Correlation – European Harm Reduction Network is a European network tackling marginalisation and social exclusion of various groups of people including drug users by improving their access to services.

Correlation es una red europea centrada en la marginación y la exclusión social de ciertos grupos de personas, entre ellos usuarios de drogas ilegales, a fin de mejorar su acceso a los servicios que necesitan.

Correlation est un réseau européen dont le travail est ciblé sur la marginalisation et l’exclusion sociale de certains groupes de personnes, y compris les consommateurs de drogues illégales, dans le but d’améliorer leur accès aux services dont ils ont besoin.

Correlation – European Harm Reduction Network

Please join us on Monday 13 May at 12.00 CET for the launch of the 

2024 Manifesto for a Progressive EU Drug Policy

 through a conversation on the future of European drug policy that will feature Members of the European Parliament and keynote European civil society speakers.

Please kindly register for the event through 

More than 260 European drug policy NGOs and 130 drug policy experts from 25 EU Member States have already signed the 2024 Manifesto for a progressive EU drug policy. We are coming together to call for a pragmatic and innovative EU drug policy that makes Europe safer, healthier, and more just.

If you want to support the manifesto, please make sure to:

Encourage your drug policy networks and colleagues to sign the manifesto.

Share the manifesto on social media with the hashtag #FutureDrugPolicyEU24.

If you want to get more involved in the campaign by translating the manifesto to your language or organizing a local launch event, please reach out to arogialli@correlation-net.org and kschiffer@correlation-net.org.

You can find the manifesto in Czech, English, Estonian, French, German, Italian, Hungarian, Lithuanian, Romanian, and Spanish, and the list of signatories, 

Thank you very much for your support, and we are looking forward to seeing you on Monday 13 for the launch of the manifesto.

Manifesto for a Progressive EU Drug Policy 2024 - Launch event

There are ongoing concerns among policymakers, law enforcement, and civil society organisations (CSOs) about the emergence of New Psychoactive Substances (NPS) in general (European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), 2023; United Nations Office on Drugs and Crime (UNODC), 2023a), about the appearance of NPS in more traditional illicit substances available in global and European markets, and about the emergence of new drug trends in general. International agencies continue to warn about the potential health risks (such as overdose) associated with illicit substances, including synthetic opioids. CSOs, particularly those working closely with people who use drugs, play a pivotal role in notifying signals of change with respect to the use of new substances, changing patterns of drug use, or in changes in local drug markets. This calls for new approaches to rapidly update data on drug trends that include qualitative data provided by people who use drugs and by experts who are in contact with people who use drugs. Data from CSOs are considered complementary to other sources, providing useful intelligence on emerging drug trends. This report aims to explore the latest insights with respect to the emergence of new illicit substances in cities where Focal Points (FPs) of Correlation – European Harm Reduction Network (C-EHRN)1are located, as well as other developments in drug use patterns, including polydrug use, routes of administration, and changes in local drug markets.The focus extends beyond NPS to allow for afull understanding of current local drug market developments.

New drug trends: Insights from focus group discussions

The BOOST project, a collaborative effort aimed at combating HIV/AIDS and viral hepatitis in Europe, supports EU and neighboring countries through community-based and led harm reduction initiatives. This response, vital due to the disproportionate impact of these diseases on people who use drugs (PWUD) and marginalized populations, is structured around four main pillars: Inform, Improve, Support, and Connect & Act, which focus on data collection, capacity building, best practice enhancement, and advocacy, respectively.

This Advocacy Strategy provides an overarching framework and sets priorities for regional harm reduction and community-led networks working for EU and neighboring countries. The objectives of the Strategy will serve as a basis for developing joint regional advocacy actions for comprehensive health and harm reduction services for people who use drugs.

The Strategy aims to enhance the quality, accessibility, and coverage of harm reduction services. It focuses on increasing political will and financial sustainability, promoting community-driven harm reduction, ensuring access to specific health services, and advocating for comprehensive health and social care. The strategy emerged from an inclusive consultation process, including extensive online dialogues, surveys, and strategic meetings, which identified key barriers to service access and outlined objectives for improving harm reduction efforts across the continent.

