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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 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.

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, www.harmreductionjournal.com, 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
61 Mansell Street
E1 8AN

Tel: +44(0) 207 324 3535
Join us on Facebook at: Harm Reduction International
Follow us on Twitter at: HRInews
Join us on Instagram at: hrinews


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.

Register to attend HR19 here.

Naloxone Research

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Beletsky - CLosing Death's Door image

This section (alongside Section 6 below) focuses on one particular overdose intervention – naloxone. Naloxone is a medication (an ‘opioid receptor antagonist’) which counters the effects of an opioid overdose, reversing the depression of the central nervous system and respiratory system. Naloxone has long been a ‘pre-hospital’ treatment used by emergency staff in many high-income countries, but is now becoming more widely distributed by harm reduction services to people who use drugs and their friends and families. This section includes several research papers on naloxone – including the attitudes of drug users to the medication and to peer distribution, and the benefits of intranasal administration (spraying the drug up the nose rather than injecting it into the body), and legal aspects of naloxone distribution to heroin users.

Barton ED, Ramos J, Colwell C, Benson J, Baily J & Dunn W (2002) Intranasal Administration of Naloxone by Paramedics. Pre-hospital Emergency Care, 6 (1), pages 54 – 58.

This study aimed to prospectively test the effectiveness of intranasal naloxone administration by paramedics in the USA. A total of 30 patients received naloxone during the study period – 11 of whom responded to naloxone. The authors conclude that intranasal naloxone may provide a safe, rapid, effective way to manage suspected opioid overdoses, and use of this route – rather than intravenous naloxone - may be preferential as associated risks are minimal. Unfortunately, we are unable to provide free access to this article at this stage.

Click here to view this document

Beletsky L, Burris S & Kral AH (2009) Closing Death's Door: Action Steps to Facilitate Emergency Opioid Drug Overdose Reversal in the United States.

This paper presents the findings from a summit on opioid overdose supported by the Drug Policy Alliance. The event brought together drug policy and public health experts to discuss strategies for preventing avoidable overdose by increasing access to naloxone and important basic overdose education. The authors explore the legal and policy obstacles to increasing implementation of naloxone prescription programmes in the United States and provide recommendations for increasing access to this life saving intervention. Unfortunately, we are unable to provide free access to this article at this stage.

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Burris S, Norland J & Edlin BR (2001) Legal Aspects of Providing Naloxone to Heroin Users in the United States. International Journal of Drug Policy, 12, pages 237 – 248.

This paper – in Harm Reduction International’s official journal – is a detailed legal analysis of naloxone provision in the United States. The authors found that the prescription of naloxone is fully compliant with state and federal laws regulating drug prescribing. They conclude that the risks of malpractice liability are consistent with those generally associated with providing healthcare, and offer simple guidelines to minimise these risks further.

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Kelly A-M, Kerr D, Dietze P, Patrick I, Walker T & Koutsogiannis Z (2005) Randomised Trial of Intranasal versus Intramuscular Naloxone in Prehospital Treatment for Suspected Opioid Overdose. Medical Journal of Australia, 182 (1), pages 24 – 27.

This research paper from Australia aims to determine the effectiveness of intranasal naloxone compared with intramuscular naloxone in the treatment of opiate overdoses and the associated respiratory depression. The authors conclude that, in prehospital settings at least – the intranasal delivery of naxolone may be preferable as it could reduce the risk of needle-stick injuries and exposure to blood-borne infections. It is also relatively safe to make more widely available – for example, to increase access to this life-saving treatment in the community.

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Kerr D, Dietze P, Kelly A-M & Jolley D (2008) Attitudes of Australian Heroin Users to Peer Distribution of Naloxone for Heroin Overdose: Perspectives on Intranasal Administration. Journal of Urban Health, 85 (3), pages 352 – 360.

This study examines the attitudes and willingness of people who inject drugs in Australia to administer naloxone to their peers in the event of an opiate overdose. Of a sample of 99 participants recruited from needle and syringe programmes, the majority reported positive attitudes toward naloxone distribution and 92% said they were willing to participate in a related training programme. Some participants raised concerns about peer administration (such as competencies, victim responses afterwards, and legal implications), and almost three quarters said that they would prefer intranasal naloxone. Unfortunately, we are unable to provide free access to this article at this stage.

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Kim D, Irwin KS & Khoshnood K. Expanded Access to Naloxone: Options for Critical Response to the Epidemic of Opioid Overdose Mortality. American Journal of Public Health, 99 (3), pages 402 – 407.

This paper explores the current evidence for scaling up access to naloxone in the United States and finds that extensive scale up is supported by findings from pilot programmes. The authors present a range of possible policy and programmatic responses to avoidable opioid overdose in the country and analyse the advantages and limitations associated with them. Unfortunately, we are unable to provide free access to this article at this stage.

Click here to view the abstract via PubMed

Lagu T, Anderson BJ & Stein M (2006) Overdoses among Friends: Drug users are willing to administer naloxone to others. Journal of Substance Abuse Treatment, 30, pages 129 – 133.

This study aims to explore the distribution of naloxone among heroin users, and whether or not drug users are willing to administer the medication to others. 329 people were recruited to the study, most of whom had used heroin and nearly two thirds of whom reported that they had injected drugs. 64.6% reported having witnessed a drug overdose in the past, and over half of these had experienced an accidental drug overdose. The majority of individuals reported that they would be willing to administer a medication to a peer in the event of an overdose, regardless of their knowledge of first aid etc. Unfortunately, we are unable to provide free access to this article at this stage.

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© 2018 Harm Reduction International.

Charity number – 1117375 | Company number – 3223265

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