The Eurasian Harm Reduction Association and a team of researchers conducted an exploratory study in Central and Eastern Europe and Central Asia (CEECA) to assess the availability of mental health care services for people who use drugs and published the findings in the report titled LINKING DOTS: Assessment of opportunities for optimal access to MENTAL HEALTH CARE services for people who use drugs in the CEECA region.

They focused on Czechia, Estonia, Moldova, and Poland, collecting data through in-depth research, literature analysis, and interviews with health service providers, harm reduction service staff, and patients/clients. The study revealed that despite relatively developed mental health facilities and treatment facilities for people who use psychoactive substances in these countries, significant obstacles persist in providing mental health services to people who use drugs.

The researchers recommend using these findings to improve harm reduction and healthcare programs, address systematic barriers, and promote cooperation among agencies to enhance access to mental health care. The study aims to advocate for the integration of harm reduction and mental health support systems to provide better care and support for individuals in need.

Two local organisations from Slovenia, NGO Stigma from Ljubljana (also a C-EHRN focal point), and NGO Šent from Nova Gorica are working towards opening drug consumption rooms in the two cities in the near future. To support the process, during the last week of September (28th-29th), Roberto Perez Gayo and Arianna Rogialli, Policy Officer and Project and Policy Support Officer from Correlation – European Harm Reduction Network (C-EHRN), visited Ljubljana to deliver a training program in collaboration with them. Besides local NGOs, representatives from the Ministry of Health, the Municipality of Nova Gorica, the National Institute of Public Health and the Psychiatric Clinic of Ljubljana have also attended.

C-EHRN in conjunction with the European Network of Drug Consumption Rooms (ENDCR) designed and delivered the training. The content was specifically tailored to align with the local context, drawing from an earlier Assessment of Needs conducted in collaboration with the two host NGOs and the DCR Manual produced by C-EHRN/ENDCR in 2022.

The training in Ljubljana had several important outcomes. Firstly, it equipped participants with practical tools and insights needed for the successful planning, establishment, and operation of DCRs. The event also served as a platform for sharing best practices and service models from different regions, with an aim to enhance the quality of care provided in DCRs.

Notably, the training fostered cooperation among local and national stakeholders, including representatives from diverse sectors like healthcare, government, and NGOs. This collaboration allowed for constructive discussions regarding needs, challenges, and joint strategies—a critical element for the future success of DCR projects.

Additionally, the training offered an introduction to various DCR models and approaches, offering tools and strategies for participants to create their own service models and operational protocols, as well as monitoring, data collection, and evaluation processes.

C-EHRN and ENDCR have made a commitment to providing ongoing support for the DCR initiatives in Slovenia. They plan to follow up with participants through a check-in meeting in the coming months and offer further support materials as required.

In conclusion, the training in Ljubljana marked a step on the long path towards the establishment of Drug Consumption Rooms in Slovenia. It provided participants with valuable tools and knowledge and fostered collaboration among stakeholders.

The 31st of August marks the International Overdose Awareness Day, a day to amplify the voices fighting to end overdose and to remember those who have passed away due to overdose. In support of initiatives making efforts on this path, we bring some of the latest updates.

Highlights include:

the European Network of Drug Consumption Rooms,
research on the effectiveness of the Scottish “How to Save a Life” mass media campaign addressing the rising number of drug-related deaths,
the efforts made in Athens in overdose prevention,

along with some additional resources that came our way in August.

New members can now join the European Network of Drug Consumption Rooms

C-EHRN hosts the International Network of Drug Consumption Rooms since 2007. In the past years, it became obvious that more cooperation is needed at the European level to support the development of high-quality DCRs. As an answer to this need, the European Network of Drug Consumption Rooms (ENDCR) began to take shape. At the beginning of 2023, we developed the Terms of Reference for the ENDCR, a network aiming to support capacity-building and advocacy activities and to create a platform for mutual support.

We invite organisations in the WHO Europe Region operating or planning to implement a DCR to apply for membership by reading the Terms of Reference and sending an email to administration@correlation-net.org, indicating their interest in joining the network. Once contacted, we can provide a membership confirmation survey link.

