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  • Harm Reduction Decade

    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

    10 by 20 Campaign

    Everything you need to know about the 10 by 20 campaign

    10 by 20 Pie Chart

  • 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.

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    Read the latest announcements and updates from HRI.

  • About

    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.

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    Meet our staff at HRI

    Governance

    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

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    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.

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    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

    An international environment supportive of harm reduction scale up

  • 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.

    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.

  • 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.

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    Harm Reduction International
    Unit 2C09 Southbank Technopark
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    SE1 6LN  

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Other Prevention Research and Interventions

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DPA - OverdoseReportMarch2009 image

In addition to naloxone distribution (see Sections 5 and 6), there are number of additional interventions and approaches which can prevent overdose deaths amongst people who use drugs. These are especially for non-opioid users (such as cocaine users), for whom naloxone offers no protection. This section includes papers on interventions in prisons, the impacts of high quality substitution treatments, and how the creation of a safer injection facility in Canada has helped to manage and reduce overdoses. There is also a comprehensive review of an overdose programme in Australia – which included peer education and informational materials.

Albizu-Garcia CE, Hernandez-Viver A, Feal J, Rodriguez-Orengo JF (2009) Characteristics of inmates witnessing overdose events in prison: implications for prevention in the correctional setting. Harm Reduction Journal 2009, 6:15

While community-based responses to drug overdose are becoming more common, information on drug overdose in prisons is scarce. This paper examines the frequency with which prisoners in Puerto Rican prisons witness drug overdose events in prison. In order to inform future overdose prevention programming in prisons, the study also examines socio-demographic variables and drug use history to assess whether those who have witnessed drug overdoses differ from those who have not.

Click here to view this document

Drug Policy Alliance (2009) Preventing Overdose, Saving Lives Strategies for Combating a National Crisis. USA: DPA.

This comprehensive report examines the extent of overdose related mortality in the United States and assesses the policy solutions available and how they have been successfully implemented across the country. It identifies areas in need of further study and investment
and offers a roadmap for responding to the national opioid overdose crisis with rational, compassionate and responsible public health policies.

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Fatseas M & Auriacombe M (2007) Why buprenorphine is so successful in treating opiate addiction in France. Current Psychiatry Reports, 9:5, pages 358-364

The successful minimization of barriers to buprenorphine maintenance therapy access in France from 1995 onwards resulted in approximately 20% of all physicians in the country prescribing BMT to over half of the estimated 180,000 people who used heroin problematically. The paper describes how this rapid increase in availability led to a substantial decline in total opiate overdose deaths in France. Unfortunately, we are unable to provide free access to this article at this stage.

Click here to view the abstract via PubMed

Kerr T, Small W, Moore D & Wood E (2007) A Micro-Environmental Intervention to Reduce the Harms Associated with Drug-Related Overdose: Evidence from the evaluation of Vancouver’s safer injection facility. International Journal of Drug Policy, 18, pages 37 – 45.

Conventional drug overdose prevention strategies have been criticised for failing to address the macro- and micro-environmental factors that shape drug injecting practices and compromise individual ability to reduce risks. This paper – from Harm Reduction International’s official journal – reports on the perspectives of injecting drug users and suggests that safer injection facilities can address many of the micro-environmental factors that drive overdose risks. These interventions may play a key role in managing and preventing overdoses – particularly in large street-based drug scenes.

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Kerr T, Tyndall MW, Lai C, Montaner JSG & Wood E (2006) Drug-Related Overdoses within a Medically Supervised Safer Injection Facility. International Journal of Drug Policy, 17, pages 436 – 441.

This is one of two papers in this section from Harm Reduction International’s official journal which focus on the role of safer injection facilities in terms of preventing overdoses. This research paper examines the incidence and features of overdoses witnessed at the supervised injection facility in Canada. In the study period, there were 336 ‘overdose events’ in the facility, most of which were treated with oxygen. Despite this relatively large number, “it is noteworthy that none of these overdoses resulted in a fatality”. Unfortunately, we are unable to provide free access to this article.

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McGregor C, Hall K, Ali R, Christie P, Braithwaite R & Darke S (1999) It’s Rarely Just the “H”: Addressing Overdose Among South Australian Heroin Users Through a Process of Intersectoral Collaboration. South Australia: Drug and Alcohol Services Council.

This document reviews the South Australian heroin overdose intervention, which started in 1994. The three strands of the project were the development of partnerships among key stakeholders and the achievement of structural change, the development and implementation of a peer education process, and the development and dissemination of information materials. This report aimed to identify the experience and circumstances of overdoses in South Australia, develop appropriate interventions to reduce these, evaluate the effectiveness of targeted interventions, and review institutional sources of data. The findings demonstrate that the majority of overdoses involve the use of heroin and other depressant drugs together, and that such interventions are feasible and effective.

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Milloy M-J, Kerr T, Tyndall M, Montaner J & Wood E (2008) Estimated Drug Overdose Deaths Averted by North America's First Medically-Supervised Safer Injection Facility. PLoS ONE, 3(10), e3351.

This research study investigates the number of deaths potentially averted by the implementation of a medically supervised safer injection facility (SIF) in Vancouver, Canada. One of the objectives of the SIF, known as InSite, is to prevent overdose incidents through the provision of education and the medical supervision of drug injecting. The authors conclude that the potentially fatal overdoses at InSite during the study period could have resulted in between 8 and 51 deaths had they occurred outside the facility. This equates to between 6% and 37% of the total overdose mortality burden in the neighbourhood during this time, illustrating a clear overdose prevention benefit from the facility.

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