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