Scottish Naloxone Distribution and Mass Media Campaigns: A Blueprint for Overdose Prevention

Recent Scottish research offers insights into addressing drug overdoses through effective strategies. Two studies delve into the roles of naloxone distribution and mass media campaigns in preventing overdose-related deaths. Scotland’s “How to Save a Life” (HTSAL) campaign, addressing increasing drug-related deaths, aimed to raise awareness and expand naloxone distribution.

The first study reveals that the campaign significantly boosted community naloxone availability. However, sustainability post-campaign requires consideration. The second study shows the campaign’s success in enhancing public understanding of drug-related deaths and naloxone while highlighting that responses to overdose need comprehensive coverage. Scotland’s proactive HTSAL campaign sets an example for similar regions, highlighting the importance of ongoing investment to sustain overdose prevention efforts beyond campaign periods.

Athens Recognized at International Summit for Naloxone Accessibility

In March 2023, Athens was amongst the 5 cities recognized for public health achievements at the Partnership for Healthy Cities Summit convened in London by Bloomberg Philanthropies, World Health Organization, Vital Strategies, and Mayor Sadiq Khan of London. The recognition was gained for the steps taken to enhance the availability of naloxone within community-based initiatives and among medical practitioners. Additionally, the city has initiated research into the factors leading to mortality among people who inject drugs to gain deeper insights into the effects of the overdose crisis.

Marios Atzemis, Harm Reduction Officer at Positive Voice, C-EHRN’s focal point in Athens, underlined the importance of recognising those who played a crucial role in the progress, including Professors Angelos Hatzakis and Vana Sypsa, the Hellenic Scientific Society for the Study of AIDS, STDs and Emerging Diseases and George Kalamitsis, chair of the Hellenic Liver Patient Association “Prometheus”. He also added: “We are tired of losing friends and peers from deaths that could be prevented and we strongly support the participation of the directly affected communities in the design, implementation and delivery of programs, services and policies that are addressed to them. We also strongly support and encourage the collaboration of all the stakeholders and the key populations in the drug field as it happened to the naloxone case.”

Read about SAVE LIFE, an inspiring initiative from Denmark

SAVE LIFE is a crucial component of HealthTeam for the Homeless (SundhedsTeam) in Copenhagen, who are also C-EHRN’s focal point. It focuses on outreach health efforts for marginalized people and people who experience homelessness. Since 2010, SAVE LIFE has developed training in lifesaving in combination with the opioid antidote naloxone. Originally in Vesterbro, Copenhagen, the project expanded across rural and urban areas in three phases. Training includes nasal spray naloxone use, overdose recognition, and life-saving assistance. The first cross-municipal project began in 2013, with some municipalities engaged for a decade. Since 2020, SAVE LIFE has coordinated nationwide training in municipalities with a substitution treatment.

Project materials and resources are available on their website, and reports and scientific articles can be accessed here. For inquiries, contact Henrik Thiesen at gg63@kk.dk or alkodoktor@dadlnet.dk.

Additional Resources

Manual | Safer Consumption Spaces

Access the DCR manual with guidance and resources for the implementation, operation and improvement of drug consumption rooms.

Article | Tales from New York. ‘We should learn from the drug treatment approach here’

Read Tony Duffin’s inspiring article about the work of OnPoint, Overdose Prevention Centres and what we can learn from the drug treatment approach in NYC.

Webinar | Report Launch: Aid for War on Drugs

Date: 12 September
Organised by: Harm Reduction International
Registration here.

In 2022, we started to intensify our cooperation with drug consumption rooms in Europe and worked together on a number of activities. C-EHRN prepared ‘Safer Consumption Spaces’, a manual to support organisations with guidance and resources in the implementation, operation and improvement of DCRs. We also organised a technical meeting in cooperation with the EMCDDA in 2022 and 2023, and a session during the ‘Symposium on DCRs’ organised by the Pompidou Group in 2023. At the beginning of 2023, we developed the Terms of Reference for the ENDCR, a network aiming to support capacity-building and advocacy activities and to create a platform for mutual support.

