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Harm reduction refers to strategies that aim to reduce the harms associated with injecting drug use.

The earliest forms of harm reduction promoted abstinence from drug use and put reducing its occurrence at the centre of substance use policy and interventions.

The concept of harm reduction was re-invented in the early 1980s at the beginning of the HIV epidemic when healthcare workers started to provide clean syringes to people who inject drugs (sometimes referred to as PWID) rather than solely trying to achieve abstinence.

Since then, there has been slow but steady progress in implementing harm reduction programmes as a component of the response to the HIV epidemic, with a wide range of initiatives tried to datein a variety of settings.

However, of the 158 countries that report drug use, only 91 of them explicitly reference harm reduction in their national policies (58%). Moreover, few countries have achieved sufficient coverage of harm reduction services. (AVERT, UK, 24.04.2017)


Europe is the birthplace of harm reduction, and the region where the successes of this approach in averting epidemics can be most plainly seen. It includes harm reduction champion countries, that have long invested in their national harm reduction programmes and implement a wide array of interventions.

However, austerity, international donor retreat and poor political support are severely limiting harm reduction responses in several countries in the EU. In some states, there is a funding crisis for harm reduction which must be addressed if public health emergencies are to be avoided.

 This report summarises research findings from Harm Reduction Works!, providing a snapshot of harm reduction investment in eighteen EU member states. It includes findings from spend tracking research in the Czech Republic, Greece, Italy, Estonia, Portugal, Hungary and Lithuania. (HRI – Harm Reduction International, 24.04.2017)


Identify quickly and respond effectively. The OoHC Toolbox provides easily accessible and effective information for the supporters and carers of young people (12 - 18) in out of home care. (The Centre for Youth AOD Practice Development, 2017)


Forbidden is an issue of four comics produced by The Romanian Harm Reduction Network with the support of Drugreporter as part of the national campaign to support harm reduction in Romania. (Drug Reporter, Ungarn, 27.03.2017)


Got that Friday feeling? The urge to party and get on one may be pretty high today. (UK, 2017)


In this expert blog, Gen Sander of Harm Reduction International states that the global state of harm reduction in prisons is inadequate, unreliable, and unlawful. She argues that the provision of good-quality and accessible harm reduction, both inside and outside of prisons, is a legally binding human rights obligation, not just a policy option. (penalreform.org, 06.02.2017)


Die umstrittene Substanz Cannabis: Anmerkungen zum Schadenspotential und Risiken, zum hedonistischen Konsum und zur medizinischen Verwendung, zu Harm Reduction, Safer Use und Public Health

Tagung: Jugend auf Drogen? Jugendlicher Substanzkonsum zwischen Verharmlosung und Dämonisierung. Linz, 28.März 2017 2017

Veranstalter: Institut Suchtprävention Oberösterreich

Referent: Hans-Günter Meyer-Thompson


Medical experts in South Africa have issued stark health warnings to people engaging in “bluetoothing", whereby people inject the blood of someone who has already injected drugs in a futile attempt to get high. (TalkingDrugs, UK, 24.02.2017)


Gail Gilchrist, Davina Swan, April Shaw, Ada Keding, Sarah Towers, Noel Craine, Alison Munro, Elizabeth Hughes, Steve Parrott, John Strang, Avril Taylor and Judith Watson

Harm Reduction Journal201714:14

DOI: 10.1186/s12954-017-0142-5


Programmes usually address individuals but most equipment sharing occurs between sexual partners. (aidsmap, 21.03.2017)


Neue Website aus Großbritannien.


Declining rates of health problems associated with crack smoking during the expansion of crack pipe distribution in Vancouver, Canada.

Prangnell A, Dong H, Daly P, Milloy MJ, Kerr T, Hayashi K.

BMC Public Health. 2017 Feb 3;17(1):163. doi: 10.1186/s12889-017-4099-9.


(MENAHRA - Middle East and North Africa Harm Reduction Association, 2016)


Prisoners in Salford are being routinely handed leaflets on how to ‘safely’ take dangerous illegal drugs such as Spice.

