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Legal Framework of Needle and Syringe Programmes

Needle and syringe programmes (NSPs), which may be to exchange, sell or freely give sterile injection equipment, are now widely accepted as a form of prevention of infectious diseases, particularly HIV and Hepatitis B and C, that could have a significant impact on a country’s health system over time. 

 

In 2003, the INCB maintained “ .. that Governments need to adopt measures that may decrease the sharing of hypodermic needles among injecting drug abusers in order to limit the spread of HIV/AIDS. At the same time, the Board has been stressing that any prophylactic measures should not promote and/or facilitate drug abuse.” (INCB Annual Report 2003 para.221).  A year later, the UNODC World Drug Report stated “There is some evidence to suggest that the availability and regular use of clean injecting equipment can prevent, halt and perhaps even reverse HIV/AIDS epidemics among injecting drug users” (World Drug Report 2004 s1.3.3 p52) and that this could form part of an effective prevention programme.

 

The EU policy developments are clear.  The EU Action Plan 2000-2004, s.3.1.2.1, requested developing services for users, including the provision of prophylactics.  The Council Recommendation of 18 June 2003 on the prevention and reduction of health-related harm associated with drug dependence recommends that Member States “provide where appropriate, access to distribution of condoms and injection materials, and also to programmes and points for their exchange” (point 2(10)).  The EU Action Plan 2005-2008 foresees the implementation of this Council Recommendation as a specific action for implementation of Objective 14 (prevention of health risks related to drug use), with Objective 15 (availability and access to harm reduction services) following closely. For further information on the types and number of syringe exchange programmes and the number of syringes provided through such programmes in the Member States, please consult Tables HSR-4 and -5 of the EMCDDA Statistical Bulletin 2008. 
 

NSPs may operate at a local, regional or national level, sometimes with a specific national legal framework to permit them, but usually without.  In some countries, this can be apparently at odds with legal provisions that criminalise “facilitation” or “incitement” to drug use, and can cause confusion between law enforcement and health services.  In countries such as Belgium and Germany, the matter has been addressed with a clause in the law that specifically exempts certain NSPs from any such charge, though there may be limits as to the number of syringes involved, above which the provider will no longer be tolerated.  In a few countries, guidance is issued to the police to direct policing practice and law enforcement near NSPs; nevertheless, the police practice of confiscating sterile syringes or needles is reported as extremely rare across the EU.

 

 

 

Country

Legal frameworks for needle and syringe programmes / possession of syringes

Legal provisions regarding incitement/ facilitating drug use, or providing/ possessing equipment

Common policing practice regarding possession of sterile syringes or needles?

Prescription required to receive / exchange syringes?

Belgium

The Royal Decree of 5 June 2000 outlines the law on needle exchange for drug users.  This decree stipulates that only general practitioners, pharmacies, specialised personnel of drug services, and streetcorner workers are allowed to exchange.  The delivery of sterile injection equipment must be accompanied by written information on the good use of the equipment, of accessibility to HIV and hepatitis screening services, to existing services for treatment.

Facilitation and incitement are an offence, but the law specifically excludes medical personnel from this (Law of 24 February 1921, Art 3(2)).

Para IV.6 of the Ministerial Directive of 16 May 2003 states that unused syringes and needles should not be confiscated by the police, but immediately restored to the owner.

Not required

Czech Republic

There are no specific laws on syringe exchange or possession.

s.188a of the Penal Code declares inducement/ support to abuse of an addictive substance as an offence.

It is considered "legal" (it is not interpreted as facilitating drug use) and is not confiscated.

Not required

Denmark

There are no specific laws on syringe exchange or possession.

Syringe exchange is not regarded as a criminal offence.

It is considered legal and is not confiscated.

Not required

Germany

Under s.29(1) of the BtMG, the supply of sterile disposable syringes to drug-addicted persons is specifically excluded from the offence of providing an opportunity for use.

Syringe supply specifically exempted from the offence, as stated.

In line with the law, as stated.

Not required

Greece

There are no specific laws on syringe exchange or possession.

Art.5 of the law 1729/1987 states that a person who contributes in any manner to the spread of use of drugs is committing a crime.

Police have the right to seize syringes if they are used for injection, but no action is taken when syringes are sterile.

Not required

Spain

There are no specific national laws on syringe exchange or possession, but this may be addressed in harm reduction provisions within the legislations of the Autonomous Communities.

Art.368 of the Penal Code prohibits the facilitation of illegal consumption of drugs.

It is not interpreted as facilitating drug use and is not confiscated.

Not required

Cyprus

Under s10A of the Narcotic Drugs and Psychotropic Substances Law of 1977, possession of any articles which could be used  (or have been used) for illicit drug use  constitutes an offence.

Covered by s.10A.

This provision of the law is rarely  implemented, unless there is a suspicion of illicit drug possession.

Not required

Latvia

There are no specific laws on syringe exchange or possession.

S. 251 Penal Code prohibits inducement to use narcotic and psychotropic substances.

Possession of syringes and needles is considered legal and police do not intervene.

