Harm reduction now has a strong foundation in scientific evidence and is widely accepted in many countries as national policy and much of the worlds scientific community, including leading U.S. and international public-health, e.g. The US National Academy of Medicine, the American Medical Association, the European Union, and the WHO. Nonetheless its impact in official U.S. policies and practices remains minimal. In this chapter, two harm reduction case studies are presented: one about needle-exchange programs for intravenous drug users and the about methadone treatment programs for heroin addiction. These studies suggest how, in order to improve impact, research questions must be strategically chosen. and presented. Such research should support our ability to implement HR policies in practice and make public-health officials more accountable for their opposition to HR, using the mounting body of evidence supportive of HR to support changing those positions. Both of these cases demonstrate the possibilities (and limitations) of advocacy research where science speaks truth to political power.
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