The Scottish Drugs Forum ’s conference Shaping Scotland’s Drug Policy took place in May in Glasgow and focused on the lessons of responding to drug-related issues over the past 35 years, reflected on the current situation and looked at future challenges. Katrin Schiffer, C-EHRN’s director has also attended the conference, giving a talk titled European Drug Policies: Myths, facts and potential impact. Katrin provided an overview of the EU Drug Policy and its impact, the role of civil society in drug policy and the challenges in implementing a balanced drug policy approach.

After the conference, SDF organised a reception in honour of David Liddell, who has been SDF’s CEO for more than 30 years. David has cooperated with C-EHRN since 2007 and is a committed colleague and friend, who always advocated for the rights of People Who Use Drugs and their meaningful involvement in the development and implementation of services and drug policy. A valued friend and champion for harm reduction, he will be missed in Scotland, but also at the European level. David is followed up by Kirsten Horsburgh, a worthy successor who will continue the legacy, embracing its gains, but also breaking new ground.

C-EHRN hosted this year’s FP Meeting in Lisbon on 30 – 31 March and launched the Civil Society led Monitoring of Harm Reduction 2023 work plan with new opportunities for exchange, consultation and synergy to continue our shared goals of Networking, Monitoring, Capacity Building and Advocacy.

Notable updates include:

HR in Prison practical toolbox building on previous years’ activities and existing guidelines and good practices
Civil Society Involvement (CSI) Case Studies building on a tool developed as part of the CSFD Project, including quality standards and principles for meaningful CSI. Focus groups and interviews in four different countries/cities to assess the level and quality of CSI will be arranged.
Establish an advocacy network of HR allies (mayors, MEPs, national MPs, national drug coordinators and journalists) to support our advocacy activities, with the support of the UNITE Network of MPs.

The meeting was grouped by sessions:

‘Monitoring 2023’ session covered the framework for the C-EHRN Monitoring 2023 as well as monitoring developments and modifications. This includes the addition of new FPs, bringing the number to 43. Modifications include for HR Essentials and Hepatitis C, which will remain collected via a survey; for the data collection of New Drug Trends; and the new addition of city reports; as well as the framework for the report on the mental health of harm reduction staff (FPs have been contacted for interviews).
‘City Reports’ sessions presented the basic framework and content of the city reports and selection criteria for 5 pilot cities for 2023; as well as the aim of the reports: advocacy, data collection and capacity building. Volunteer cities include: Warsaw, Luxembourg, London, Cracow, Lille, Dublin, Amsterdam, Athens and Rome.
Monitoring and Advocacy sessions focused on the needs of FPs to support / improve advocacy and how C-EHRN has been using the Monitoring results for advocacy.
FGDs capacity building and New Drug Trends 2023 sessions introduced the ‘Monitoring New Drug Trends in 2023’ plan – a newly introduced section of the survey – as well as ran focus groups following the FP decision in Athens in 2022 to collect data on this topic via Focus Group Discussions (FGD) to ensure more quality and reliability of data. These sessions included capacity building on how to run an FGD, which several FPs are currently organising.

The next Expert and Member Meeting takes place in Budapest on 4 – 5 December.

We are excited to share two publications on National Harm Reduction Networks in Europe; Building Solidarity & Mutual Support and the accompanying Policy Recommendations.

National harm reduction networks are represented in 17 countries – with structures such as mission statements, steering committees, registered members and annual work plans. Roughly two-thirds of the existing networks receive funding for their operation, mostly from national or local authorities. The main activities of these networks are capacity building, advocacy, and networking. They also contribute to strengthening the organisation’s commitment to enhancing the linkage between European and national-level drug policies.

Many civil society organizations, such as various service providers and groups of people who use drugs, seek to shape the development of drug policy at both the national and international levels. The existence of networks brings numerous benefits and added value to the harm reduction field. Networks are best positioned to transmit to governments and decision-makers information on work carried out by organisations, including the needs and challenges faced by people who use drugs.

Read the full publication here.

