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    About HRI

    HRI is a leading non-governmental organisation working to reduce the negative health, social and human rights impacts of drug use and drug policy by promoting evidence-based public health policies and practices, and human rights based approaches to drugs. Read more about HRI’s history.

    Vision and Mission

    Our vision is a world in which individuals and communities benefit from drug laws, policies and practices that promote health, dignity and human rights.


    Meet our staff at HRI


    HRI is governed by a nine person Board of Directors, elected for three-year terms.

    What is harm reduction?

    Harm reduction refers to policies, programmes and practices that aim to reduce the harms associated with the use of psychoactive drugs in people unable or unwilling to stop. The defining features are the focus on the prevention of harm, rather than on the prevention of drug use itself, and the focus on people who continue to use drugs.

    Harm reduction definition and principles in 12 languages

    Contact Us

    Please feel free to contact us if you have any questions or queries about our website, our work, membership or the international harm reduction conference.


    HRI benefits from the generous support of the Open Society Foundations, the European Commission, the Elton John AIDS Foundation, the MAC AIDS Fund, UNAIDS, the World Health Organization, the UN Office on Drugs and Crime, the World Bank, The Robert Carr Networks Fund and the Swiss Government.

    Harm Reduction International Awards

    HRI presents a number of awards at outr international conference to acknowledge the contributions of outstanding groups or individuals in the field.

    Strategic Plan

    Our vision is a world in which individuals and communities benefit from drug policies, laws and practices that promote health, dignity and human rights

  • Our Work

    Evidence for advocacy

    HRI produces groundbreaking research and policy analysis informing advocacy across our sector.

    Spending where it matters

    Funding for harm reduction services is dangerously short while billions are wasted on drug enforcement. HRI works to assess resourcing needs and advocates for a reinvestment in health.

    Harm Reduction Decade

    Read our latest report calling for a Harm Reduction Decade, sign the Harm Reduction Decade Declaration, call for #10by20, and stand up for human rights of people who use drugs, their families and communities.

    10 by 20 Campaign

    We are calling on governments to redirect 10% of the resources currently spent on ineffective punitive responses to drugs and invest it in harm reduction by 2020.

    Human rights-based policy

    Human rights abuses and drug enforcement go hand in hand. HRI challenges laws, policies and practices that generate harm.

    The Death Penalty for Drug Offences

    HRI monitors the death penalty for drugs in law and practice worldwide, and also considers critical developments on the issue.

    Sector strengthening

    HRI builds advocacy coalitions and supports emerging harm reduction networks to strengthen the international harm reduction sector.

    International conference

    Harm reduction is a global movement. Our biennial gathering is the International Harm Reduction Conference, convened by HRI.

  • News

    News and Announcements

    Read the latest announcements and updates from HRI.

  • Global State of Harm Reduction

    Global State of Harm Reduction

    Our flagship publication is the biennial Global State of Harm Reduction report. First published in 2008, it involves a coordinated effort across practitioners, academics, advocates and activists to map global data and responses to HIV and hepatitis C epidemics related to unsafe injecting and non-injecting drug use. It is the only report to provide an independent analysis of the state of harm reduction in the world. The information collated within the report is stored and regularly updated on an interactive e-tool for researchers and advocates.

    The Global State of Harm Reduction report is supplemented by regular thematic reports and advisories on key issues and emerging challenges. Please search our Resource Library for more information or join our e-list for regular updates.

    Interactive e-tool

    Global State of Harm Reduction’ e-tool is an interactive resource containing up-to-date information on harm reduction policy and programming around the world. Users can select countries or regions and create tables for an at-a-glance guide to the current state of harm reduction worldwide.

  • Resource Library

    Resource Library

    Use our extensive resource library to search for HRI, NGO and academic reports, articles and presentations, including materials from past international conferences.

    Harm Reduction Journal

    Harm Reduction Journal,, is an open access, peer-reviewed, online journal whose focus is on the prevalent patterns of psychoactive drug use, the public policies meant to control them, and the search for effective methods of reducing the adverse medical, public health, and social consequences associated with both drugs and drug policies.

  • Contact Us

    Contact Us

    Harm Reduction International
    Unit 2C09 Southbank Technopark
    90 London Road
    SE1 6LN  

    Tel: +44(0) 207 717 1592
    Join us on Facebook at: Harm Reduction International
    Follow us on Twitter at: HRInews
    Join us on Instagram at: hrinews

  • HR19

    Conference 2019

    The 26th Harm Reduction International Conference (HR19) which will take place April 28-May 1 in Porto, Portugal at the Alfândega Porto Congress Centre.


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Best - Overdosing on Opiates P1 image

This section provides a broad introduction to overdose and overdose prevention. In particular, the two papers by David Best and his colleagues neatly outline the main causes of overdose and the ways in which it can be prevented.

Advisory Council on the Misuse of Drugs (2000) Reducing Drug Related Deaths. UK: The Stationary Office.

This detailed report was commissioned in order to inform policy and programming responses to drug related deaths in England and Wales. It examines the epidemiology of overdose related death by substance as well as mortality associated with chronic drug related illnesses. It explores the various social, structural and societal risk factors for drug related death and the current data collection methods in this area, before outlining priorities for a policy framework.

Click here to view this document

Best D, Man L, Zador D, Darke S, Bird S, Strang J & Ashton M (2000) Overdosing on Opiates: Part 1 – Causes. Drug and Alcohol Findings, Issue 4.

