For more than 30 years, Drug Consumption Rooms (DCRs) have been implemented in Western countries. These services typically aim to reduce overdose-related morbidity and mortality, prevent the spread of infectious diseases and provide access to a broad range of medical and social support services. As frontline, low-threshold services, DCRs are also often among the first sites where insights into new drug use patterns can, and they, therefore, play an important role in the early identification of new and emerging drug trends. In addition, DCRs may also aim to reduce drug use in public and improve public amenities.

In some countries, DCRs are a well-established and integrated component in responses to drug-related problems. Additionally, a substantial body of practical experience and research evidence has accumulated to support its effectiveness in achieving public health and safety. Yet, the scale of DCR implementation still varies considerably worldwide as they remain contested measures, particularly at the level of political and public debates.

This map shows the current number and location of drug consumption facilities throughout Europe (as of March 2024), incorporating the latest data from the European Network of Drug Consumption Rooms [ENDCR] yearly update. The source data for this map may be found in the following document. The coordinates here are approximate and cannot be used to locate facilities.

Naloxone is a medication that can counteract the effects of an opioid overdose, available in pre-filled syringes or nasal spray formats. When promptly administered following an overdose, it can be life-saving, offering vital support while waiting for emergency medical assistance. Given the concerning rise in cases of overdose involving synthetic opioids like nitazenes in various European cities, there’s an urgent call for widespread distribution of Naloxone and comprehensive training for people who use drugs.

In Copenhagen, C-EHRN’s Danish Focal Point, Red Liv, Center for Vulnerable Adults and Families, has been at the forefront of developing a nationwide training program on Naloxone administration for people who use drugs since 2010. This initiative has served as a model for other countries, including Norway and Sweden. By employing a train-the-trainer approach and adhering to national and WHO standards, staff at local services offering opioid agonist treatment (OAT) have been equipped to provide take-home Naloxone (in nasal spray form) and educate local communities on its usage and the identification of opioid overdoses. What began in Vesterbro, Copenhagen, has expanded into a nationwide network encompassing rural and urban municipalities.

This experience has proven the feasibility of establishing a supportive network of trainers for Naloxone administration and provision. However, sustaining such a network requires ongoing support, which local organisations find challenging due to insufficient political prioritisation and uncertain funding. Despite these obstacles, organisations like Red Liv continue to advocate for the importance of these initiatives amidst the many responsibilities faced by staff at harm reduction services.

Building on their extensive experience, Red Liv has compiled a series of reports and recommendations on Naloxone administration and how to support and upscale the existing network, available in multiple volumes in Danish and a summarised version in English. Their work is an excellent example that can support other European organisations wishing to implement similar interventions.

Read the English summary and recommendations here.

You can find more information on the development from pilot project to national standard [in Danish] here:
-Save Life 4 (read here and here)
–Save Life 3
–Save Life 2
–Save Life 1 (pilot)

C-EHRN and UNITE occupy distinct positions within the realm of drug and health policy. While C-EHRN fosters collaboration among civil society, harm reduction services, advocates, and community members, UNITE comprises elected officials and politicians dedicated to a human rights-centered approach to health.

The collaboration between these networks promises to enhance mutual understanding and awareness, amplifying the effectiveness and impact of advocacy efforts in health, harm reduction, and drug policies. By bringing together a diverse array of policymakers, practitioners, and advocates, this partnership facilitates the exchange of experiences, expertise, best practices, and lessons learnt, thus establishing a robust platform for advocacy.

The cooperation between C-EHRN and UNITE endeavours to prioritise harm reduction and the health of individuals who use drugs, aiming to elevate these issues on the public health agenda. Ultimately, this concerted effort seeks to advance the adoption of evidence-informed policies firmly grounded in human rights principles.

This report offers a summary of findings derived from a series of online consultations conducted among civil society and harm reduction experts. Additionally, it provides an overview of the sources and methodologies employed by C-EHRN and UNITE throughout these consultations. The central content of the report is based on discussions held during these consultations, supplemented by C-EHRN’s previous work in the thematic areas of communicable diseases, migration, and drug consumption rooms [DCRs].

Furthermore, we have included additional references and resources in the concluding section of the document to provide further insights into the subject matter from various perspectives.