Read the Policy Recommendations here.

One year ago, Russia launched Europe’s biggest war since WWII. The toll of human suffering has been staggering – thousands have been killed, and more than 8 million Ukrainians fled abroad. Its social, econonomic and health effects have been felt in nearly everyone’s life.

However, conflicts don’t impact all people equally. War and violence exacerbate structural inequalities and discrimination. This last year, people who use drugs and other marginalised communities in Europe have disproportionately experienced its negative consequences. Equally, harm reduction organisations have been put to the test.

On this day, we remember and mourn all the victims of Russia’s crime of aggression against Ukraine and pay tribute to Ukrainian’s resilience and courage. Equally, we join governments, institutions, organisations and individuals across the world in demanding the immediate, complete and unconditional withdrawal of Russia from the territory of Ukraine.

Until this moment comes, we will continue to #StandWithUkraine and work with our members, partners and friends to ensure that the health, safety and livelihood needs of people who use drugs and other underserved communities are met.

During the #CEHRNAthens22 meeting, DrugReporter made an informative video of the visit to the drug consumption room OKANA.

Péter Sárosi has written an informative article about his experience at the CEHRN Athens meeting earlier this month, alongside a video showing an inside look at the OKANA drug consumption room.

The Organisation Against Drugs (ΟΚΑΝΑ) was established pursuant to Law 2161/93 which was passed unanimously by the Greek Parliament, and has been operational since 1995 as a legal person that is governed by private law and reports to the Ministry of Health and Social Solidarity.

Its constituent instrument stipulates that OKANA shall:

plan, promote, coordinate and implement a national policy on prevention, treatment and rehabilitation of drug addicts

address the drug problem at a national level, provide valid and documented information, and raise public awareness

establish and effectively manage prevention centres, treatment units and social and professional reintegration centres

OKANA has always endeavoured to combine the roles of national coordinator and services and programmes provider in the fields of prevention, treatment and reintegration.

We are thankful to OKANA for inviting us to have a look at their way of working, and showing us their innovative technology used on site. Their drug consumption room is the first of its kind in Greece, and we hope sharing the amazing work they are doing will bring new opportunities for more, much needed, drug consumption rooms to open in Greece.

Abstract submission for HR23 is now open.

The theme for HR23 is Strength in Solidarity, with a particular interest in how harm reduction intersects with other social justice movements.

A list of starting point ideas includes;

Indigenous, rural and underserved communities and harm reduction (particularly Aboriginal and Torres Strait Islander peoples’ priorities for harm reduction)
Prisons/services/compulsory drug treatment/decarceration/abolition
Harm reduction and covid-19 (community-led responses, access to vaccines, enforcement & human rights violations)
Sex work and harm reduction
Racism/white supremacy/decolonising drug policy
Financing/funding harm reduction (sustainability and resilience in challenging environments/budget advocacy for harm reduction)
Death penalty for drug offences
Harm reduction as an ethic
Children, young people and adolescents
LGBTQI+ communities and harm reduction
Traditional and medicinal use of drugs
Current peer- and drug user-led services, programmes and organisations – advantages, challenges and history
Progress in harm reduction (DCRs/overdose prevention/harm reduction for stimulant users/integrated services/intersections with mental health)
Safer nightlife/party drug harm reduction/drug checking
Feminism and harm reduction
Harm reduction activism (successes/new strategies/social media tools)
Drugs and pleasure: beyond harm reduction
Harm reduction in crises (war/migration/humanitarian disasters/climate crisis/pandemics)
Civil disobedience and harm reduction (illicit provision of naloxone/unsanctioned DCRs/safe supply)
Tainted drug supplies/markets – their threat, and what they illustrate (E.g., fentanyl, benzo dope)

The call for abstracts will close at 23.59 BST on 30 September 2022.

More information, and how to apply here.

Report on Access to Mental Health Care for People Who Use Drugs in Central and Eastern Europe and Central Asia

Training in Ljubljana: Advancing Drug Consumption Room Initiatives

Overdose Awareness Day – Some of the latest updates in the fight to end overdose