DuPont R L
Institute for Behavior and Health, Inc., Rockville, MD 20852, USA.
Subst Use Misuse. 1996 Dec;31(14):1929-45; discussion 1947-72. doi: 10.3109/10826089609066439.
Harm reduction, an alternative to both drug legalization and drug prohibition, seeks to preserve prohibition by keeping the supply of drugs illegal while softening some of the harsh consequences of prohibition. Typical harm reduction proposals are needle exchanges for intravenous drug users to reduce the spread of HIV infection and the medical use of marijuana for a variety of illnesses including AIDS, glaucoma, multiple sclerosis, and cancer chemotherapy-induced nausea and vomiting. While attractive as a reasonable-sounding compromise, harm reduction carries a high price because it undermines the social signal of prohibition. This signal is a vital public health strategy, especially when it comes to primary prevention of use of alcohol and other drugs by youth. A personal experience with harm reduction, leading to rejection of this approach, is described. Harm reduction, enjoying a minor comeback in the United States, is a favored policy in much of Europe today. Harm reduction is not new, and it is a failure as a public health policy.
减少伤害是介于毒品合法化和毒品禁令之间的一种选择，它试图在保持毒品供应非法的同时保留禁令，以此减轻禁令带来的一些严苛后果。典型的减少伤害提议包括为静脉注射吸毒者提供针头交换服务，以减少艾滋病毒感染的传播，以及将大麻用于包括艾滋病、青光眼、多发性硬化症和癌症化疗引起的恶心呕吐等多种疾病的医疗用途。虽然作为一种听起来合理的折衷方案很有吸引力，但减少伤害付出了高昂代价，因为它破坏了禁令的社会信号。这个信号是一项至关重要的公共卫生策略，尤其是在涉及青少年对酒精和其他毒品使用的一级预防时。文中描述了一段个人经历，该经历导致对这种方法的拒绝。减少伤害在美国正稍有回潮，在当今欧洲大部分地区是一项受欢迎的政策。减少伤害并非新鲜事物，而且作为一项公共卫生政策，它是失败的。