Finally, the report presents recommendations for policy and practice aimed at supporting harm reduction advocacy in Europe, informed by the expertise of harm reduction specialists.

We are launching our publication New Drug Trends: Insights from Focus Group Discussions, part of Correlation – European Harm Reduction Network’s Civil Society-led Monitoring of Harm Reduction In Europe 2023 Data Report.

The study relies on 18 focal group discussions conducted among civil society organisations designated as focal points within the Network and explores the latest insights concerning the emergence of new illicit substances in cities where focal points are located, as well as other developments in drug use patterns, including polydrug use, routes of administration, and changes in local drug markets.

We bring an interview with Daan Van der Gouwe, primary author, researcher at Trimbos Institute and coordinator of the Dutch Harm Reduction Network. Read the interview and download the publication below!

Which main developments would you highlight when it comes to new or unknown substances compared to last year’s report?

We have witnessed a number of developments this year. When we look at the community of people who are engaged in high-risk drug use, we see the appearance of various synthetic opioids in heroin or benzodiazepines, for instance, nitazenes, but fentanyls are also gaining ground in some areas in Europe. With nitazenes, it seems to be geographically limited still in the northwestern part of Europe, mainly in Ireland and the UK. Whereas when it comes to fentanyls that are found in heroin, we see it in other areas of Europe. This is the main finding that we didn’t see so much last year.

Within the group of people with high-risk drug use, we also see an increa

se in the use of cocaine and methamphetamine. This cocaine includes crack cocaine, especially.

People also spoke about the ban on opium cultivation by the Taliban in 2023, that this should have an effect on the heroin market, but we don’t see that very clearly at the moment. Heroin is still available but it may be the case that this year, in 2024, it will be a different situation.

When it comes to recreational drug use, we do not see so much difference. We see some appearance of 2C-B, ketamine, some cathinones and especially also cocaine being more present on local drug markets in Europe.

The findings show that the internet takes up an increasing space in the sale of drugs. Are there any recommendations or best practices on how harm reduction services can respond to this?

Yes, this is a clear finding. We have witnessed this feature for several years already, but last year it was really strong. I’d like to make a plea for harm reduction NGOs to go online and inform themselves about the changing markets, to see what’s going on online, but also to start some interventions there and to do internet-based harm reduction, for instance, online outreach work.

We have had a pioneer, his name is Fernando Caudevilla, DoctorX, who did this work already 10-15 years ago. He did that on the darknet, he answered questions of people who use drugs, and he gave very proper harm reduction advice to anyone who had questions about drug use. Maybe in some countries like the Netherlands, we have this clear-cut information everywhere online, but in many other countries, for instance, in Russia, this information is not available.

This kind of work, online harm reduction services are essential for people to take note of. This would be a very important thing to do and to start conducting.

Would you pick a quote from the report that you find significant and explain why you find it relevant?

I’d like to quote the focal point in Glasgow in the UK, Scotland:

“(…) There are few reports to corroborate (the use of nitazenes), but (…seem to be….) people who have reported long term use of other drugs and have purchased as heroin.” (p. 13.)

I think this quote is a good example of where we are nowadays. We have a number of reports on nitazenes and other synthetic opioids in heroin, but the evidence is lagging behind, particularly because there’s a lack of drug checking services in the European Union or globally. So people do not really know what they are buying and using. This is why it’s very important to have drug checking services so that when people purchase heroin, they could find out that this ‘heroin’ contains no heroin, or contains heroin but also nitazenes, which are much stronger and can be lethal. So it’s essential to have these services all around the globe.

How do you think harm reduction organizations can use the report?

The report can be used as an advocacy tool, to advocate for a better early warning system, especially since now drug markets are more polluted. Look at the heroin market, but some other markets also seem to be more polluted. Also because drug markets continue to go online.

Harm reduction services also need to find funding for better services and for better serving the needs of people who use stimulant drugs, especially crack and methamphetamine, since we have seen an increase in crack and methamphetamine on the market and services for these users are also lagging behind.

This report clearly identifies these developments which are in line with data from, for instance, the EMCDDA [European Monitoring Centre for Drugs and Drug Addiction]. It would be good that harm reduction services use the report and the recommendations to get access to additional funding to serve the people they’re working for in a better way.

