Take a look at the new website that will serve as a resource center for BOOST project outcomes

The new website of BOOST, a project supporting community-based & community-led organisations in providing communicable diseases services, is now available online!

BOOST enhances the implementation of harm reduction interventions by supporting community-based and community-led services that work to counteract the prevalence of communicable diseases including HIV/AIDS and viral hepatitis.

Those interested can read about BOOST, its aims and activities on the new web platform. In later project phases, the resources produced throughout the project activities will also be published here, including an up-to-date overview of the quality of testing and linkage to care services offered by harm reduction organisations in the EU and selected neighbouring countries, good practice examples, webinars and training materials.

Co-funded by the European Union. Views and opinions expressed are however those of the author(s) only and do not necessarily reflect those of the European Union. Neither the European Union nor the granting authority can be held responsible for them.

Transforming Perceptions: Harm Reduction Efforts to Combat Stigma

When it comes to addressing drug consumption and its associated risks, the stigma surrounding people who use drugs negatively impacts their access to support and health services. When stigmatised, people feel discouraged from seeking the care they need due to feeling judged and degraded.

Harm reduction services approach drug use in all its complexity, upholding the rights of people who use drugs while searching for evidence-informed strategies of care and support. Harm Reduction aims to empower and support people who use drugs in regaining agency and leadership, contributing to their meaningful participation in reducing the potential harm of their drug use. Among others, examples of strategies to reduce stigma and improve access to treatment and support services include advocating for and contributing to the decriminalisation of drug use or the implementation of alternatives to incarceration.

For the International Day against Drug Abuse and Illicit Trafficking, we have collected some updates from the harm reduction field touching on addressing stigma.

→ 2023 #SupportDontPunish Global Day of Action
June 26th marks the 11th #SupportDontPunish Global Day of Action. The Support. Don’t Punish. Campaign unites initiatives working towards sustainable alternatives to the ‘war on drugs’ and supporting strategies to drug- and drug-policy-related challenges that are based on solidarity and the rights of the communities they represent. The campaign aims to connect and visibilise these local efforts as part of a global movement.
Find out more here.

→ Recommendations for tackling stigma and discrimination – joint statement by the EUHPP Thematic Network
The European Health Policy Platform Thematic Network on HIV, TB, viral hepatitis, and STIs, led in collaboration with the EU Civil Society Forum, is working to involve non-governmental organizations in policy development, implementation, and sharing of information. They released a joint statement in June that has been supported by 40 European organizations.

The statement points out the gaps in addressing the needs of individuals affected by HIV/AIDS, viral hepatitis, and tuberculosis in the EU. It also provides recommendations to tackle the stigma and discrimination faced by key populations, including people who use drugs.
You can read the statement here.

→ Statement from UN experts addresses stigma and discrimination and calls for people-centred alternatives to the ‘war on drugs’
A recent statement by United Nations experts underscores the detrimental effects of stigmatization and urges the exploration of alternative approaches to address the global challenge of drug-related issues. The experts advocate for a comprehensive and restorative justice framework, alongside inclusive and community-based measures. By challenging the paradigm of the ‘war on drugs,’ they emphasize the importance of adopting a more compassionate and efficient response. For further insights, you can access their statement here.

→ New toolbox to initiate harm reduction in prisons will be available by October
A toolbox to give guidance on the application of harm reduction approaches in prisons is under development. The toolkit, developed by C-EHRN in consultation with relevant stakeholders and experts, will be launched in October and presented at the C-EHRN Member and Expert Meeting in Budapest in December.

→ Civil society involvement in Finland, Ireland, Hungary and Greece – What stage are we at?
In 2023, C-EHRN and the Rights Reporter Foundation will conduct a study to assess the level and quality of civil society involvement in four EU countries, Finland, Ireland, Hungary and Greece. The case studies will reflect on the application of quality standards based on the Quality Standards for Civil Society Involvement in Drug Policy, developed in 2021 as part of the Civil Society Forum on Drugs (CSFD) Project. The study will also address how CSO are involved in the implementation of drug policies in each country.

BOOST Project at the Central and Eastern European Summit 2023

The Central and Eastern European Summit 2023 on Hepatitis C, HIV and other infections – screening, linkage to care and treatment took place in Prague on the 15-16th of June and gathered over 200 participants from Czechia and Central and Eastern Europe. The aim was to facilitate knowledge exchange, share good practices and improve care for hard-to-reach communities, particularly people who use drugs.

 
Some elements of the BOOST project were also presented by Tessa Windelink (Free Clinic) and Jukka Koskelo (A-klinikka Foundation), representatives of project lighthouses, with the title “Community management plan – how to improve continuum of care at the local level? Project BOOST” as part of the Local Strategies session. On the second day, a Boost project meeting for members of the project team and interested partners also took place, bringing more clarity regarding cooperation and organisation among the partners.
 
The main aim of the BOOST project is to enhance the implementation of high-quality community-based & community-led communicable disease services as part of a comprehensive, people-centred and integrated harm reduction approach. The project is funded by the EU4Health programme of the European Union.
 
