Over the last 40 years, approaches to drug control around the world have been the focus of heated debate. At the end of the twentieth century, harm minimization became a dominant policy consideration around the world, but tension arises in relation to how reductions in drug-related harm can best be achieved. This article explores the different ways this type of policy platform has been put into practice by contrasting police-centred applications of this concept with formulations that operate across a spectrum of social policy sectors. In doing so, it compares dominant law enforcement trends in South East Asia and China with the development of Australia’s broad-based National Drug Strategy Framework. We argue that the effective application of harm minimization to address drug problems involves adopting an understanding of a continuum of harm that productively positions drug users as members of the broader society, favours pragmatic policy action over moral judgment, and shares the burden of harm reduction across all social service sectors (for example, education, health, and law enforcement). We conclude our article with a brief overview of some strategies for implementing best practice in the development of pragmatic preventive partnerships designed to reduce drug-related harm.