From Margin to Mainstream: The Evolution of Harm Reduction Responses to Problem Drug Use in Europe

• NCJ Number: 226002
• Journal: Drugs: Education, Prevention and Policy Volume: 15 Issue: 6 Dated: December 2008 Pages: 503-517
• Author(s): Dagmar Hedrich; Alessandro Pirona; Lucas Wiessing
• Date Published: December 2008
• Length: 15 pages
• Publication Format: Article
• Publication Type: Historical Overview
• Language: English
• Country: United Kingdom

Annotation

This article discusses the development of two major drug harm-reduction interventions in Europe designed to reduce heroin injection and its adverse effects, i.e., opioid-substitution treatment and needle-exchange programs.

Abstract

Methadone maintenance treatment for heroin users was introduced into Europe nearly 40 years ago in Sweden, followed shortly by the Netherlands, the United Kingdom, and Denmark. Since then, the number of European Union (EU) countries with opioid-substitution treatment increased from four in 1970 to seven in 1977. It was not until the late 1980s onwards that the rate of such treatment accelerated; by 2001, 26 EU countries had introduced it, although important differences in scale and coverage continue to exist among countries. Needle and syringe exchange programs first emerged as a response to HIV in the mid-1980s. By 1987, Denmark, the Netherlands, Malta, Spain, and the United Kingdom had officially adopted them as a public health measure. Over the 1990s, the number of countries with needle and syringe programs continued to increase; by 2001, 26 of the current 27 EU countries had such programs in place. Although current social, cultural, and legal responses to drug use in EU member states remain diverse, a recent assessment of national priorities and approaches in preventing infectious diseases and drug-related deaths showed a trend toward a convergence of policies. The findings presented in this article suggest that by including harm reduction as a key objective of drug policy, EU Action Plans not only reflect what was already happening in some member states in response to serious public health challenges, but that European instruments further consolidated harm reduction as one of the central tenets of drug policy. This facilitated the inclusion of harm reduction in countries in which drug policies have developed more recently, primarily the new member states in Central and Eastern Europe. 17 notes and 27 references