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June 1, 1994

'Harm Reduction' Approach May Be Middle Ground

JAMA. 1994;271(21):1641-1645. doi:10.1001/jama.1994.03510450013006

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MEDICINE has been given a back seat in this country's so-called war on drugs.

Dealing with drug addiction was once primarily the purview of physicians. But since the initiation of prohibition in the early part of this century, and especially since the "war on drugs" was declared in the 1970s, drug use, abuse, and addiction have been treated primarily as crimes and only secondarily as a public health problem. Critics say this makes the public health problem worse.

Medicine as Cornerstone  Medicine, however, is the cornerstone of an alternative approach to drug policy referred to as "harm reduction." This approach emphasizes comprehensive and compassionate treatment for addiction, with physicians providing medical therapy and not viewing abstinence as the only worthy outcome.International comparison studies suggest that the success of medical treatment for heroin addiction is related to the quality of the treating staff, especially the involvement of physicians, says John

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