Not required

Luxembourg

The grand-ducal decree of 23 December 2003 regulates the distribution and the exchange of syringes, and specifies that the exchange of a sterile syringe to a drug addict can be executed either by a pharmacist, a general practitioner of the substitution programme or designated members of specialised drug agencies. The decree also includes the legalisation of syringe distribution by means of distribution machines.

 

No confiscation if syringes do not show traces of illegal substances.

Not required

Hungary

There are no specific laws on syringe exchange or possession.

None.

In 2003 possessing a needle or syringe was still an indicator of a drug offence. It was the task of the police to confiscate and start a legal procedure. There is nothing about needle exchange in the present provisions of the Penal Code. In 2003 the Police of Budapest and the Needle Exchange Program agreed that the police will back the program, and tolerate those who join the program.

Not required

Netherlands

There are no specific laws on syringe exchange or possession of syringes. Syringe exchange is not prohibited in prisons.

Use of drugs is not illegal.   The possession of sterile syringes or needles are not bounded by regulation.

There are no guidelines/ policies concerning the needle/syringe exchange so the involved health care organisations and/or specialized drug treatment facilities developed their own syringe exchange activities.

Not required since 1980

Austria

There are no legal restrictions to / the possession of sterile syringes/needles, and the provision of syringes/needles to injecting drug users is considered a relevant aspect of drug-related health policy.

None.

None.

Not required

Poland

The amendment of 6 September 2001of the Act of 24 April 1997 on counteracting drug addiction, gives the legal basis for harm reduction activities (which include the programme of syringes exchange).

 Art. 1, par. 1, item 6 of the Act of 24 April 1997 on counteracting drug addiction (as amended on 6 September 2001).

n/a

Not required

Portugal

Syringe exchange schemes are clearly regulated by Arts 50-57 of Decree-Law 183/2001. This includes provisions on management, access rights, working hours and procedures, premises and location (including the possibility of dispensing machines), coordination with other bodies, and assessment. Providing syringes in the scope of the national syringe exchange programme "Say no to a second hand syringe" allowed.

Facilitation and incitement are an offence.

Injecting drug users are allowed to carry sterile injecting material under the Decree-Law n.º183/2001.

Not required

Slovenia

In Slovenia, Art. 13 of the law "Prevention of the Use of Illicit Drugs and Dealing with Consumers of Illicit Drugs Act 1999" regulates (allows) this kind of services. Needles and syringes can be freely obtained from the Harm Reduction NGOs, or are sold by vending machines (in Ljubljana only) and in all pharmacies.

Syringe supply specifically permitted, as stated.

No sanctions are foreseen for the possession of sterile material; it is neither a criminal nor minor offence.

Not required since 1993

Slovakia

There is no specific law on regulations of syringe/ needle exchanges.

Facilitating and inciting crimes are criminal offences according to the Criminal Code, for all offences. S 188a is a criminal offence of spreading substance abuse that is linked to the abused substances.

There is no legal problem/ restriction relating to paraphernalia possession.

Not required

Sweden

There are no specific laws on syringe exchange or possession.

Inciting or facilitating drug offences is criminalized regarding every act except possession and drug use. Providing equipment is therefore not criminalized if it is only for private use.

The use of a narcotic drug/psychotropic substance is a criminal offence in Sweden and syringes confiscated as equipment/ aid of a criminal offence (article 6 of the Narcotic Drugs Punishments Act (1968:64)).

Can only be bought with a prescription

United Kingdom

Section 9A of the Misuse of Drugs Act 1971 makes it an offence to supply any article used for administering a controlled drug unlawfully - except a hypodermic syringe (including a needle) - or to supply any article used to prepare such a drug for administration.   A Statutory Instrument (SI No:1653/2003), Misuse of Drugs (Amendment) (no.2) Regulations 2003, came into force 1st August 2003 permits doctors, pharmacists and drugs workers to supply certain items of drug injecting articles to drug users; these included swabs, utensils for preparation, citric acid, filters and ampoules of water for injection.

Syringe supply specifically exempted from the offence, as stated.

The police accept syringe exchange as a useful tool in reducing drug-related harm.

Not required.  In most of the UK there are no limits to the number of needles and syringes provided.  However, in Scotland, Health Guidance (MEL (1998) 55, limited the number of sets given out per visit; 5 on first visit and 15 on subsequent visits, with 120 when facilities might be closed.  In 2002, the Lord Advocate amended guidance (NHS HDL (2002) 90) increasing the limits to a maximum of 20 sets on the first visit and 60 on subsequent visits.  These limits are for guidance only.

Norway

There are no specific laws on syringe exchange or possession.

Aiding and abetting a drug offence (which includes using drugs) is an offence under s.31 of the Act no.132 of 4 June 1992 on medicinal products, but syringe exchange schemes are not regarded in such a way, as syringes are legal goods and so obtaining and using them is not in itself illegal.

Possession of syringes and needles is not illegal and the police will not confiscate syringes or needles. Prison officers will normally confiscate syringes and needles found among prisoners.   

Not required since the 1970s

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The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) is the reference point on drugs and drug addiction information in Europe. Inaugurated in Lisbon in 1995, it is one of the EU's decentralised agencies. Read more >>

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Page last updated: Friday, 31 October 2008