Harm reduction models are misunderstood by many and unknown to others. The harm reduction model is in opposition, by implication of organizational structure, design, and outcomes, to punitive approaches or the zero tolerance model.

Zero tolerance models intend to punish those that use substances by making an example of offenders. Harm reduction models respect drug users and work for social justice linked to human rights (Harm Reduction International, 2016; Harm Reduction Coalition, n.d.). Harm reduction implies implementing safety measures for all psychoactive drugs including controlled drugs, alcohol, tobacco, and pharmaceutical drugs.

In this way, the zero tolerance and the harm reduction models are philosophies about drug use, which implies drug policy, too. The philosophies as theory. The policies as practice. Harm reduction philosophies accept the inevitability of drugs in society. Their use and abuse.

Harm reduction philosophies emphasize individual substance users, communities, and policies in a singular framework. It contrasts with the zero tolerance approach, where the unification is punishment of offenders divided into four big consequences for youth, for one instance of drug use, possession, trafficking, or in reality, simply being caught.

The Center for Addiction and Mental Health (CAMH) says, “Harm reduction is any program or policy designed to reduce drug-related harm without requiring the cessation of drug use” (Erickson et al, 2002).

Rodney Skager of the United Nations Office on Drugs and Crime (UNODC) says the big four consequences for youth within the zero tolerance philosophy are “exclusion from extracurricular activities, transfer to another school, suspension, and expulsion…” (Skager, 2016). Skager claims zero tolerance approaches worsen the issue (Ibid.). CAMH concluded harm reduction should be implemented with “other proven successful interventions for those with substance use problems” (Erickson et al, 2002).

The main divide between the harm reduction model and zero tolerance model, philosophies, or strategies are the emphases on harm and punishment. The former focuses on the minimization of harm to individuals and communities through respect for persons and rights. The latter focuses on punishment for drug users to punish the individual drug user and set an example for others.

To conclude, Bill C-2 An Act to amend the Controlled Drugs and Substances Act (Respect for Communities Act) (2015) describes the full support of the Canadian Medical Association for the harm reduction strategies with the “aim to reduce mortality and morbidity” in spite of “continued exposure to a potentially harmful substance,” especially with addiction defined as “an illness” and that “harm reduction is clinically mandated” as an “ethical method of care and treatment” (Canadian Medical Association, 2015). Although this bill has limited harm reduction by making criteria for applicants and limited exemptions for new clinics, we’re excited that more supervised injection clinics are slowly opening in key cities around Canada, that prescription heroin was just approved as a new evidence-based harm reduction strategy, and that there is opportunity for CSSDP to work together with our local communities and politicians towards harm reduction and to raise awareness about what we can do to help!

Scott Jacobsen

Scott Jacobsen


Scott Douglas Jacobsen researches and presents independent panels, papers, and posters, and founded In-Sight: Independent Interview-Based Journal and In-Sight Publishing. Find out more.