Qualitative data is a significant complementary source to gain information, and as you mentioned, there seem to be limitations when it comes to gaining information about the quality or composition of substances, and that’s where drug checking can be very important. How do you think research methods can be combined in the best way and what do you think is necessary for this to happen?

What I think is necessary to develop further is that we look at different sources. In the scientific world, we call it triangulation of data. It means that we use data from the focus groups that we have been conducting for many years now in the framework of Correlation to compare those data with the drug checking data from several cities. But also, I think wastewater analysis could be a very interesting tool. Also, there’s a project going on which identifies and detects drugs in syringes.

I think with all those different sources together we can quickly see trends and developments in the drug markets. Also, what is even more important than just detecting or identifying is to intervene as quickly as possible.

For instance, this situation with nitazenes, it’s very worrying in a specific part of Europe now, but it could extend to the whole of Europe quickly. Then it also needs to be responded to in a very quick and precise manner. The data we get, along with all the other data, for instance from drug checking, could help to do so.

What is the added value of this type of civil society-led monitoring with focal group discussions in comparison with the other types of monitoring of drug trends that are already done by major monitoring agencies?

The added value of the work that we do within the framework of Correlation is that we can get much richer data across than just the valuable data that are being collected by other agencies. They also take some time for publications, which means the day they are published, the data is rather old. We have developed now a system in which we can publish our data in a bit quicker way, which also means that we can intervene more quickly.

The other value is that we can put more layers of information of context in the data that are provided by other services, for instance, about drug markets. As an example, besides the internet-based drug markets that are now emerging, in some focus group discussions, there was a mention of increasing violence in the drug markets. Violence between drug dealers, violence between people who use drugs, violence between people who use drugs and drug dealers, and also violence between people who use drugs, drug dealers and the largest society. It seems that in some cities this violence is becoming more apparent than before, and this is also something we need to address.

What do you think the most urgent steps are that need to be done at the European level?

Two things I’ve already mentioned are the expansion of drug checking services throughout Europe, and also the expansion of harm reduction online.

Since there’s an increase in the appearance and use of stimulant drugs, especially crack cocaine and methamphetamine, but also some cathinones, harm reduction services should step up in delivering services that address the people using these stimulants.

Finally, there’s a need for preparedness for the changing heroin markets. As I said before, we see that the heroin market is increasingly polluted with fentanyls, but also in some areas with nitazines, and we believe that harm reduction services throughout Europe should prepare themselves in the best possible way to respond to the crisis that may emerge in the coming years.

Following a new format, Correlation – European Harm Reduction Network’s Civil Society-led Monitoring of Harm Reduction in Europe 2023 Data Report is launched in 6 volumes: Hepatitis C Care, Essential Harm Reduction Services, New Drug Trends, Mental Health of Harm Reduction Staff, TEDI Reports and City Reports (Warsaw, Bălţi, Esch-sur-Alzette, London, Amsterdam). The Executive Summary can be accessed here.

The publication is a segment of Correlation – European Harm Reduction Network (C-EHRN)’s Civil Society-led Monitoring of Harm Reduction In Europe 2023 Data Report and is dedicated to the well-being and working environment of harm reduction staff. The study focuses on the various challenges harm reduction workers encounter in their work and how those challenges affect them and their organisations, as well as coping mechanisms and organisational opportunities for support.

The participants in this study are identified as focal points within the C-EHRN. The network encompasses a diverse array of contributors, including grassroots and community-based organisations, service providers, drug user organisations, and research entities. Within this network, focal points act as hubs for collecting data and information on a broad range of issues related to harm reduction in the cities they work.

Watch the recording of the report launch webinar where 3 representatives of the participating focal points, Magdalena Bartnik (Prekursor Foundation for Social Policy, Warsaw, PL), Martin Blakebrough (Kaleidoscope 68 Project, Newport, GB) and Tessa Windelinckx (Free Clinic, Antwerp, BE), joined the primary author, Laoise Darragh, to discuss the findings:

This report has been developed by Correlation – European Harm Reduction Network (C-EHRN) in cooperation with the Rights Reporter Foundation (RRF). The report summarises the findings of a study conducted in 2023 which assessed the level and quality of civil society involvement in drug policies in four countries: Finland, Ireland, Greece and Hungary.

