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Please note that the information on this page is based on the EMCDDA Annual report 2010: the state of the drugs problem in Europe. Most statistical data relate to the year 2008 (or the last year available).


Annual report 2010: the state of the drugs problem in Europe
Responding to drug problems — an overview

Published: 10 November 2010

Harm reduction

The prevention and reduction of drug-related harm is a public health objective in all Member States and in the EU drugs strategy (1). Reviews of the scientific evidence of harm-reduction interventions, as well as studies showing the combined impact of these interventions, are now also available for service planning (EMCDDA, 2010). Among the main interventions in this field are opioid substitution treatment and needle and syringe exchange programmes, which target overdose deaths and the spread of infectious diseases. These measures are reported to be available in all countries except Turkey. While considerable differences exist in the range and levels of service provision (see 'Opioid use and drug injection' and 'New drugs and emerging trends'), the general European trend is one of growth and consolidation of harm-reduction measures.

Most European countries provide a range of further health care and social services, including those that are recommended by WHO, UNODC and UNAIDS (2009), as part of a ‘comprehensive package’ for HIV prevention among drug injectors. The interventions routinely offered depend on the national context, but include individual risk assessment and advice, targeted information and safer-use education, distribution of injecting equipment other than needles and syringes, promotion for condom use among injecting drug users, infectious disease testing and counselling, antiretroviral treatment, and vaccination against viral hepatitis. Many of these services are provided at low-threshold agencies. Harm-reduction responses aimed at preventing drug-induced deaths are, however, scarce (2), despite an increasing awareness of the need for such interventions. New initiatives in this field include early warnings or alerts about substances associated with higher risks (3). For example, all low-threshold facilities in the Czech Republic were notified in 2009 about a possible penetration of fentanyl into the local drug market.

Following recent improvements in the treatment of hepatitis C, most countries are now increasing their efforts to prevent, detect and treat hepatitis among drug users, including those in substitution treatment. Recent examples of this include the new national hepatitis plan in France; a pilot study to develop recommendations for HCV prevention in Germany; and hepatitis treatment guidance in the Czech Republic, the Netherlands and the United Kingdom. Studies and screening campaigns in prison settings are also reported by several countries, including Belgium, France, Luxembourg and Hungary.

The focus of harm-reduction responses has expanded beyond the HIV/AIDS epidemic into the broader perspective of catering for the health and social needs of problem drug users, especially those who are socially excluded. The incorporation of harm reduction into the response to drugs has also advanced the collection of data on the drug problem. National inventories of services and studies of service quality (Czech Republic, Germany, Ireland, Finland) and client surveys (Estonia, Lithuania, Luxembourg, Hungary) provide a better insight into service provision and users’ needs. It also helps to promote quality assessment and exchange of best practice, to improve prevention materials and techniques, and to develop new interventions.


(1) COM (2007) 199 final.

(2) See Table HSR-8 in the 2010 statistical bulletin.

(3) See the box ‘Anthrax outbreak among heroin users in the United Kingdom and Germany’ in Drug-related infectious diseases and drug-related deaths.

Bibliographic references

EMCDDA (2010a), Harm reduction: evidence and impacts, EMCDDA Monograph, Rhodes, T. and Hedrich, D. (editors), Publications Office of the European Union, Luxembourg.

WHO, UNODC and UNAIDS (2009), Technical guide for countries to set targets for universal access to HIV prevention, treatment and care for injecting drug users, World Health Organization, Geneva.

About the EMCDDA

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: Monday, 25 October 2010