Summary
Abstract
Let me begin by emphasizing a couple of points: I did not (as Wodak says) recommend that we abandon harm reduction because the United States is vehemently opposed to it. Nor did I (as Strathdee & Patterson allege) fail to mention the benefits of treatment. These commentators were so eager to slay the dragon that they ended up tilting at windmills.
My concern was with harm minimization (namely, macro harm reduction), not micro harm reduction. The problem I raised was this. If commitment to harm minimization helps to improve our policies and programmes then it ought to be possible to determine which policies/programmes best minimize harm. This is impossible, because (a) there is no common metric in which drug‐related harms can be compared; (b) many drug‐related harms are difficult, if not impossible, to measure; and (c) reducing one type of drug‐related harm often increases others.