Harm reduction is one of the four pillars of the National Strategy on Drug and Addiction Policy. The activities for this strategy are, for the most part, financed by public funds and their primary aim is to reduce mortality and morbidity among drug users. In the last few decades, a system of low-threshold facilities has been established in Germany, which fulfils an important function by making drug- related health services more accessible to marginalised populations of drug users in urban settings. Germany is among the few European countries that provide the full range of harm reduction services, along with needle and syringe programmes, peer naloxone programmes for overdose prevention, supervised drug consumption rooms and heroin-assisted treatment. However, the availability of services differs among the regions (Länder) and cities.
Availability of selected harm reduction responses
NBYear of data 2016.
Needle and syringe programmes have operated unofficially in some cities since 1984 but were only legalised in 1992. Clean needles and syringes and other drug use paraphernalia are provided through a network of low-threshold services and counselling facilities; syringes are also available from vending machines. Data on the number of syringes distributed are not available for the country as a whole, but some information on the number of syringes that have been distributed is available from North Rhine-Westphalia and Berlin.
The outpatient treatment centres serve as additional contact points for drug users, providing crisis interventions and offering psychosocial and medical help; many of them also offer outreach services.
Drug consumption rooms can be opened in the regions (Länder) where the regional government has passed a special regulation on the basis of national law. This was done by 6 of the 16 Länder and, currently, there are 23 drug consumption rooms at fixed locations in Germany and a drug consumption vehicle operates in Berlin. A new development in 2014-15 regarding the prevention of opioid overdose deaths is the expansion of take-home naloxone programmes; five programmes are operational and a project for issuing naloxone before release from prison is currently at a planning stage.
In 2016, five take-home naloxone programmes are operational and a project for issuing naloxone before release from prison is currently at a planning stage