Out of Sight, Out of Mind: Shedding Light on Two Blind Spots in Harm Reduction Discourse.

Harm reduction policies aim to reduce drug-related harms. This has historically involved providing tailored health services to people who use drugs to do so more safely. Social justice is another defining element of harm reduction. This component aims to reduce drug-related stigma and minimise the social harms experienced by people who use drugs by advocating for the decriminalisation of the possession of illicit drugs. However, the harms that occur before drugs reach a user's hands or a country's borders have received less attention in harm reduction. These harms include the environmental damage that arises from illicit drug production and the humanitarian violence many individuals experience when carrying drugs across borders to escape extreme poverty and/or gang violence. In this debate piece, we highlight the extent of these harms and argue that they need to be considered when developing more comprehensive international approaches to harm reduction.