Saint Louis University Journal of Health Law & Policy

Document Type



In the United States, more than 100,000 people now die each year from drug overdose, but nearly all of these deaths are preventable. The purpose of this Article is to show that harm reduction interventions could go a long way towards saving these lives, but we don’t adopt many of these interventions, or fail to adopt them at the scale needed. Although it is often suggested by opponents of harm reduction that the interventions are unlikely to actually reduce harm, this Article argues that the empirical debate is largely over—decades of data demonstrate that harm reduction saves lives, promotes health, saves money, and even improves public order. Rather, this Article suggests opposition to harm reduction is actually often moral, stemming from the implicit moral philosophies that we all carry around. For this reason, this Article takes seriously some of the most powerful ethical arguments against harm reduction, and shows that the richest philosophy of harm reduction undermines these arguments by recognizing the value neutrality of drug use. This Article concludes that harm reduction is justified on a wide variety of moral philosophical grounds.