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

Harm Reduction in Europe: The Past, Present, and Future

Europe has seen a wide variety of harm reduction strategies over the years. From needle exchange programs aimed at reducing the spread of HIV among people who use drugs, to supervised consumption rooms that provide a safer space for substance use, the continent has been at the forefront of innovative harm reduction policies. However, these approaches have not been without controversy and have evolved significantly over time.

As we reflect on the history and practices of harm reduction in Europe, we see a tapestry of different models, policies, and paradigms. The past few decades have witnessed a shift from punitive drug policies, which criminalize drug use, to more compassionate, health-focused approaches. Further, the mainstream harm reduction paradigm has seen an evolution from a health focus, with prioritized professional-led prevention of infectious diseases, towards a more holistic and autonomous view of an individual, and community-led, grassroots initiatives proliferating in recent years. Yet, the journey has been complex and uneven, with different regions adopting harm reduction at different paces and to varying extents.

In the present day, harm reduction in Europe stands at a crucial juncture. While significant progress has been made, challenges remain, including the ongoing stigma faced by people who use drugs, the need for greater and more equitable access to harm reduction services, especially for specific vulnerable groups, and chronic precarity of funding, both in terms of instability and insufficient resources.

Looking ahead, we are interested in exploring innovative and creative visions for the future of harm reduction in Europe. How can we build on the lessons of the past and present to create a more inclusive, effective, and compassionate approach to drug use? How can we ensure that harm reduction services are accessible to all who need them, regardless of where they live or their socioeconomic status?

50 years of harm reduction in Europe: high time for transformation


Authors: Iga Jeziorska, Thomas F. Martinelli, John-Peter Kools


Trends in distribution of harm-reduction equipment for persons who use drugs in Norway, 2016–2022


Authors: Jens Christoffer Skogen, Katharina Natalie Gottschlich, Martin Blindheim, Janne Årstad


Four decades of overdose prevention centres: lessons for the future from a realist review


Authors: Jolie R. Keemink, Alex Stevens, Sam Shirley-Beavan, Zarnie Khadjesari, Gillian W. Shorter


City-level drug policies in Portugal: the COVID-19 pandemic as an analyser of harm reduction responsiveness in Porto and Lisbon


Authors: Cristiana Vale Pires, Adriana Curado, Ricardo Fuertes, Maria Carmo Carvalho, Helena Valente


Relational anonymity in reducing the harms of illicit drug use: accounts of users of dark web- and street-based services in Finland


Authors: Johanna Ranta, Teemu Kaskela, Juha Nurmi, Teemu Ruokolainen, Gillian W. Shorter


Progress and challenges in the elimination of hepatitis C among people who inject drugs in Germany


Authors: Gyde Steffen, Amrei Krings, Sarah Guttmann, Nadine Lübke, Kristin Meyer-Schlinkmann, Carsten Tiemann, Jörg Timm, Andreas Walker, Ruth Zimmermann


Harm reduction and its monitoring in Europe, from EMCDDA to EUDA

Exploring drug consumption rooms as ‘inclusion health interventions’: policy implications for Europe


Authors: Benjamin D. Scher, Benjamin W. Chrisinger, David K. Humphreys, Gillian W. Shorter


Who is the drug user activist?: recounting the conceptualisation of drug user activism in the United Kingdom


Authors: Raymond John S. Naguit, Shayla S. Schlossenberg, Praveena K. Fernes


Challenges and support needs among persons with a migration background who use drugs in four European metropolitan cities


Authors: Aline Pouille, Clara De Ruysscher, Lena van Selm, Jan van Amsterdam, Wim van den Brink, Machteld Busz, Roberto Perez Gayo, Marios Atzemis, Wouter Vanderplasschen


How far are we? Civil society monitoring of hepatitis C response towards WHO 2030 goals in 25 European countries (2020–2023)


Authors: Mojca Maticic, J. Cernosa, C. Loboda, J. Tamse, R. Rigoni, E. Duffell, I. Indave, R. Zimmermann, L. Darragh, J. Moura, A. Leicht, T. Windelinckx, M. Jauffret-Roustide, K. Schiffer, T. Tammi


Europe must continue to lead on harm reduction


Authors: Brendan Kahn, Michel Kazatchkine


Reframing Dutch drug policies: a new era for harm reduction


Authors: Machteld Busz, Katrin Schiffer, Ancella Voets, Alice Pomfret


Harm reduction in Europe: Histories, choices and hopes - Collection commemorating 20 years of C-EHRN

On 23 July 2025, more than six months later than expected, the European Commission finally published the 

, with a total budget of €571 million. This significant delay created profound uncertainty and financial distress for NGOs and civil society organisations (CSOs) in the health sector, many of which had been waiting for months for confirmation of continued operating grant funding.