Through this collective approach, the BOOST project and its partners aim to address the critical health needs of people who use drugs, advocating for changes that support harm reduction, health rights, contribute to the priorities of the EU Drugs Strategy 2021-2025, and ultimately, the goal of eliminating HIV/AIDS and viral hepatitis as public health threats by 2030.

United for change: Advocacy strategy for comprehensive health and harm reduction services for people who use drugs in Europe

Despite billions spent in drug control, European drug policies have failed to protect the health and safety of our communities.

Drug use is reaching historical records. New substances are entering the EU market every year. War-on-drugs policies have been unable to stop the growing power of organised crime. Evidence shows that prevention, treatment, and harm reduction are necessary to save lives and protect our communities, but services for people who use drugs lack resources and political support.

The 2024 European elections must bring a paradigm shift. This manifesto lays down a vision for a pragmatic, innovative, and human rights-centred European drug policy that will deliver healthier and safer communities. We invite all European civil society organizations, parties, and candidates to endorse the following calls to action.

Together, we will build a drug policy that prepares Europe for the future.

Open To Everyone, Initiated by Correlation – European Harm Reduction Network, the International Drug Policy Consortium (IDPC), NEWNet Enjoying Safer Nightlife.

The Principle of the Drug Policy Manifesto:

Ramp up investment in health and social care

Drug use in Europe is at record levels, and the growing presence of new psychoactive substances, including synthetic opioids, has raised the alarm. Law enforcement and drug control will not stop this new threat, just as they have failed in other regions of the world. To be prepared for the future, the EU institutions must prioritise support and funding for integrated health and care services that are proven to work. A focus on services that support, rather than punish, people who use drugs is necessary to save lives and keep communities safe.

EU drug policy must be rebalanced, ending the current prioritisation of law enforcement over health. The EU institutions must ramp up investment and support for selective and indicated prevention programmes, evidence-informed voluntary treatment, life-saving harm reduction (including HIV/AIDS and HCV prevention, opioid assisted treatment, take-home naloxone, drug checking services, and drug consumption rooms), and community-based and community-led services that can reach out to everyone in need.

It is time to abandon war-on-drugs policies that, despite costing billions, have failed to reduce the size of illegal drug markets, to curb the power of organised crime or to reduce violence. Policies and narratives that stigmatise and blame people who use drugs and marginalised communities must be replaced with interventions grounded in evidence, inclusion, and human rights.

To ensure an integrated, holistic, and intersectional approach to drugs, EU health bodies must have a pivotal role in shaping EU drug policy. Drug policy must be mainstreamed across social, health and economic policies, and not be left at the hands of law enforcement alone.

The EU institutions must mainstream an inclusive, human rights and gender-based approach to drugs, including an unequivocal support for the decriminalisation of people who use drugs as a measure to remove stigma and improve access to services.

The new EU Drugs Agency must create indicators that monitor the effectiveness and impact of current drug policy approaches such as crime prevention and demand and harm reduction, including on stigma, access to services, and human rights, and conduct more policy-oriented research. EU bodies mandated to uphold human rights, EU values and the rule of law must also be involved.

Ensure civil society and community participation

A safer and more effective drug policy requires the involvement of civil society organizations that work every day with communities, can reach out to vulnerable populations, and are best informed of new trends in drug markets. EU drug policy must reflect the principle ‘nothing about us without us’, involving first and foremost affected communities and people who use drugs.

Mechanisms for civil society participation in EU drug policy, including the Civil Society Forum on Drugs in the EU, should be appropriately funded, supported, and meaningfully consulted by the European Commission, the EU Drugs Agency, and all relevant EU institutions. They should include representatives of affected communities, including people who use drugs, young people, women, and those disproportionately affected by criminalisation, stigma, and discrimination.

Explore innovative approaches, including responsible regulation

A pragmatic drug policy requires exploring innovative approaches to drug markets, including the responsible regulation of drugs such as cannabis, as a key measure to protect the health and human rights of communities, and reduce the power of organized crime. The EU should facilitate these innovations, and monitor their impact on health, safety, and human rights.

European policy makers must ensure that European laws and policies facilitate the adoption of innovative approaches to drug markets, including responsible regulation. The EU Drugs Agency should monitor the impact of drug policies and regulation, to allow for evidence-informed policy making. This will support mutual learning, increase uptake of best practices, contribute to pragmatic solutions, and prepare Europe for the future.