In 2021, the Civil Society Forum on Drugs (CSFD) established guiding principles for meaningful civil society involvement in decision-making regarding drug policy. These principles were published in the Quality Standards for Civil Society Involvement in Drug Policy. The four case studies assess the implementation of these standards.

We are excited to launch Eliminating Hepatitis C in Europe: Report on Policy Implementation for People Who Inject Drugs! The publication is part of C-EHRN’s Civil Society-led Monitoring of Harm Reduction In Europe 2023 Data Report and focuses on the availability of and access to interventions that constitute the HCV continuum of care specific for people who inject drugs.

The report analyzes data from 35 European cities, provided by civil society organisations designated as focal points within the C-EHRN network. It assesses the impact of national strategies on HCV testing and treatment accessibility for people who inject drugs, examines the continuum of care across countries and cities, explores changes in the continuum of services over time, and highlights the role of harm reduction services in this context.

We asked Tuukka Tammi, programme director at the Finnish Institute for Health and Welfare and the primary author about the findings and how harm reduction organisations can use the report to advocate for their work at a city level. Download the report and read the interview below!

How do you see the role of harm reduction organisations in hepatitis C care?

People who inject drugs are the main target group, if we use these words, for hepatitis C -related work. I don’t think that in any country only the specialized infectious experts could do enough in contacting, finding, treating them and keeping them in the treatment system.

Harm reduction services, services for the unhoused and all these low-threshold services are the only places where many of the people who use drugs are met, not anywhere else. This is also the case in Helsinki, where I come from. Even if we have quite a good general health care, many of the people who are hepatitis C positive don’t ever go there for one reason or the other. So I think harm reduction organisations are necessary partners for the healthcare system and infectious disease experts.

How would you describe the connection between national guidelines and actual practice?

The hepatitis C testing & treatment guidelines are part of the questionnaire and the idea is to see the progress on the formal side of things. To be successful in hepatitis C work with people who use drugs, the country or the city needs to have formal guidelines so that these people are treated in a uniform way in different clinics. But we know that formal guidelines or instructions do not yet mean that the same happens in practice. So we also asked if they see contradictions or limited impact in practice.

Respondents reported many kinds of real-life impacts of these guidelines for testing and treatment and other services for people who use drugs. Mostly they say that these have a positive impact. They make hepatitis C-related work better in many ways, meaning people have better access to treatment and testing, and other positive impacts. Some mentioned that civil society organisations have better access to work with hepatitis C or are more involved because of the guidelines if these have an emphasis that low threshold services like harm reduction services should be included in the work.

Respondents from three cities from Eastern Europe believe that the guidelines had a negative impact. This mainly has to do, I think, with stressing in the guidelines that all hepatitis C-positive people need to be treated in specialized healthcare. We know it would be important to include harm reduction services in this work because people who inject drugs are often marginalized, often unhoused, and do not usually go to these specialised public healthcare settings.

One repeated missing thing was that undocumented migrants are not included in the guidelines. In practice, in many cities, there is no access to any testing or treatment services for them.

You made a comparison among 25 cities that have taken part in the monitoring process in the past years to see if there are changes in the big picture in addressing hepatitis C. Are there any changes you would highlight?

At the very general level, the interpretation from the past 4 years was that there is some positive development and also that this positive trajectory has been reestablished after the pandemic when the situation in many places got worse because of restricted opening hours and moving from face-to-face clinical work to some other forms of work.

Also on a very general level, it can be said that there is polarisation of European cities. In many cities, it seems that they are proceeding quite well and might even reach the global elimination goal for 2030, to eliminate hepatitis C totally or almost totally. Then there are cities where the progress is very slow and there’s a lack of many things like economic and political support for this work or advocacy, and insufficient infrastructure for testing and treatment in general. Some cities still have old-fashioned working methods, even the interferon treatment, which is not very effective and not very nice for the patient, but luckily this is quite rare.

Would you highlight one of the graphs from the report and explain why you find it relevant?