Operating grants are a vital source of core funding for EU-wide civil society networks. While they represent only a small portion of the overall EU4Health budget, their impact on the ground has been substantial. These grants have enabled civil society to carry out essential work in health promotion, policy monitoring, capacity-building, and advocacy, especially in support of vulnerable and underserved communities.

Shockingly, when the 2025 work programme was finally released, it became clear that the Commission had unilaterally decided to eliminate operating grants altogether. This move disregards the essential contributions of civil society over the years and delivers a serious blow to organisations that have worked tirelessly to advance public health, uphold EU values, and protect marginalised populations.

Although the Commission asserts that civil society can still participate in the EU4Health Programme, the elimination of operating grants removes the primary funding mechanism that supported sustained civic engagement in health policy. As a result, civil society networks are no longer in a position to effectively fulfil their core missions of promoting fundamental rights, democratic participation, and public accountability. This is not only deeply concerning, it actively undermines civil society and accelerates the erosion of civic space at a time when it is already under increasing threat across Europe and globally.

Between 2018 and 2024, C-EHRN received operating grant funding that accounted for over 60% of our annual budget. This support was essential to strengthening our network, gathering critical data on harm reduction and drug policy trends, and contributing to the evidence base needed for informed, health-based drug policies across Europe. It also allowed us to build capacity among our members and engage in meaningful advocacy at national and EU levels. The loss of this funding critically undermines the sustainability of this work and threatens to undo years of progress.

C-EHRN is not alone. More than 30 health NGOs across Europe are affected by this decision. Many signed multi-annual Framework Partnership Agreements in 2024, based on the assumption that funding would continue through 2025 and 2026. These organisations planned their activities accordingly and are now left without the operational support they were led to expect.

This decision must be seen in a broader context. Across Europe, civil society organisations working in health and human rights face mounting pressures. Harm reduction services remain chronically underfunded, and marginalised groups, including people who use drugs, migrants, LGBTQI individuals, sex workers, and people experiencing homelessness, continue to face stigma, discrimination, and systemic exclusion. The shrinking of civic space and the rise of authoritarian and populist politics only deepen these challenges.

The elimination of operating grants further undermines democratic governance and social justice in the EU. It jeopardises the sustainability of essential public health services and sends a troubling signal about how the EU values civil society. Moreover, this decision directly contradicts the Union’s stated commitments to democracy, transparency, and meaningful citizen engagement.

C-EHRN urges the European Commission to reconsider this damaging course of action and engage in genuine, constructive dialogue with civil society stakeholders. Sustainable and predictable funding for CSOs is not optional, it is essential to uphold democratic governance, safeguard human rights, and promote public health.

We remain in strong solidarity with other European civil society networks and reaffirm our commitment to defending civic space and advocating for robust, long-term funding mechanisms that recognise the indispensable role of civil society in building a healthier, more inclusive, and democratic Europe.

C-EHRN statement on the elimination of EU4Health operating grants for civil society organisations

Drug use cuts across all demographics, but its harms are exacerbated among marginalized populations due to punitive drug laws that amplify inequities. This includes women, LGBTQI+ individuals, Indigenous communities, migrants, and incarcerated populations, all of whom face compounded barriers to accessing harm reduction services. 

The bold targets of the Global AIDS Strategy 2021–2026 are supported by evidence that shows the peer-led and peer-to-peer harm reduction initiatives as effective. The Strategy underscores the critical need to apply an inequality lens to bridge gaps hindering progress, with the Sevilla Declaration6 advocating for the integration of community engagement commitments into local TB and viral hepatitis responses alongside HIV efforts. 

Current funding for community-led organizations falls short of the commitments outlined in the Strategy and although domestic HIV expenditure has increased in some cases, only a small fraction of these funds is allocated to community-led organizations.