This is the first instalment of a two-part series of thematic review papers. It consolidates findings on the causes and epidemiology of opiate overdoses, drawing on research and experiences from Western Europe and Australia.

Click here to view this document

Best D, Man L, Zador D, Darke S, Bird S, Strang J & Ashton M. (2001) Overdosing on opiates: Prevention. Drug and Alcohol Findings, Issue 5.

This is the second instalment of a two-part series of thematic review papers. It consolidates findings on methods of preventing opiate overdoses, and explores the various interventions that have been implemented – including naloxone distribution, peer education, extending maintenance therapy, and prison through-care.

Click here to view this document

Coffin P & Strodaha A (2002) Overdose in Central and Eastern Europe and the Former Soviet Union. New York: Open Society Institute.

Recent developments and public interest in overdose prevention approaches led the Open Society Institute’s ‘International Harm Reduction Development’ programme to explore the situation across Central and Eastern Europe. The results of this survey, based on the perceptions of harm reduction programme stakeholders throughout the region, suggest that there is a significant opportunity to stimulate overdose prevention initiatives in the region. More overdose prevention initiatives would help prevent fatalities, contribute to the value society places on the lives of drug users, and give even more legitimacy to harm reduction.

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Darke S & Hall W (2003) Heroin Overdose: Research and Evidence-Based Intervention. Journal of Urban Health, 80 (2), pages 189 – 200.

This article provides an overview of research into heroin overdose, in order to inform interventions that will reduce the rate of overdose-related death. The demographic characteristics of overdose cases are discussed, including factors associated with overdose (such as poly-drug use, drug purity, drug tolerance, routes of administration, and suicide), and responses by heroin users upon witnessing overdoses. The paper then explores potential interventions to reduce the rate of overdose and overdose-related morbidity. Unfortunately, we are unable to provide free access to this article at this stage.

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Darke S & Zador D (1996) Fatal Heroin “Overdose”: A Review. Addiction, 91(12), pages 1765–1772.

This paper provides an analytic review of the literature on fatal heroin overdose – including the circumstances accompanying overdoses, overdose causes and features, as well as possible strategies to lower mortality associated with heroin use. The report found that deaths attributed to overdose are typically among older heroin-dependent males who are not in drug treatment at the time of death – and the minority involve heroin alone. The authors conclude that the term overdose is perhaps misleading, since it implies the same mechanism of death in all cases.

Click here to view this document online

Eurasian Harm Reduction Network (2009) Overdose (website).

This dedicated section of the Eurasian Harm Reduction Network website features a regional situation analysis for overdose, an overview of overdose programmes in the region, and links to resources on overdose prevention, first aid, and service provision.

Click here to view this website

Eurasian Harm Reduction Network (2008) Drug Overdose in Selected Eurasian Countries: Key Points. Lithuania: EHRN.

This short factsheet introduces some key points around overdose and overdose responses, with particular reference to countries in Eastern Europe and Central Asia. It covers overdose data and research, overdose services, knowledge and skills as well as current policies and laws.

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Harm Reduction Coalition (2009) Overdose (website).

This web-page from the Harm Reduction Coalition in the USA includes a range of resources such as key research, guide materials, training materials, and a description of the Harm Reduction Coalition’s own overdose prevention programmes.

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Preston A, Hunt N & Derricott J (2001) Preventing Overdose: A Briefing Paper. UK: Exchange Supplies / Department of Health.

This twelve page document is a comprehensive briefing paper on drug overdose, and aims to provide workers, advocates and people who use drugs with a clear understanding of the prevalence of overdose, the associated risks, and the responses which can help reduce this ultimately preventable cause of death. The guide sets out the case for providing injecting drug users with first aid information and advice to help them to respond appropriately to overdose situations.

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Stancliff S, Rath C (2008) Building Capacity in Overdose Prevention. Power Point Presentation. USA: Harm Reduction Coalition.

This presentation from the Harm Reduction Coalition outlines the key arguments and the main challenges for the provision of overdose prevention services in needle and syringe programmes, homeless shelters, hospitals, drug treatment and HIV programmes, prisons, and with formerly incarcerated individuals. It also provides a good summary of the overdose prevention services that are delivered in New York. For more information about the Harm Reduction Coalition’s work on overdose, visit

Click here to view this power point presentation

Warner-Smith M, Lynskey M, Darke S, Hall W (2000) Heroin Overdose: Prevalence, Correlates, Consequences and Interventions. National Drug and Alcohol Research Council Monograph No. 46. Australia: University of South Wales.

This detailed monograph outlines the prevalence of heroin use, dependence and both non-fatal and fatal overdose in Australia. Related risk factors are examined as well as the causes, mechanisms and health consequences of overdose. The authors conclude with recommendations for policy and research in this area.

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World Health Organization Substance Use Department (1998) Opiate Overdose: Trends, Risk Factors, Interventions and Priorities for Action. Geneva: WHO.

This document reviews international data on trends in illicit opioid use and opioid overdose deaths, in order to identify research priorities and strategies for overdose prevention. It covers the risk factors for opioid overdose and suggests a number of potential interventions that may reduce opioid overdose deaths. The document concludes with priorities for action to better define and record overdose and other drug-related deaths and to reduce the toll of overdose deaths.

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