Alliance Nationale des Communauté pour la Santé (ANCS)

Asociace poskytovatelů adiktologických služeb, z.s.

Correlation European Harm Reduction Network (C-EHRN)

Episteme - Investigació i Intervenció Social

International Drug Policy Consortium (IDPC)

RefletsduReel (RdR) - Asud auto-support usagers de drogues

For a drug policy that makes Europe safer, healthier, and more just - Drug policy manifesto for the 2024 European Parliament elections

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.

The mental health challenges faced by harm reduction staff

Civil society is a critical partner in policy-making. Decision-makers must work with civil society in developing and implementing policies. Civil society organisations and activists work closely with affected communities and have extensive on-the-ground experience incremental to make policies reality-based and effective. Civil society is also a critical voice because it is part of the mission of a vibrant civil society to be critical of all-time power. As the so-called “third sector,” civil society is a counterbalance to the government and the market. Ideally, civil society organisations partner with governments without giving up their independence to express their criticisms of government policies publicly.

In theory, this all sounds great. However, in actual criticisms of real policies, the conflicting understandings of the role of civil society often generate conflicts. When civil society organisations make positions and express their critical opinion about laws and policies, they are often seen by governments as political actors.

Some mechanisms to involve civil society in national drug policies exist in all four countries but they vary greatly in many aspects.

Despite the existence of formal mechanisms, most participants of civil society FGDs claimed that the most meaningful dialogue happens through informal channels.

There was a significant difference between the perception of the meaningfulness of civil society
involvement between decision makers and civil society.

The transparency and accountability of decision making in the drug field was perceived as low by most civil society representatives in all four countries.

It was recognised by both decision makers and civil society in all countries that the selection of CSOs who are engaged is sometimes not balanced and inclusive.

In most countries, both decision makers and civil society found that there is sufficient time given to civil society to express its views about proposed new policies and laws.

In most countries, government officials are seen as approachable by civil society.

There was a general perception in all countries that civil society representatives are highly competent in their professional knowledge of the field in which they work but this competence is limited when it comes to policy making.

Decision makers often see civil society overstepping its role by making statements about policies. Civil society often sees this attitue as a violatation its autonomy.

This research identified a perceived trend in most countries that can be called the shrinking space for civil society: organisations and activists feel that they are increasingly excluded, marginalised and scapegoated for being critical.

The work of civil society representatives as consultants in civil society involvement mechanisms is not paid in any of the assessed countries.

One of the key findings of this research is that despite existing formal mechanisms, and despite the openly declared support and recognition of civil society involvement by civil servants, all civil society representatives participating in the FGDs expressed their frustration about being unable to make a meaningful impact in policy making.

Critical partners: Level and quality of civil society involvement in the field of drug policy

WHO's global hepatitis strategy, endorsed by all WHO Member States, aims to reduce new hepatitis C virus (HCV) infections by 90% and HCVrelated deaths by 65% between 2016 and 2030. According to the latest surveillance report (ECDC 20222), a total of 14,560 newly diagnosed cases of hepatitis C were documented across 29 EU/EEA Member States in 2021. Among these cases, the most common mode of transmission was injecting drug use. However, the nature of the infection, which is often asymptomatic until in advanced stages, complicates surveillance efforts as the data often reflects testing patterns rather than the underlying epidemiology and the burden of the disease.

There is a necessity for tailored surveillance and coordinated responses including public health programmes and harm reduction strategies that address the specific epidemiological patterns within each local context. To achieve WHO’s HCV elimination goal by 2030, a continuum-of-care for people who inject drugs must be implemented and monitored.

Eliminating hepatitis C in Europe: Report on policy implementation for people who inject drugs

We, the undersigned organisations, are deeply concerned about the drastic intensification of anti- drug operations in Sri Lanka leading to significant human rights violations.

On 17 December 2023 the Acting Inspector General of Police Deshabandu Tennekoon, with the endorsement of Minister of Public Security Tiran Alles, spearheaded an operation titled “Yukthiya”, with the stated aim of controlling “the drug menace”. The operation is ongoing as of 10 January 2024, with at least one thousand persons arrested daily.

