In their recent article [1], Dupont and Voth characterize harm reduction as "a creative renaming" of the "dismantling of legal restrictions against the use and sale of drugs." This is a fundamental misconception of harm reduction as we understand it [2-4]. Indeed, within the harm-reduction perspective, "civil and criminal laws are seen as potent tools" [4] for reducing drug-related harm.

DuPont and Voth apparently view drug policy as a dichotomous choice between "two opposing policy options": prohibition and legalization. In our understanding of harm reduction, the intellectual power of the concept comes precisely from its potential to transcend the old "legalization versus prohibition" debate [3]. Consider the following prototypes of harm-reduction programs:

1) Providing many easily accessible treatment programs for persons dependent on psychoactive drugs [both legal and prohibited]; 2) providing syringe-exchange programs for injection drug users at risk for infection with the human immunodeficiency virus and other blood-borne pathogens (note that syringe-exchange programs have not led to increased drug use and have been found to reduce transmission of blood-borne viruses [[5]]; 3) providing "designated driver" and "call a taxicab" programs to reduce drunken driving; and 4) restricting advertising for, and banning vending machine sales of, cigarettes. None of these programs should be considered as requiring either full legalization or full prohibition of the drugs in question.

We invite readers to take the following short test: Can you think of several new programs, new public policies, new laws, or new social customs that might reduce drug-related harms—without resorting to the old forced choice between legalization versus prohibition? If you can, then you can understand the fundamentals of harm reduction and of contributing constructively to this new paradigm.