How Effective are Harm Reduction Programmes for Drug Users? Some Insights from an Evaluation of the Programme at Sharan in Delhi

Abstract

Drug use and the physical, psychological and social problems associated with it have been one of the major concerns among professionals in the domain of health and health psychology. One important reason for drug use being a matter of deep concern is the risk of HIV infection associated with it. Apart from the practice of unsafe sex among drug users, in recent decades sharing of needles/syringes by injecting drug users has contributed substantially to the spread of HIV/AIDS. The WHO has noted that the harm reduction approach provides an anxiety-free atmosphere (denied by the traditional abstinence-based intervention programmes) for drug users where they learn and discuss the personal social significance of not sharing needles/syringes and exchanging free needles/syringes. Importantly, apart from needle/syringe exchange, oral substitution of drugs, medical care and education to prevent HIV/AIDS, a harm reduction programme provides a psychological space to drug users that not only acts an emotional support but also enables them to reflect upon their life and risk behaviour. Apart from indicating the need of harm reduction programmes, this article also evaluates the effectiveness of such a programme run by Sharan, an NGO in Delhi, during 1999–2002. Apart from various components of the programme, unconditional acceptance of the drug users by the service providers has brought about substantial reduction in risk behaviour and noticeable improvement in their quality of life.