Harm reduction: Come as you are
Harm reduction: Come as you are
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DOI：
10.1016/0306-4603(96)00042-1
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发表时间：
1996-11-01
影响因子：
4.4
通讯作者：
Marlatt, GA
中科院分区：
文献类型：
--
作者：
Marlatt, GA
本文的目的是描述什么是减少伤害，它是如何发展的，它是如何工作的，以及为什么它成为成瘾行为领域的主要方法。根据公共卫生原则，减少伤害提供了一套务实而富有同情心的战略，旨在减少成瘾行为对药物消费者及其所生活的社区的有害后果。为了说明如何将减少危害应用于成瘾问题的预防和治疗，现介绍一次全国减少危害会议的要点。介绍了欧洲（荷兰和英国）减少危害方案的历史根源。论文最后讨论了对减少伤害至关重要的四个基本假设：(a)减少伤害是对吸毒和成瘾的道德/犯罪和疾病模式的一种公共卫生替代方案；(b)它承认禁欲是一种理想的结果，但接受减少伤害的替代方案；(c)它主要是作为一种基于对成瘾者的倡导的“自下而上”的办法出现的，而不是由成瘾专业人员制定的“自上而下”的政策；(d)促进低门槛获取服务，作为传统高门槛方法的替代方案。
The purpose of this paper is to describe what harm reduction is, how it developed, how it works, and why it is becoming a major approach in the addictive behaviors field. Based on principles of public health, harm reduction offers a pragmatic yet compassionate set of strategies designed to reduce the harmful consequences of addictive behavior for both drug consumers and the communities in which they live. To illustrate how harm reduction has been applied to both the prevention and treatment of addiction problems, highlights of a national conference on harm reduction are presented. The historical roots of harm reduction programs in Europe (Netherlands and the United Kingdom) are described. The paper concludes with a discussion of four basic assumptions central to harm reduction: (a) harm reduction is a public health alternative to the moral/criminal and disease models of drug use and addiction; (b) it recognizes abstinence as an ideal outcome but accepts alternatives that reduce harm; (c) it has emerged primarily as a ''bottom-up'' approach based on addict advocacy, rather than a ''top-down'' policy established by addiction professionals; and (d) it promotes low threshold access to services as an alternative to traditional high threshold approaches.