Harm reduction--a framework for incorporating science into drug policy.

The articles on addictive substances in this issue of the Journal provide additional information on both the adverse heath consequences of the nonmedical use of psychoactive drugs and the ways in which such consequences might be reduced. It is now abundantly clear that the nonmedical use of psychoactive drugs is one of the major causes of health problems in the United States, as reflected in the physiological effects of the drugs (overdoses and alcohol cirrhosis), behavior while under the influence of drugs (drunken driving and domestic violence), and consequences inherent in drug administration (carcinogens in tobacco Smoke, human immunodeficiency virus (HIV) and other serious infections transmitted through shared injection equipment). Additional health problems arise when criminal laws are used to suppress psychoactive drug use. The recent increases in homicide among US youth(1) may be a result of the increased availability of firearms associated with the illegal distribution of crack cocaine.