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When in a drug epidemic should the policy objective switch from use reduction to harm reduction?

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  • Caulkins, Jonathan P.
  • Feichtinger, Gustav
  • Tragler, Gernot
  • Wallner, Dagmar

Abstract

A heated debate in drug policy concerns the relative merits of "harm reduction" (e.g., reducing drug-related HIV/AIDS transmission) vs. "use reduction" (controlling drug use per se). This paper models whether shifting emphasis between these goals over the course of a drug epidemic might reduce social costs relative to pursuing one or the other exclusively. Results suggest different answers for different drugs and/or countries. In particular, harm reduction may have always been effective for Australia's injection drug use problem, but for US cocaine it may not have been in the past even if it could be so today. In certain circumstances harm reduction may "tip" an epidemic toward a high- rather than low-use equilibrium. The location in state space of regions where this occurs can be sensitive to parameter changes, suggesting caution may be in order when advocating harm reduction, unless there is confidence the epidemic has been modeled and parameterized accurately.

Suggested Citation

  • Caulkins, Jonathan P. & Feichtinger, Gustav & Tragler, Gernot & Wallner, Dagmar, 2010. "When in a drug epidemic should the policy objective switch from use reduction to harm reduction?," European Journal of Operational Research, Elsevier, vol. 201(1), pages 308-318, February.
    • Handle: RePEc:eee:ejores:v:201:y:2010:i:1:p:308-318
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    References listed on IDEAS

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    Cited by:

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    2. Caulkins, Jonathan P. & Feichtinger, Gustav & Grass, Dieter & Hartl, Richard F. & Kort, Peter M. & Novak, Andreas J. & Seidl, Andrea, 2013. "Leading bureaucracies to the tipping point: An alternative model of multiple stable equilibrium levels of corruption," European Journal of Operational Research, Elsevier, vol. 225(3), pages 541-546.
    3. Massin, Sophie, 2012. "Is harm reduction profitable? An analytical framework for corporate social responsibility based on an epidemic model of addictive consumption," Social Science & Medicine, Elsevier, vol. 74(12), pages 1856-1863.
    4. Miléna Spach & Antoine Pietri, 2018. "Is Heavy Drinking Always Profitable For Alcohol Industry? An Epidemic Framework For Alcohol Consumption [Le binge drinking est-il toujours profitable à l’industrie alcoolière ? Un modèle épidémique," Université Paris1 Panthéon-Sorbonne (Post-Print and Working Papers) hal-02867917, HAL.
    5. Choudhury, Nishat Alam & Ramkumar, M. & Schoenherr, Tobias & Singh, Shalabh, 2023. "The role of operations and supply chain management during epidemics and pandemics: Potential and future research opportunities," Transportation Research Part E: Logistics and Transportation Review, Elsevier, vol. 175(C).
    6. Wei Wang & Sifen Lu & Haoxiang Tang & Biao Wang & Caiping Sun & Pai Zheng & Yi Bai & Zuhong Lu & Yulin Kang, 2022. "A Scoping Review of Drug Epidemic Models," IJERPH, MDPI, vol. 19(4), pages 1-18, February.

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