'Just say no' doesn't work

Tony Gizzie speaks out against harm reduction as a strategy in fighting drug addiction. Harm reduction is a proven strategy that helps many people who drink or use drugs. I am a member of Parent Action on Drugs, a community group that, like the Centre for Addiction and Mental Health and Toronto Public Health, has successfully delivered programs based on harm reduction. They've all done so because it works.

In the U.S., the "Just Say No to Drugs" strategy did not stop youth from drinking and taking drugs. Should we just continue to preach abstinence as the only solution?

Teaching people they should not drink and drive is harm reduction. Educating youth that condom use will prevent not only pregnancy but also disease is harm reduction. Giving people options to the heavy use of alcohol is harm reduction - like showing a daily drinker that he or she can cut back to three days a week and be healthier.

Making people aware, giving them options and helping them change their behaviour - whether it's stopping, cutting back or adding new strategies to their lives - is harm reduction.

It is not a cop-out, as Gizzie implies. It's a proven solution that helps thousands of people who drink or take drugs, and helps society around them.

Nancy Miller, Toronto

Commentaries like the one written by Tony Gizzie, a banker from Oakville, are precisely the reason why harm-reduction programs fail. Such programs for intravenous drug use have been shown to be effective in reducing the burden of drug abuse in countries all over the world, including Canada.

However, many of these programs are threatened by knee-jerk appeals to the "common sense" of people with no experience treating or living with substance abuse. Gizzie referred to Alcoholics Anonymous and its policy of complete withdrawal, but he neglected to mention that many alcoholics return to normal drinking patterns later in life. He also failed to mention the enormous societal cost of treating drug addiction and the fact that for the vast majority of addicts, abstinence does not work.

"Harm reduction" applies to the society that no longer has to shoulder the immense economic, social and health burden of complications due to unsafe drug use.

It is this kind of "up by your bootstraps" thinking that shuts down progressive social programs, or prevents them from starting in the first place. I would implore the Toronto Star and Gizzie to leave the arguments on harm reduction to people who know more about it.

Ian Cromwell, Toronto

In Canada, the application of the harm-reduction approach in substance-abuse treatment has become accepted public-health policy. It is part of any professional program that seeks to assist any person who has become addicted to drugs. Self-help programs such as Alcoholics Anonymous and its offshoots, which focus on a spiritual force to recovery, can also be part of successful treatment programs.

Tony Gizzie obviously has not done his homework before stating his beliefs. There is no strong evidence that an AA approach is superior to harm reduction in any time frame for all addicts. There is no evidence that the AA immediate-abstinence approach will help all addicts or substance abusers. And there is no evidence that AA reduces overall social and health costs to the individual and society.

Non-judgmental harm reduction has been accepted in Canada and around the world as a smart strategy for the individual and society.