This operation is unfolding in a context of already severe repression against persons who use or are suspected of using drugs, who suffer discrimination and stigma within the Sri Lankan criminal justice system and society.

Alongside the Sri Lankan police, members of the armed forces have been supporting this operation, during which several human rights violations have been reported. These violations include alleged arbitrary arrests, primarily against individuals from marginalised socio-economic communities; searches conducted without warrants or reasonable suspicion; and degrading treatment including strip searches in public as well as cavity searches. The searches and arrests have been televised, in violation not only of the right to privacy (and of basic human dignity) but also of a person’s right to be presumed innocent. According to lawyers, persons are being arrested even when no drugs are found in their possession, simply for having been arrested for drug offences or having been sent to compulsory rehabilitation in the past. The arrests of main livelihood earners and mothers have adversely impacted the ability of families to meet their basic needs during a time of economic crisis in Sri Lanka, and the wellbeing of children.

Persons are being arrested primarily under Section 54A of the Poisons, Opium and Dangerous Drugs Ordinance, an offence which is non-bailable. As a result, those arrested are bound to spend time (sometimes months) in pretrial detention, thereby exacerbating already poor conditions of imprisonment in an overburdened prison system. The Human Rights Commission of Sri Lanka has previously stated that the existing prison conditions and treatment of incarcerated persons are “inhumane and degrading.”At present, as per statistics issued by the Department of Prisons, the level of overcrowding of the prison system is at nearly 200% - with punitive drug policies playing a significant role: as of 2022, 63% of convicted persons were sentenced for drug-related offences.

The total reported number of arrests pursuant to operation Yukthiya has exceeded 29,000 as of 9 January 2024, while nearly 1,500 people are in administrative detention in police custody for further investigation.  At least 1,600 more persons have been sent for compulsory drug rehabilitation, in violation of several fundamental rights; including the right to the highest attainable standard of health, which includes the right to consent to and withdraw from medical treatment. “Drug treatment” in these centres is abstinence-based, essential harm reduction services are not available, and persons undergo severe withdrawal symptoms without any medical assistance while in detention. The use of violence to discipline and punish has been reported in at least two compulsory drug rehabilitation centres which are within the purview of the Bureau of the Commissioner General for Rehabilitation and are operated by the military, which is in itself a violation of international standards.

The UN Working Group on Arbitrary Detention in its statement at the conclusion of its visit to Sri Lanka in 2017 expressed concern regarding the involvement of military personnel in drug treatment and rehabilitation, the fact that strenuous physical exercise was the core component of compulsory drug treatment, and at the lack of trained professionals to monitor the health of people in detention. Furthermore, the statement highlighted the irregularities in the judicial process by which persons were sent to drug rehabilitation centres without a medical assessment.

More broadly, the UN Special Rapporteur on Torture has highlighted that by denying persons access to substitution therapies, states are subjecting “a large group of people to severe physical pain, suffering and humiliation, effectively punishing them for using drugs and trying to coerce them into abstinence.” The Special Rapporteur has further stated “forcible testing of people who use drugs without respecting their autonomy and their right to informed consent may constitute degrading treatment, especially in detention settings. States are obliged to respect the enjoyment of the right to health, including by refraining from using coercive medical treatment. The requirement of informed consent, including the right to refuse treatment, should be observed in administering any treatment for drug dependence.”

Since the 2016 UN General Assembly Special Session on drugs, there is international consensus on pursuing a holistic and health and human rights-based approach to drugs, which encompasses supply and demand reduction as well as harm reduction. The 2019 Ministerial Declaration on drugs – the current global drug policy document - as well as multiple resolutions of the UN General Assembly, the UN Commission on Narcotic Drugs, and the UN Human Rights Council reiterate and recommend a similar approach.

A punitive and militarised approach to drug control contravenes recognised international human rights standards and guidelines, is ineffective to protect individual and public health, and ultimately fails to make communities safer.

