The absence of pleasure in harm reduction discourse is more and more frequently noted, but few have considered what, exactly, more attention to pleasure might do. What is the value of pleasure for harm reduction praxis? Central to such an inquiry is the question of how pleasure is grasped, conceptually and methodologically. In this paper I use Foucault's History of Sexuality to elaborate a perspective on the use of pleasure within harm reduction. I argue that Foucault's work suggests a distinction between therapeutic and social-pragmatic approaches to pleasure, and that such a distinction is important for harm reduction ¿ to the extent that it seeks to maintain a critical awareness of the relation between stigma and care ¿ in that the latte...