by By Mark and Julia Sine of the Baltimore Student Harm Reduction Coalition

  The term “harm reduction” is being dropped more and more frequently in discussion around drug use and public health in general. What is harm reduction? In its driest form, it is a set of practical, non-judgmental strategies to mitigate risk and prevent the negative consequences of human behavior. What does this mean? It can be something as simple and common as an individual choosing to wear a seat-belt while traveling in a car. Or, it can be as organizational as establishing a sterile syringe distribution program to prevent the spread of infectious disease among people who inject drugs. Harm reduction is a very broad topic, but it is most often linked to drug use and drug policy.

  During this year’s Legislative Session in Annapolis, bills were introduced and testimony was given regarding expanding access to sterile syringes, establishing supervised injections sites, and decriminalizing small amounts of currently illegal substances. These may seem like small reforms, and in the grand scheme of things, they are. But they show an evolving conversation in mainstream debate and represent the incremental progress of legislative politics. In addition to direct action and activism, it is one of many ways to enact change. A gradual redirection from decades of failed policies is taking place in Maryland and across the country, and these small changes will help thousands of people while we fight for broader institutional changes and restructuring.

  Harm reduction is more than a traditional public health initiative; it also focuses on the often-overlooked social harms of drug prohibition. These hidden costs are commonly overshadowed by the violence associated with the drug trade and the health issues associated with drug use. Incarceration, or even a single arrest, can have far reaching and long lasting consequences, especially for people who are already marginalized from society and are disproportionately targeted by the war on drugs. While substance-use disorders and overdose deaths are a mounting and serious concern, we must also look at the social structures supporting the conditions in which the drug trade flourishes. The fact still remains that young people in many poor communities see few viable economic opportunities beyond selling drugs, and basic health care for all populations is still not recognized as a human right. Harm reduction, as both a practice and philosophy, seeks to address both the individual and social forces which lead to negative health outcomes.

  We are already seeing in federal and local governments an increased momentum towards reform. As we approach the election of our next President, mayor, and city council members, we need to seize the opportunity to demand and implement a more just system. We should recognize that educated, safe drug use is both possible and commonly practiced. Instead, we must focus our approach on drug addiction; this is a public health issue, not a criminal issue, and we need to drastically reduce our society’s own addiction to punishment and incarceration. Elected officials must realize and rectify the harms they are causing by continuing along a failed prohibition track, and direct their efforts to a more compassionate and inclusive system. We have the power to make change, and harm reduction is one of the strongest and most humane tools at our command.

  The Baltimore Student Harm Reduction Coalition is a collection of students, faculty, health care professionals, and community members who promote harm reduction principles and practices through education, advocacy, and training. Learn more at or contact

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