Where there is fruit, there is seed: Scaling up community involvement for integrated, responsive, and sustainable harm reduction

In 2025, the European Union will adopt a new EU Drug Strategy that will define the political direction and priorities for the period 2026–2030.

While the current strategy (2021–2025) recognises the pillars of drug supply reduction, demand reduction, and harm reduction, its implementation has remained disproportionately focused on law enforcement and punitive measures.

This imbalance has not led to improved public safety—instead, it has worsened health outcomes, increased stigma, and deepened the marginalisation of people who use drugs.

Access to essential health and harm reduction services continues to be limited, particularly for vulnerable and underserved communities.

As the next EU Drug Strategy is being shaped, we face a critical opportunity to advocate for a more balanced, health-centred, and human rights-based approach to drug policy.

To seize this momentum, leading European drug policy networks — including C-EHRN, EHRA, IDPC, and HFHR — have launched the European Drug Policy Campaign.

This initiative is supported by the European Drug Policy Alliance, a coalition of civil society and harm reduction experts working to influence the content and implementation of the new strategy.

The campaign will be presented during a webinar on 26 June, the Support, Don't Punish Global Day of Action, bringing together policymakers, civil society representatives, and European drug policy experts to foster dialogue and build momentum for drug policy reform in the EU.

This webinar will feature diverse perspectives from key stakeholders and serve as a platform to mobilise support for a more just, inclusive, and effective EU Drug Strategy.

Harm reduction works! A call to invest in a european health-based drug policy - Campaign webinar

In 2025, the European Union will adopt a new EU Drug Strategy that will define priorities for 2026–2030. As this critical moment approaches, we call for a shift towards a balanced, health-focused, and human rights-based approach to drug policy.

To support this effort, we are launching the 

, coordinated by C-EHRN in collaboration with the 

Eurasian Harm Reduction Association (EHRA)

International Drug Policy Consortium (IDPC)

Helsinki Foundation for Human Rights (HFHR)

. The campaign is accompanied by the publication of a new 

Support Don’t Punish Global Day of Action

 outlines urgent recommendations for the EU and Member States, including:

Ensuring a balanced EU Drug Strategy 2026–2030

Establishing dedicated EU-level funding for harm reduction

Prioritising decriminalisation and responsible regulation

We will present the campaign’s goals and share ways civil society organisations and allies can get involved.

Harm reduction works! A call to invest in a European health-based drug policy

Civil Society Monitoring of Harm Reduction in Europe

 series explores developments in hepatitis C care for people who inject drugs, based on observations from C-EHRN focal points in 40 cities across 35 European countries. The findings point to trends such as expanded access to direct-acting antivirals (DAAs), ongoing healthcare stigma, and disparities in harm reduction funding. To gain further insights into this year’s report, we spoke with primary author Tuukka Tammi. Download the publication and read the interview below.

Compared to last year’s findings, what has changed the most in hepatitis C care for people who inject drugs?

The biggest shift is the record number of cities in the survey, giving us again a broader view of what’s happening across Europe. Forty cities across 35 European countries is a significant number. Most cities are actively encouraging treatment for people who inject drugs, and DAAs are available everywhere now, but restrictions still prevent universal access. And stigma in healthcare remains a major hurdle.

Were there any surprises in this year’s data—either positive or concerning?

A big win is that free HCV testing is now available in every city, and non-invasive diagnostics with Fibroscan® is more common. But there are still serious challenges. Harm reduction services continue to struggle with funding, and bureaucratic barriers like slow insurance approvals delay treatment.

This year’s report includes more participating cities than ever before. Did this expanded dataset bring new insights?

Definitely. The larger dataset highlights stark differences between cities making good progress and those falling behind. Some have strong policies, easy access to treatment, and well-funded harm reduction, while others still face major gaps due to restrictive policies and lack of funding. As we know more broadly, there are major divides in access to harm reduction services across Europe.

Some cities are making strong progress toward the 2030 HCV elimination goal, while others are lagging. What are the key factors that explain these differences?

Cities moving forward typically have well-funded harm reduction, fewer treatment restrictions, and national policies that prioritize HCV elimination. When treatment is accessible, and stigma is tackled, things improve. But in cities with funding cuts, excessive red tape, and discrimination in healthcare, progress stalls.

Stigma and discrimination remain a major issue in HCV care. What new insights does the 2024 report offer on this challenge?

