Germany Country Drug Report 2019

Harm reduction

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 municipal and regional public funds and their primary aim is to reduce mortality and morbidity among drug users. In 2016, a national strategy to reduce human immunodeficiency virus (HIV), hepatitis B virus and hepatitis C virus infections was adopted, which defines people who inject drugs as a target population. Germany is among the few European countries that provide the full range of harm reduction services, along with needle and syringe programmes (NSPs), take-home naloxone programmes (THNs) for overdose prevention, supervised drug consumption rooms (DCRs) and heroin-assisted treatment (HAT). However, the availability of services differs greatly among the Länder and between cities and rural areas.

Harm reduction interventions

Clean needles and syringes and other drug use paraphernalia are provided through a network of low-threshold services, outpatient counselling facilities and vending machines. Data on the number of syringes distributed are not available for the country as a whole, but data from local syringe monitoring are available in the Land North Rhine-Westphalia and some larger cities, including Frankfurt and Berlin.

The outpatient treatment centres serve as additional contact points for drug users, providing crisis interventions and offering psychosocial and medical help; some also offer outreach services. There are currently 22 DCRs at fixed locations in Germany, and two drug consumption vehicles operating in Berlin.

In recent years, the number of programmes providing overdose emergency training and giving out the antidote naloxone to potential bystanders of opioid overdose has increased, and activities are reported from Berlin, Saarbrücken and several cities in North Rhine-Westphalia and Bavaria. Based on an on-going government-funded project, prevention and harm reduction interventions targeting migrants are being developed. To reach people in rural areas for early testing, a pilot project in Bavaria provides online access to order diagnostic tests for HIV, following an initial face-to-face counselling session.

Availablity of selected harm reduction responses in Europe
Country Needle and syringe programmes Take-home naloxone programmes Drug consumption rooms Heroin-assisted treatment
Austria Yes No No No
Belgium Yes No Yes No
Bulgaria Yes No No No
Croatia Yes No No No
Cyprus Yes No No No
Czechia Yes No No No
Denmark Yes Yes Yes Yes
Estonia Yes Yes No No
Finland Yes No No No
France Yes Yes Yes No
Germany Yes Yes Yes Yes
Greece Yes No No No
Hungary Yes No No No
Ireland Yes Yes No No
Italy Yes Yes No No
Latvia Yes No No No
Lithuania Yes Yes No No
Luxembourg Yes No Yes Yes
Malta Yes No No No
Netherlands Yes No Yes Yes
Norway Yes Yes Yes No
Poland Yes No No No
Portugal Yes No No No
Romania Yes No No No
Slovakia Yes No No No
Slovenia Yes No No No
Spain Yes Yes Yes No
Sweden Yes No No No
Turkey No No No No
United Kingdom Yes Yes No Yes

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Methodological note: Analysis of trends is based only on those countries providing sufficient data to describe changes over the period specified. The reader should also be aware that monitoring patterns and trends in a hidden and stigmatised behaviour like drug use is both practically and methodologically challenging. For this reason, multiple sources of data are used for the purposes of analysis in this report. Caution is therefore required in interpretation, in particular when countries are compared on any single measure. Detailed information on methodology and caveats and comments on the limitations in the information set available can be found in the EMCDDA Statistical Bulletin.