Number 15. I think this is one of the main graphs from the viewpoint of harm reduction-related work, what kind of limitations are there for harm reduction organisations in addressing hepatitis C? This has been a more or less similar graph for many years. We see that there are 2 main obstacles: lack of funding and also lack of integration with the healthcare system. That’s a resource problem and a structural problem, not having links and connections.

10 cities mentioned a lack of staff doing testing and treatment, extra work in addition to other work they do. Then maybe the lack of recognition is related to the lack of integration with the healthcare system. Not everywhere are the harm reduction organisations regarded as relevant or qualified partners for doing this work. On the same level is a lack of political support, and there is a general weakness of local harm reduction services, they don’t have capacities to do this work. A lack of data for planning the work was also mentioned.

I think if we turn this into an advocacy or planning language, these are also the same factors that would need to be paid attention to.

Are there any best practices that can serve as an inspiration for the better integration of harm reduction services with the healthcare system that you would mention?

There surely are good practices and good examples from many cities, how they are very well integrated, such as in Amsterdam, or in Barcelona where they also have an observatory for monitoring stigma in services.

The lack of funding and lack of political support is a more tricky one. It varies a lot, how the funding works in different cities. We know that for instance, in many Eastern European countries, there’s a general lack of or no funding for harm reduction services more generally, not only related to hepatitis C work.

How do you think organisations can use the report?

One way to use it is to compare their situation with the others. If it’s worse than in other cities, making some noise about it in their cities and countries would be useful. Comparing different situations can also be an effective way to talk to policymakers. Not naming and shaming, but showing that harm reduction organisations can be very effective partners for the healthcare system in reaching people with hepatitis C and providing testing and treatment to them because we know that the prevalence of hepatitis C is most common among people who inject drugs and these people are not usually very well reached by the public healthcare system. So showing that this is possible, also in old fashioned systems where they still doubt that harm reduction organisations would be able to do this, showing from the example of other places that it’s working fine.

This report is hopefully useful for peer learning for some people. The more open and qualitative narratives in the report tell how things work in practice in different cities, which could be a source of inspiration for others. They could see what is happening in other cities and contact their colleagues from those cities to ask them for more detailed information: how does it work and how did they succeed in getting it done in the first place.

The EMCDDA and Correlation – European Harm Reduction Network (C-EHRN) have published today the latest overview on the situation of drug consumption rooms (DCRs) in Europe. The purpose of the report is to encourage evidence-based discussions around DCRs and the implementation of varied DCR models in Europe.

DCRs are a fundamental health and social response that fosters the well-being of people who use drugs by providing hygienic and safer spaces where to use substances in the presence of trained social workers and/or healthcare professionals. DCRs are usually located in areas where there is an open drug scene and where injecting in public places is common. The primary target group for DCR services are people who engage in drug use patterns that can result in dangerous health outcomes.

According to the report, in 2022, over 100 DCRs were operating globally, with services in several countries such as Belgium, Denmark, France, Germany, Greece, Luxembourg, the Netherlands, Norway, Portugal and Spain, as well as in Switzerland, Australia, Canada, Mexico and the USA.

Primarily, DCRs aim to prevent drug-related overdose deaths, reduce the risks of disease transmission through the use of unhygienic supplies and/or their sharing, and connect people who use drugs with support, health and social services. Besides this, they can also aim to minimise public nuisance.

In the report, two main operational models of DCRs in Europe are described: integrated DCRs, operating within low-threshold facilities, where the supervision of drug use is just one of the services offered, and specialised DCRs, offering a narrower range of services directly related to supervised consumption.

As frontline, low-threshold services, DCRs can support the monitoring of new and emerging local trends. For example, it has been found that in Europe, injecting heroin is less common in recent years, while the use of synthetic opioids and stimulants has increased in some countries. Over the years, following a dynamic drug landscape, many harm reduction services, including DCRs, have adapted to the needs of local clients. For example, some DCRs have started providing services for smoking as well as injecting and allowing the consumption of a wider range of substances within the facility.

DCR evaluation presents specific challenges, but currently available evidence supports the positive impact of DCRs on the access to healthcare and harm reduction services among people who use drugs, and especially groups that are not reached enough by these services. DCRs do not increase crime in the areas where they are located and, instead, contribute to a decrease in public drug use. Evidence also shows how DCRs contribute to reducing drug-related deaths.

