Spain Country Drug Report 2019

Harm reduction

The public health approach has been a predominant feature in Spanish drugs policy in the past 25 years. The current National Strategy on Addictions 2017-24 includes among its key objectives the reduction of harm associated with the use of substances with addictive potential. It seeks to maintain and enlarge the coverage of harm reduction programmes, to improve early diagnosis of infections and to integrate harm reduction transversally, connecting it with primary healthcare, mental health care and services for behavioural addictions. Furthermore, both the 4th Strategic Plan for the Prevention and Control of HIV Infection and Other Sexually Transmissible Infections 2013-20 and the National Plan for responding to Hepatitis C in the Health System 2015 identify people who inject drugs (PWID) as a priority population.

Harm reduction interventions

Harm reduction services are provided by a large network of public facilities, including social emergency centres, mobile units, pharmacies and prisons, and are available throughout Spain, although with varying service profiles in the different autonomous communities.

Most harm reduction programmes include a socio-sanitary service that offers preventive educational interventions, clean needles and syringes and other paraphernalia, testing for drug-related infections, vaccination against hepatitis A and B viruses, and emergency care and assistance for PWID, who are not usually in contact with any assistance intervention.

In 2016, public needle and syringe programmes (NSPs) in Spain distributed more than 1.5 million syringes, which represents a third year of stability after a long-term declining trend that started in 2005. The drop in the number of syringes distributed may be related to a decreased incidence of injecting drug use in Spain. Thirteen facilities for supervised drug consumption are available in the autonomous communities of Catalonia and the Basque Country. In 2016, these facilities served 3 160 clients and dispensed more than 7 % of all syringes given out in Spain (these facilities also operate as large harm reduction centres).

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.