Injecting heroin is a decreasing practice in the young population, following the HIV epidemic and changes in young culture, replaced by other legal and illegal psicoattive substances. However, heroin has not disappeared. It is present in situations of social exclusion, in marginalized groups (psychiatric patients; immigrates) and also in well-integrated young population, through new patterns of consumption in the contest of poly-drug use. Grosso suggests an empowerment of the harm reduction strategies through the three plans: early warning system, consumption rooms and medical prescription of heroin. All that should be supported by the integration between social and health system and by coherent political choices and decisions (i.e. not considering the consumption of illicit drugs as a penal offence).