A Thai government policy taking measures to curb the use of illicit drugs has changed the pattern of use away from heroin to other alternatives such as dormicum (Midazolam), hypnotics, and alcohol, which are not suitable for intravenous injection. Serious health complications arising from injecting drugs are related to high-risk user practices such as needle sharing resulting in blood occlusion, HIV infection, AIDS, and tuberculosis. Policies and laws have been primarily aimed at protecting the users and eradicating the suppliers. Convincing intravenous drug users (IDUs) to stop injecting is the desired result, but many drug users are either unready or unable to do so. Stakeholders and health providers have to patiently help them by basing their treatment on the theory of harm reduction. Harm reduction involves various techniques, primarily through the use of alternatives such as Methadone maintenance. Other methods are Voluntary Counseling and Testing (VCT), access to antiretroviral therapy (ART) and tuberculosis care. Outreach programme activities aim to identify new cases while community networks and continual encouragement aim to help drug users believe they can be successful by empowering them. Comprehensive prevention, treatment, and care programmes for IDUs should be continued, along with programmes to improve linkages with communities, which include a good referral system for new patients. Policies and laws should target the provision of extended health care through harm reduction programmes. Harm reduction in Thailand, we believe, should start with positive thinking, accepting the weak points of IDUs and trying to develop their self-esteem.