Africa Network of People Who Use Drugs (AfricaNPUD) (Africa)

Anti-Death Penalty Asia Network (ADPAN) (Asia)

Association for Humane Drug Policy (Norway)

Centre on Drug Policy Evaluation (CDPE) (Canada)

Centro de Estudios Legales y Sociales (CELS) (Argentina)

Corporación Acción Técnica Social (Colombia)

Correlation - European Harm Reduction Network (Europe)

Drug Harm Reduction Advocacy Network Nigeria (Nigeria)

Foreningen Tryggere Ruspolitikk /Safer Drug Policies (Norway)

GREA - Groupement Romand d'Etudes des Addictions (Switzerland)

Helsinki Foundation for Human Rights (Poland)

International Commission of Jurists (ICJ)

International Drug Policy Consortium (IDPC) (Global)

International Network of People who Use Drugs (INPUD) (Global)

Skoun, Lebanese Addictions Centre (Lebanon)

Zimbabwe Civil Liberties and Drug Network (Zimbabwe)

Sri Lanka: Stop abusive anti-drug operation and release those arbitrarily detained

Drug consumption rooms (DCRs) are fixed or mobile spaces in which people who use drugs are provided with sterile drug use equipment and can use illicit drugs under the supervision of trained staff.

They exist in several European countries, Australia, Canada, Mexico and the USA, and are usually located in areas where there is an open drug scene and injecting in public places is common. Their primary goal is to reduce morbidity and mortality by providing a safer environment for drug use and training clients in safer forms of drug use. Other explicit objectives may be providing a conduit to other care services and reducing public nuisance.

A main aim of this report is to inform discussions on DCRs by examining the available evidence, as well as reviewing the various models being adopted and their characteristics.

Two operational models are typically used in Europe:

(1) integrated DCRs, operating within low-threshold facilities, where the supervision of drug use is just one of several services offered; and

(2) specialised DCRs, which provide a narrower range of services directly related to supervised consumption.

Services typically available within DCRs include: provision of a supervised environment for drug use; clean drug use equipment, including sterile syringes; and rapid interventions if overdose occurs. In addition, DCRs may offer counselling services; primary medical care; training for clients in safer forms of drug use, overdose awareness and the use of naloxone; and referral to social, healthcare and treatment services.

Access to consumption facilities may be restricted to registered service users, and often certain conditions have to be met, for example minimum age and local residency. Typically, drugs used in these facilities must be obtained prior to entry. Drug dealing and drug sharing are not allowed within the facilities (staff may be required to call in the police if necessary), and staff can advise but do not directly assist clients in administering their drugs.

As frontline, low-threshold services, drug consumption rooms are often among the first places where insights can be gained into new drug use patterns, and, thus, they also can have a role to play in the early identification of new and emerging trends among high-risk populations using their services. The operation and functioning of DCRs has adapted to changes in the profiles and needs of their target groups, and to new patterns of use, as well as to new types of drugs emerging on the market. DCRs may also therefore be well placed to identify and inform strategies to mitigate harms related to developments in the illicit drug market that present new health challenges.

In Europe as a whole, the injection of heroin has been on the decline for a number of years and in some countries has been superseded by the misuse of synthetic opioids and/or stimulants. Within this dynamic context, many drug services, including DCRs, have had to adapt their services to the needs of local populations and the marketplace, often this implies addressing a broad range of practices and harms. This has included, in some countries, providing spaces for non-injecting routes of administration, most commonly smoking, and allowing the consumption of a wider range of substances within the facility.

As services, DCRs are particularly challenging to evaluate due in part to the considerable differences in the operational models that exist. This is further exacerbated by the differences in definitions used in by reviews of the topic and the heterogeneity of outcomes measures adopted by different research studies. This means generalising from the research evidence that exist in this area is challenging.

Currently available evidence does suggest that DCRs may have a beneficial impact on the level of access to healthcare and harm reduction services among hard-to-reach target groups; do not increase crime in the surrounding area; and may contribute to decreasing drug use in public spaces as well as reducing overall public nuisance. There is also some evidence indicating that drug consumption rooms can reduce drug-related deaths (1). In addition, an expert panel concluded that DCRs may contribute to reducing injecting-related risk behaviour and therefore potentially contribute to efforts to reduce the transmission of viral infections among people who inject drugs (ECDC and EMCDDA, 2023).

Despite the difficulties of conducting research in this setting, more studies are needed to improve the evidence on the extent to which DCRs may contribute to reducing both individual and community harms, in terms of outcomes associated with both drug injecting and non-injecting routes of administration.

Correlation – European Harm Reduction Network

Region

Translations

Related Content