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.
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.
|Country||Needle and syringe programmes||Take-home naloxone programmes||Drug consumption rooms||Heroin-assisted treatment|