In addition, an expert panel recently concluded that DCRs foster safer injecting practices and therefore can contribute to reducing the transmission rate of communicable diseases among people who inject drugs.

Among other measures to reduce cases of fatal and non-fatal overdose, the EU Drugs Action Plan 2021–2025 calls for DCRs to be introduced, maintained or enhanced ‘where appropriate and in accordance with national legislation’.
The report concludes that, despite the challenges encountered in conducting research in this setting, more studies are needed to support the work of DCRs by showing their contributions to reducing both individual and community harms.

Read the joint EMCDDA and C-EHRN Report on DCRs in Europe here.
Read the EMCDDA Report Release here.

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.

The European Monitoring Center for Drugs and Drug Addiction (EMCDDA) recommends the promotion of research and monitoring of drug use and health incidents in prisons. However, little or no research has been done on drug use in prison settings in the Netherlands in recent years.

International research shows that people in detention have used drugs substantially more often and are more likely to use drugs regularly. Incarcerated persons also experience drug-related problems more often than those not incarcerated. Drug use in prisons worldwide is relatively high. Yet, drug policies in prison mainly aim to combat the drug trade rather than provide care for those using drugs in prison.

In 2021, the Netherlands had nearly 30,000 people in detention across 29 penitentiary institutions. Understanding current drug use among people incarcerated in Dutch prisons is essential. In response, Correlation – European Harm Reduction Network (C-EHRN) and Trimbos Institute conducted an exploratory study in late 2022. The study, funded by the Ministry of Health, Welfare and Sport, investigated drug use in the Penitentiary Institution (PI) in Ter Apel.

Synthetic Cannabinoids (SCRAs)

The reason for the research in collaboration with Trimbos Institute is the continuous innovation in the way drugs and, in particular, synthetic cannabinoids (SCRAs) are smuggled into prison as impregnated on letter mail. There are signs of widespread synthetic cannabinoid use in Dutch prisons, which has been seen in foreign prisons for some time. One of the main reasons is that these substances are more difficult to detect than traditional drugs such as cannabis or cocaine. SCRAs impregnated on paper are odourless, and their use cannot be identified in conventional urine tests. The effects of SCRAs are similar to those of THC, making the user feel relaxed and intoxicated. However, the effects can vary considerably in strength and duration and can cause other side effects that can even be life-threatening in extreme cases.

Ter Apel

The qualitative research in the Penitentiary Institution Ter Apel is an initial exploration through a questionnaire distributed among employees and people in detention, as well as in-depth interviews held with key informants from the institution. The findings suggest high usage of SCRAs and inappropriate use of prescription pain, sleep and sedative medication, besides cannabis and alcohol use. Although drug use in the PI in Ter Apel does not seem to lead to visible significant safety or health incidents, likely, people in prison do not readily turn to the medical service for drug-related health problems, partly for fear of sanctions or stigmatization.

“The investigation results have made us realize that we have been looking at the subject of drugs for too long from a safety point of view only. We do our best to prevent drugs from being smuggled in one way or another. It is also important to look at drugs from the perspective of health, care and the professionalization of our employees.” – Laurens Huizenga, branch director PI Ter Apel.

Recommendations

In order to have a better understanding of substance use in Dutch prisons, more research is needed. Additionally, it is essential to gain better insights into the care needs of people in detention and the challenges faced by prison staff regarding drug use.
Such new research insights are necessary to implement more targeted and appropriate care and to improve access to addiction care.

The researchers advise keeping up-to-date and neutral information about drugs’ effects and health risks available to staff and people in detention. It is also desirable to have a broad and open discussion about substance use and SCRAs, particularly within the prison system.

For detailed information and more recommendations, read the research report.

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 or the European Health and Digital Executive Agency (HaDEA). Neither the European Union nor the granting authority can be held responsible for them.

Infographic. Location & Number of DCR throughout Europe

Empowering Communities: Red Liv’s training program on Naloxone administration

Harm Reduction Advocacy in Europe: Needs, Challenges and Lessons Learnt

New Drug Trends: Insights from Focus Group Discussions