Critics of the international drug control regime contend that supply-oriented policy interventions are not just ineffective, but they also produce unintended adverse consequences. Research suggests their claims have merit. Lasting local reductions in opium production are possible, albeit rare; but, unless global demand shrinks, production will shift elsewhere, with little or no effect on the aggregate supply of heroin and, potentially, at some expense to exiting and newly emerging suppliers.

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The net consequences of the international drug control regime and related national policies are as yet unknown. In this paper, we consider whether “harm reduction,” a subject of intense debate in the demand-oriented drug policy community, can provide a unifying foundation for supply-oriented drug policy, one capable of speaking more directly to policy goals. Despite substantial conceptual and technical challenges, we find that harm reduction can provide a basis for assessing the net consequences of supply-oriented drug policy, choosing more rigorously among policy options, and identifying new policy options. In addition, we outline a practical path forward for assessing harms and policy options.