In Italy, the need to contain the spread of human immunodeficiency virus (HIV) among injecting heroin users in the early 1990s involved setting up outreach programmes and low-threshold centres, and the provision of clean injecting equipment and drug treatment. This was the beginning of the shift towards ‘contacting and taking into care’ those who were not receiving treatment from drug treatment services. The harm reduction approach was further consolidated in the state-regional accord of 1999 and in harm reduction guidelines, which were presented at the Genoa Conference by the Ministry of Health in November 2000. By decree of the President of the Council of Ministers of 12 January 2017, harm reduction services are listed among the assistance services to be provided by the national health system to people with dependencies.
The range of harm reduction services and initiatives in Italy continues to be heterogeneous and diversified. Some outreach programmes and projects exist at local levels and are operated by both public and private social and health organisations, together with specific projects funded through the National Drugs Fund; these usually include needle and syringe programmes, information dissemination and counselling.
Harm reduction programmes are more extensive in the northern and central Italian regions, and are usually located in the larger cities. Harm reduction interventions are delivered through mobile units, fixed sites (drop-in centres and reception units), outreach programmes, and needle- and syringe-dispensing machines. A recent study indicates that, as well as needle and syringe exchange programmes, naloxone is also available in a number of surveyed harm reduction units. New guidelines for screening and diagnosis of infectious diseases have been prepared to increase the practice of testing in addiction treatment centres.
|Country||Needle and syringe programmes||Take-home naloxone programmes||Drug consumption rooms||Heroin-assisted treatment|