A/HRC/30/65 B. Harm reduction 11. Harm reduction interventions aim to reduce the harms associated with the use of psychoactive drugs, without necessarily discouraging use. They include needle and syringe programmes, prescription of substitute medications, drug-consumption rooms, promotion of non-injecting routes for the administration of drugs, overdose prevention practices, and outreach and education programmes (see A/65/255, para. 50). Persons who inject drugs are at a heightened risk of contracting HIV, hepatitis B and C,6 and tuberculosis.7 12. The Committee on Economic, Social and Cultural Rights, 8 the Committee on the Rights of the Child9 and the Special Rapporteur on the right to health have all determined that a harm reduction approach is essential for persons who use drugs. WHO, UNODC and the Joint United Nations Programme on HIV/AIDS (UNAIDS) promote harm reduction for injecting drug users.10 The Office of the United Nations High Commissioner for Human Rights has supported harm reduction and the Human Rights Council, in its resolution 12/27, recognized the need for harm reduction programmes. 13. Needle and syringe programmes involve the provision of sterile injection equipment to injecting drug users. WHO has endorsed the use of such programmes, noting that they reduce HIV infections substantially, in a cost-effective manner, without any major negative consequences.11 Needle and syringe programmes eliminate contaminated needles, which reduces the risk of transmitting HIV and other blood-borne diseases such as viral hepatitis, in particular hepatitis B and hepatitis C (see A/65/255, para. 51).12 14. Opioid substitution therapy 13 is an evidence-based approach involving the prescription of medications such as methadone or buprenorphine to treat opioid dependence. Opioid substitution therapy decreases the prevalence of injecting drug use and of sharing injecting equipment, thereby reducing the risk of contracting HIV and other blood-borne viruses, and is effective in managing withdrawal from opioids and preventing a relapse into drug use (see A/65/255, para. 52). WHO has recommended that all people from key populations who are dependent on opioids be offered and be given access to opioid substitution therapy.14 15. Drug overdoses, most of which involve opioids, are the main cause of drug-related deaths. Opioid substitution therapy reduces the use of drugs by injection and thus of overdosing by almost 90 per cent. 15 The Special Rapporteur on the right to health and WHO have highlighted that first aid training for the administration of naloxone, which 6 7 8 9 10 11 12 13 14 15 4 WHO, Guidance on Prevention of Viral Hepatitis B and C among People Who Inject Drugs, policy brief (July 2012). Harm Reduction International, Global State of Harm Reduction 2012. See E/C.12/RUS/CO/5, E/C.12/ZAZ/CO/1, E/C.12/EST/CO/2 and E/C.12/UKR/CO/5. In its general comment No. 15 (2013) on the right of the child to the enjoyment of the highest attainable standard of health. WHO, UNODC and UNAIDS, Technical Guide, pp. 10-26. WHO, “Effectiveness of sterile needle and syringe programming in reducing HIV/AIDS among injecting drug users” (Geneva, 2004), p. 28, and WHO, Consolidated Guidelines, p. 4. WHO, “Four ways to reduce hepatitis infections in people who use drugs” (21 July 2012) and UNAIDS, The Gap Report (Geneva, 2014), p. 173. Opioid substitution therapy is also referred to as opioid maintenance treatment, opioid agonist maintenance treatment or medication assisted treatment, according to WHO. WHO, Consolidated Guidelines, p. 4. WHO, Community Management of Opioid Overdose (Geneva, 2014), p. 3.