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Harm reduction overview for Germany

Map of Germany

1. National context

Harm reduction is one of the four pillars of the German national drug strategy. The major aim of harm reduction is to reduce mortality and morbidity. In the last few decades a system of low-threshold measures has been constructed that has an important function, in particular, in the drug scenes of cities.
 
Needle and syringe programmes have operated unofficially in some cities since 1984 but were only legalised in 1992. According to a recent survey, Germany has the highest number of needle and syringe vending machines in the world — around 160 vending machines across nine of its 16 Länder are reported by the German Aidshilfe. Since the quality of reporting varies very much between Länder, it is possible that there are vending machines missing from the data. One needle and syringe programme is available in prison. Data on the number syringes distributed are not available for the country as a whole.
 
There are also drug help centres, which serve as a contact point for drug users and give support in emergency cases by offering psychosocial and medical help; many also offer outreach services. A review of safer use initiatives across the country documented that at least one-quarter of rural and urban districts have a syringe distribution site (a vending machine or other facility). Drug consumption rooms can be opened if the government of the Länder passes a special regulation on the basis of a national law. This was done by six of 16 Länder, and currently there are 23 stationary drug consumption rooms in Germany and a drug consumption vehicle operates in Berlin.
There are about 300 low-threshold services and counselling facilities, which are, for the most part, funded by public funds.

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2. Responses to prevent and reduce drug-related infectious diseases

Needle and syringe programmes Country  data
Availability of  NSP programmes  :
% NSP availability at NUTS3  30 %
Drug use equipment distributed at specialised drug agencies (standard prevention material)
availability of alcohol pads  Yes
availability of dry wipes  No
availability of containers  No
availability of water  Yes
availability of condoms  Yes
availability of foil  Yes

Sources:

Structured questionnaire 'Prevention and reduction of health-related harm associated with drug use' (SQ23/29), submitted in 2014.
For an explanation of terms used, see the definitions of terms.
Availability expert rating scale:

  • Full – nearly all persons in need would obtain it.
  • Extensive – a majority but not nearly all of them would obtain it.
  • Limited – more than a few but not a majority of them would obtain it.
  • Rare – just a few of them would obtain it.
Testing, vaccination and treatment of infections Country  data
Availability of Hepatitis C testing in the community  :
Availability of universal hepatitis B immunization programme  No
Hepatitis B vaccination programme specific for high risk groups  Yes
ARV treatment of HIV infection  :

Sources:

Structured questionnaire 'Prevention and reduction of health-related harm associated with drug use' (SQ23/29), submitted in 2014.
Availability expert rating scale:

  • Full – nearly all persons in need would obtain it.
  • Extensive – a majority but not nearly all of them would obtain it.
  • Limited – more than a few but not a majority of them would obtain it.
  • Rare – just a few of them would obtain it.
Health promotion responses Country  data
Availability of individual counselling programmes  :
Availability of programmes for practical advice and training on 'safer use/safer injecting'  :
Involvement of peer educators in the response to infectious diseases prevention  Yes

Sources:

Structured questionnaire 'Prevention and reduction of health-related harm associated with drug use' (SQ23/29), submitted in 2014.
Availability expert rating scale:

  • Full – nearly all persons in need would obtain it.
  • Extensive – a majority but not nearly all of them would obtain it.
  • Limited – more than a few but not a majority of them would obtain it.
  • Rare – just a few of them would obtain it.

Drug Treatment

See the country specific treatment profile.

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3. Responses to prevent and reduce drug-related deaths

Availability of drug-related death responses in the community Country  data
Availability of overdose information materials  Rare
Availability of individual overdose risk assessment (provided by trained drugs or health workers)  Rare
Availability of overdose response training  Rare

Sources:

Structured questionnaire 'Prevention and reduction of health-related harm associated with drug use' (SQ23/29), submitted in 2014.
Availability expert rating scale:

  • Full – nearly all persons in need would obtain it.
  • Extensive – a majority but not nearly all of them would obtain it.
  • Limited – more than a few but not a majority of them would obtain it.
  • Rare – just a few of them would obtain it.
Availability of drug consumption rooms Country  data
Number of facilities 24
Number of cities 15
Number of consumptions per year :

Sources:

Structured questionnaire 'Prevention and reduction of health-related harm associated with drug use' (SQ23/29), submitted in 2014.
N.Av. stands for ‘The intervention is not available in the country’.

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4. Responses to prevent and reduce drug-related harms in recreational settings

Provision of specific responses implemented in night clubs and festivals Free, accessible, cold water Immediate First Aid ‘Chill out’ rooms Information material Outreach work Amnesty bins
Night clubs  :  :  :  Rare  Rare  :
Festivals  :  Full  :  Rare  Rare  :

Sources:

Structured questionnaire 'Prevention and reduction of health-related harm associated with drug use' (SQ23/29), submitted in 2011.
Provision expert rating scale:

  • Full – in nearly all night clubs/festivals.
  • Extensive – a majority of night clubs/festivals provide the intervention (but not nearly all of them).
  • Limited – more than a few night clubs/festivals provide the intervention (but not a majority of them).
  • Rare – just a few night clubs/festivals provide the intervention.

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5. References and links

Related EMCDDA resources

 

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Page last updated: Tuesday, 12 April 2016