 
Read more about the BOOST project here.

 

Improving Access to Health Services for Migrants Who Use Drugs: Insights from EU Experts

Access to drug dependency services and healthcare among migrants who use drugs in the European Union remains a topic with limited available information. However, EU experts agree on several risk factors influencing the non-medical use of medicines and illicit substances, as well as shortcomings in service accessibility.

To address these challenges and promote better access to healthcare services for migrants who use drugs, a Delphi study engaged 57 European experts from various work fields across 24 countries. As a result of the study, 15 actionable recommendations were formulated. The study’s findings and recommendations are now available in the recently published research paper titled “Drug use and access to drug dependency services for vulnerable migrants who use drugs in the European Union: Consensus statements and recommendations from civil society experts in Europe.”

The study emphasizes the significance of European-level collaboration and cross-sectoral cooperation in delivering improved and more accessible healthcare services to migrants who use drugs. It also suggests that the establishment of an EU expert committee on migration and health, as well as the development of EU guidelines on migrant and drug services, can contribute to enhancing the quality and availability of these services. These initiatives aim to ensure that service improvements are based on reliable data.

Furthermore, the paper advocates for the inclusion of migrants in the development of health services and highlights the importance of ensuring easy accessibility to services for undocumented migrants. Additionally, the study emphasizes the need for psychological screening to be incorporated into these services.

The research was conducted as part of the Services for vulnerable MIgrants who use Drugs in the EU (SEMID-EU) project, which received funding from the European Union’s Justice Programme—Drugs Policy Initiatives. The project’s objective is to gain a deeper understanding of the needs of migrants who use drugs and enhance local responses based on this knowledge.

To access the research paper, click here.

A new drug demand and harm reduction quality standard implementation toolkit will be launched in June

Drug prevention, treatment/social reintegration and harm reduction programmes and service providers will soon have access to a helpful toolkit to support them when it comes to applying quality standards in their day-to-day activities.

Quality standards can support interventions and organizations in improving the quality of their professional practice. However, the currently available documents are often complex and abstract, which can discourage the personnel delivering prevention, treatment/social integration and harm reduction programmes and services. The quality standards implementation toolkit has been developed as a response to this issue as part of the FENIQS-EU project.

It provides educational resources and step-by-step guidance to break down the QS implementation into a feasible process. The toolkit includes a presentation of the basic concepts, practical guidance, tools and tips for service providers and a selection of good practices which can serve as examples.

The toolkit will be presented at the FENIQS-EU final conference taking place in Prague between the 12th-13th June and will be available on the FENIQS-EU project’s website in early July, along with a video tutorial regarding its contents.

Rafaela Rigoni on Civil Society-led Monitoring for Harm Reduction @ISSDP 2023

The 2023 Conference of the International Society for the Study of Drug Policy (ISSDP) took place in Leuven, BE between the 30th of May – the 1st of June 2023, gathering around 250 participants including researchers, academics and some civil society organizations.

As part of the event, Rafaela Rigoni, C-EHRN’s Scientific Officer presented the Civil Society-led Monitoring for Harm Reduction, one of C-EHRN’s most significant achievements from recent years, with the title Frontline perspectives: Civil society-led monitoring of harm reduction in Europe.

Rafaela discussed the crucial role of civil society organisations (CSOs) in the development and implementation of measures to reduce the harms of drug use and in monitoring and evaluating program policies. Her presentation analysed the challenges and experiences in building a framework to monitor the implementation of harm reduction in Europe from the viewpoint of frontline harm reduction workers.

She presented the monitoring framework developed by C-EHRN’s research group since 2018, which collects data on the accessibility and acceptability of harm reduction services, hepatitis C care for people who inject drugs, and drug trends. The monitoring tool operates through a network of Focal Points, harm reduction services in 36 European cities in 34 different countries.

Mapping the situation on a city level, the approach provides the foundations for the critical evaluation of harm reduction implementation against European policy goals and reflects the CSO’s perspectives, which is critical for optimising the local planning of services and developing effective and respectful drug policies.

 

Curious about the results of last year’s monitoring? Check out the Monitoring Data Report and the Executive Summary!

DRUG-PREP update: Research on the current drug landscape to be published soon

Research on the growing complexity of the current drug landscape was carried out during the course of last year as part of the DRUG-PREP project led by the Trimbos Institute and 6 European partners, the results of which will soon be published.

The objective of the research project was to assess the current European situation regarding drug-related developments and emerging threats. It also aimed to identify recommendations and best practices that can enhance the preparedness of drug information systems, threat assessment and response interventions. Methodologies included desk research and literature reviews, questionnaires submitted to the EMCDDA (European Monitoring Centre for Drugs and Drug Addiction) Reitox National Focal Points, in-depth interviews with 30 key experts, and qualitative and thematic analysis.

