Harm reduction, in its present terminology, first started to come on the agenda in the 1980s, and it was seen as an alternative in drug policy to the American-inspired war on drugs. Did harm reduction have an earlier history? Yes, harm reduction did have an earlier history, although it wasn't called harm reduction at the time. In Britain, from, well, the 1920s at least, and earlier as well, doctors were able to prescribe morphine and heroin to drug users if they wouldn't otherwise be able to modify their drug use. If they just couldn't give up. So that had been a kind of leading principle in British drug policy for quite a long while. But in the 1970s, it fell out of favor for various reasons. Treatment moved away from general practitioners in the community into hospital-based specialist drug dependence units and it moved towards abstention as the primary aim of treatment. How did the coming of HIV and AIDS lead to harm reduction in drug policy in the UK? Well, British politicians in the 1980s had taken on the war on drugs approach from the Americans and there was opposition to this even before HIV/AIDS came on the scene from other players in drug policy. In particular, the drug voluntary sector which wanted a harm reduction approach, and in some cities, Liverpool in particular, harm reduction approaches were already being tried but HIV provided a catalyst for quite radical change and for general adoption of the harm reduction approach. The discovery that drug users in Edinburgh were HIV positive or a large proportion of them were HIV positive in 1985 when the HIV tests first became available, raised fears among the government and the population at large that drug use might be a conduit for AIDS spreading in the population as a whole. A government expert committee, the Advisory Council on the Misuse of Drugs, produced a report on AIDS and drug misuse in 1988, which was forced change and it talked about what it called a hierarchy of objectives. So, there could be different objectives to treatment and one of those objectives was harm reduction. There was research done. Research into pilot needle exchanges which also helped to change the opinion of politicians. So, AIDS in a sense was a catalyst for something that a lot of people who want it to happen anyway, but its importance was that it convinced politicians, too. Later on, under the Labor Government in the 1990s, harm reduction became allied to a view that it would lead to a reduction in the prison population. So, harm reduction in the use of methadone was seen as an alternative to prison for drug users. What happened in other countries? Well, harm reduction became an international movement through the international conferences and the international harm reduction association but it didn't apply, it didn't get adopted in all countries. In the United States, for example, there was a racial dimension to harm reduction and black politicians accused advocates of harm reduction of potential genocide by advocating the distribution of needles. Countries like Russia, too, haven't adopted the harm reduction approach and also countries in the far east as well. In recent years, too, the terminology and the idea of recovery has come onto the agenda as an alternative to harm reduction.