The pamphlet - distributed to inmates when they order items such as toiletries and cigarettes - details an 11-point checklist of ‘safety rules’ for taking ‘new psychoactive substances’, which were outlawed last April. (ITV, 16.02.2017)


PRISONERS are getting advice on how to take drugs safely amid fears that substance abuse is out of control in jails. (Angle News, 17.02.2017)


Sixteen years after Vancouver formally adopted a ‘four pillars’ approach to drug strategy, the city – and the province – finds itself in the grip of an overdose crisis. (The Globe and Mail, Kanada, 10.02.2017)


Angesichts des bleibend hohen Konsums von Kokain auch innerhalb der Gruppe von Drogengebraucher*innen, die ihre Drogen injizieren, besteht eine ganz spezielle Gefahr:

Bei den nicht seltenen aber gefährlichen bakteriellen Verunreinigungen des Kokains, etwa durch den Transport im Mund oder andere hygienische Defizite des Schwarzmarkts, kann sich die Tatsache, dass die Kokain/Wasser-Lösung von der Szene nur in den seltensten Fällen vor dem Spritzen aufgekocht wird, fatal auswirken. Dem lässt sich effektiv entgegen wirken, denn:

Kokain darf man kochen! Man sollte es vor der Injektion sogar unbedingt tun! Alles andere ist ein hartnäckiges Gerücht.

Dies gilt auch beim „Cocktail“ (Kokain und Heroin): Zum Schluss alles noch mal kurz aufkochen!

Viele Keime sind auf diese Weise abzutöten und die Qualität bzw. die Wirkung des Kokain`s leidet nicht.

Falls die Droge mit stark alkalischen Stoffen gestreckt wurde, kann zur Sicherheit auch beim reinen Kokain-Druck vor dem Aufkochen etwas Ascorbinsäure zufügt werden. So vermeidet man, dass aus einem Teil des Kokains freie Basen werden. Aber Letzteres ist wohl eher ein theoretisches Problem.

(JES NRW e. V., 06.02.017)


Responding to drug and alcohol use and related problems in nightlife settings

As of today, the EU drugs agency (EMCDDA) will be hosting an online Healthy Nightlife Toolbox (HNT), which collects and provides information on good-practice interventions targeting drug and alcohol use and related problems among young people in nightlife settings. The European database is designed to support prevention workers and local, regional and national policymakers in identifying and implementing effective responses in nightlife settings. (EMCDDA, 27.01.2017)


UK. Jon Derricott

A large and ever-growing archive of harm reduction based videos, covering  a wide area from heroin to tobacco, with pieces about politics, policy and practice as well. All of them made by me, with the generous help and support of others.


The mission of MENAHRA is to support, develop and advocate for harm reduction approaches in the field of drug use, HIV/AIDS, public health, and social inclusion by following the principles of humanity, tolerance and partnership with respect to human rights and freedoms.


Development of a filter to prevent infections with spore-forming bacteria in injecting drug users.

Alhusein N, Scott J, Kasprzyk-Hordern B, Bolhuis A.

Harm Reduct J. 2016 Dec 1;13(1):33.



Safer Use mit Hindernissen, Kerstin Dettmer, Fixpunkt e.V., Berlin

56. DHS Fachkonferenz Sucht vom 10. – 12. Oktober 2016 in Erfurt


Dr Ingrid van Beek (Kirketon Road Centre, Australia) asks how radical harm reduction can be.

City of Health, City of London, 19.09.2016, Video, 27:20


Professor Neil McKeganey (Centre for Substance Use Research) discusses the limits of harm reduction.

City of Health, City of London, 19.09.2016, Video, 23:16


WEDINOS is a harm reduction project, and reflects trends in substance use.

Public Health Wales, 2016


Harm Reduction International is very pleased to share with you the newly launched Global State of Harm Reduction 2016.

This is the fifth report in the Global State series, which provides the most up-to-date picture of harm reduction policy and practice around the world. 

The new data in this report shows a worrying slowdown in the provision of harm reduction services for people who use drugs, with no new countries introducing needle and syringe programmes since 2014.

Along with this, there has been a rise in injecting stimulant use across all regions of the world, and a dramatic increase in overdose deaths.

Harm reduction in prisons also remains vastly insufficient, with only a very small number of countries providing needle exchange or overdose training in at least one prison.

We would like to recognise the invaluable contribution of harm reduction advocates, networks and researchers, organisations of people who use drugs, activists, donors and multilateral agencies this year and throughout the life of this unique project. It is thanks to this collective effort that the Global State has become a key resource for so many in their work.