:

Harm reduction is, broadly speaking, a set of strategies and treatment methods used in the treatment of drug and alcohol addiction (though the use of the term has ‘leaked’ into many areas of social policy). These strategies are meant to meet the addict where s/he is, and to offer alternatives to methods or sites of drug use, as well as treatment options that gradually move the person toward health care services and drug treatment programs. (Graham, 2007: 12)

Similarly, learner-centred approaches to adult literacy try to meet the learner where she/he is, value the development of self-esteem and advocate personal or individual empowerment (Norton, 2001: 13). In practice, learners are supported to set their own learning goals and work towards them at their own pace.

Another way to understand HR is by assessing competing philosophies or approaches. For example Erickson, Riley, Cheung and O’Hare (1997) describe three competing views on how to work with drug users: prohibitionist (drug use is “morally wrong”), legalization (de-criminalization and killing the black market — a sensible approach, but too radical for some) and the medical model (drug users are medically deviant, bad or sick). The authors argue that Harm Reduction challenges all these approaches because it is value-neutral, avoids over-simplification and assumes the user is active rather than passive.

Sarah’s response: Our perspective needs to be humanistic and holistic. Users are learners, not just students; human beings, not just clients; agents, not victims or service-recipients. Like all of us, users are people with hopes, dreams and potential, not just case studies.

Another comparative description comes from Bruce Alexander (2001), a respected Simon Fraser University-based expert on addictions. In a 2005 seminar for residents of Vancouver’s Downtown Eastside, he described how three overlapping periods in Vancouver’s history in which drug use was approached differently: From WW1 to 1985, a “Policing” approach was used, featuring horrendous police brutality, long jail terms and heavy police activity. From 1960-1995 the focus was on psychological treatment for drug addiction, with a lot of money going into treatment programs. And from 1990 to the present, a Harm Reduction approach has predominated, featuring less punishment, and more acceptance, but also less money available for treatment. Alexander argues that Harm Reduction is the best and most humane approach, but it will not eliminate or reduce the drug addiction problem.

This literature focuses on drug use, but parallels can be made with other areas of risk such as violence, street entrenchment and sex trade work. For example, a recent history of the sex trade in Vancouver (Francis, 2007) describes how the reigns were tightened and loosened over the years by legislation and social attitudes. The variations in the law were often in response to political and commercial pressure, rather than concern for the welfare of the sex-trade workers.