Results from the literature review, desk research and questionnaires show an increase in drug use in Europe in the last two years, specifically in crack cocaine, methamphetamine, nitrous oxide, the emergence of off-label medicine use, especially (counterfeit) benzodiazepines and of polysubstance use, or the use of several drugs simultaneously.

Furthermore, developments in the drug market have been noted, such as larger availability and purity of cocaine together with its decrease in price, changes in cannabis prices and usage of synthetic cannabinoids, and adulteration of “traditional” drugs with different new psychoactive substances. The drug trade through online markets and social media is also on the rise. Other phenomena, such as a renewed use of crack cocaine, use of GHB/GBL, synthetic opioids and changes in administration routes (vaping, smoking, inhalation) have been observed especially within more marginalised communities. Another finding is that a larger number of harm reduction services are available in Europe, including DCRs, Naloxone provision and low-threshold integrated services.

From the in-depth interviews with key experts, it was concluded that staying prepared for new, unknown or unexpected drug-related threats is currently still a challenge at both the national and European levels. Other issues include the slowness of monitoring and surveillance tools combined with difficulties in delivering monitoring results to policymakers and successfully translating them into policy.

To counter these problems it would be good to innovate monitoring tools and complement them with foresight activities, including a larger number of individuals, field practitioners and stakeholders in trend detection, and investing in the coordination and formalisation of national threat assessment and information exchange systems. Lastly, it would be necessary to ensure that monitoring results are delivered to target audiences and decision-makers, that effective response protocols are formalised, and that responses are strategic, coherent and inclusive of a broader range of stakeholders on the regional and European level.

 

The full report on this research activity will soon be available on the DRUG-PREP project’s website.

Activists build a pop-up drug consumption room in Helsinki to protest against the Finnish government’s inaction on the issue

Protesting against the lack of efforts on the part of the City of Helsinki to take action on a project that was proposed back in 2019, which called for the establishment of a pilot drug consumption room, on May 24 a group of activists and volunteers built a pop-up drug consumption room in a tent in the middle of the capital. This act of civil disobedience comes at an especially relevant time, considering that the negotiations around the national Finnish program for the next four years are currently taking place.

In the tent, people who use and inject drugs would have been able to do so in a safe environment, and they would have been offered hygienic equipment and food. Health professionals were also present to provide visitors with advice and support. The purpose of this type of space is that of preventing or limiting the risks of using and injecting drugs in unsafe environments, such as overdose or infection through shared equipment – which is why the implementation of drug consumption rooms is so crucial.

The tent was soon taken down on request of the police, which suggested that the action might have been illegal, as this type of facility is criminalised. However, by the time the police intervened, nobody had had the time to make use of the drug consumption room, meaning that no illegal activity had taken place.

Tuukka Tammi, who is the Programme Director at the THL, the Finnish Institute for Health and Welfare (which supports the plan to open a pilot drug consumption room in Finland), empathises with the motives of the protest. In his statement, he said that while “illegal activity is illegal activity”, “these activists know the reality. Many people die of drug overdoses every year and this kind of facility is one possible solution.”

(This article is based on the report of YLE, the Finnish national news agency.)

SEMID-EU | Partners Meeting

The partners of the SEMID-EU (Services for Vulnerable Migrants Who Use Drugs in the EU) project met in Paris on the 25th-26th of May. As part of the project, a Community-Based Participatory Research Program was carried out, the outcomes and lessons of which were discussed, and some localized advocacy points were outlined.

Amongst other issues, migration being extremely politicised in EU countries was underlined, which provokes distrust, thus challenging the work of initiatives seeking to better the circumstances of migrants. On the other hand, community support and connection to harm reduction services seem to be protective factors for people, supporting them to navigate an unknown system and serving as an entry into care and more formalised support.

The SEMID-EU project intends to fill knowledge and practice gaps regarding migration and drug use in the EU to facilitate better responses to local challenges. For more information about the project, click here.

31st Annual NISPAcee Conference

Except for being our Research Officer, Iga Jeziorska is also an Assistant Professor at Corvinus University of Budapest in Hungary. Within this capacity, since 2017, she has been coordinating a Working Group on NGOs in Central-Eastern Europe in a non-profit scientific association called Network of Schools and Institutes on Public Administration in CEE (NISPAcee). This year, in Belgrade, Serbia, Iga presented some results from our 2022 civil society-led monitoring of harm reduction, focusing on challenges and needs of harm reduction service providers in European cities.

Even more importantly, however, Iga’s work was appreciated by the Network by being awarded the Mzia Mikeladze Award for the best PhD in the region for her portfolio dissertation titled Understanding the Determinants of Policy Performance in Collaborative Context: The Case of Drug Harm Reduction Services in Central-Eastern Europe, including the peer-reviewed papers that can be accessed here:

A Sin or a Health Issue? Morality Policy Framing and the State of Harm Reduction in East-Central Europe

Collaborative Governance Regimes in Illiberal Democracies: A Comparative Case of Drug Harm Reduction Policy in Central-Eastern Europe

Needle exchange programmes in Visegrad countries: a comparative case study of structural factors in effective service delivery.