The ‘risk environment’: a framework for understanding and reducing drug-related harm

Abstract 

Public discourses on health increasingly emphasise the environment. While harm reduction has developed in parallel with the new public health movement, and both seek to encourage risk reduction by promoting individual and community action as well as environmental change, there remains an over reliance on individualistic modes of behaviour change. This commentary offers the concept of the ‘risk environment’ as a potentially useful framework for understanding and reducing drug-related harm, especially HIV infection associated with drug injection. It is argued that a shift in focus towards the ‘risk environment’ as a unit of analysis and change helps to overcome the limits of individualism characterising most HIV prevention interventions as well as to appreciate how drug-related harm intersects with health and vulnerability more generally. This in turn raises the importance of ‘non-drug’ and ‘non-health’ interventions for harm reduction and the facilitation of alliances between harm reduction and other social movements oriented to tackling vulnerability as a means of promoting public health.

Keywords:  Risk environment, Injecting drug use, Structural factors, HIV prevention