The report makes it clear that stigma is still a huge issue, especially in general healthcare, gastroenterology clinics, and prisons. One major problem is that many healthcare providers lack training on HCV, leading to unnecessary referrals and delays in treatment. Prescription restrictions for DAAs add another layer of difficulty. If stigma isn’t tackled through policy changes and provider training, it will continue to hold back progress.

The report mentions monitoring schemes for people who inject drugs after their HCV diagnosis and treatment. How well are cities doing in this area?

It’s mixed. Just over half of the cities have structured post-treatment follow-up, which helps prevent liver damage and reinfection. But many still lack proper monitoring systems, making it easy for people to fall through the cracks.

This year’s report also examines access to hepatitis C services for people who use drugs but don’t inject. What are the key takeaways from these findings?

People who inject drugs get most of the attention, but those who use drugs in other ways are often overlooked. The report shows that access to testing and treatment for this group varies widely.

What are the top recommendations from this year’s report for policymakers and harm reduction organisations?

Mostly the same as in previous years. HCV care needs to be easier to access. Funding for harm reduction has to be protected—when services like needle exchanges and opioid agonist therapy are cut, transmission rises. Bureaucratic delays in treatment must be reduced, and healthcare providers need better training to diagnose and treat HCV without stigma. Free testing should be expanded, and governments need clear elimination strategies. Integrating harm reduction into mainstream healthcare is also key to breaking down barriers.

Based on this year’s findings, what should we be paying close attention to in 2025?

Harm reduction funding is a big concern—if cuts continue, progress could backslide. We also need to watch how policies evolve. Are they making treatment easier or harder to access?

Eliminating hepatitis C in Europe: A report on policy implementation for people who inject drugs - 2024

For almost 40 years, the Drug Consumption Rooms (DCRs) have been providing effective solutions in terms of harm reduction, human rights and public health.

Local actors, elected representatives and citizens make the opening of new DCRs worldwide possible through their commitment. Despite the many positive evaluations, the subject remains sensitive in the public debate.

This is why the City of Strasbourg, the Council of Europe's Pompidou Group and the Ithaque association are pleased to invite you to the fourth international symposium on drug consumption rooms, to be held on 18 and 19 June 2025 in the Hemicycle of the Council of Europe.

This conference continues the strong momentum started in 2019, bringing together more than 30 countries and 50 different cities at the Council of Europe in Strasbourg. Its aim is to promote the model of DCRs and to harmonize international policies around human rights and harm reduction. It offers the opportunity to share the diversity of experiences, the different legal frameworks and, their evolutions, and to put innovative practices into perspective.

Institutional actors and associations in the field, peoples who use drugs, local, national and international political leaders are all invited to attend and will be able to take the floor.

DCRs Symposium 2025: Drug consumption rooms, a pillar of harm reduction and human rights

In recent years, Europe has seen early warning signs of an emerging synthetic opioid crisis. While heroin remains the primary opioid of concern, the rise of nitazenes—potent synthetic opioids with unpredictable effects—poses a growing threat. Unlike traditional opioids, nitazenes are often found in counterfeit medications or mixed with other substances, increasing the risk of overdose and complicating harm reduction efforts.

Correlation-European Harm Reduction Network

, is organising a webinar with leading European experts. The webinar will provide an evidence-based overview of the situation around nitazenes in Europe, examine emerging trends, and discuss which policy, healthcare, and harm reduction responses are needed to prepare.

Understanding Nitazenes: What are they, and why are they a growing concern?

Current Trends in Europe: Where are nitazenes being detected, and who is most at risk?

Health and Policy Responses: How can we prepare for and mitigate the risks?

Harm Reduction Strategies: What measures can effectively prevent overdose and support affected communities?

Drug Checking and Surveillance: How can early detection and monitoring systems help?

This interactive webinar will include expert presentations and case studies from different European countries, and a panel discussion to explore the most effective strategies for tackling nitazenes. Participants will have the opportunity to ask questions and share insights during the Q&A session.

Introduction – Tony Duffin (C-EHRN Chair)

European perspective – Joanna de Morais (EUDA)

Community Perspective – Leo Jefferys (EuroNPUD)

This webinar is crucial for harm reduction and healthcare professionals, policymakers, public health officials, and anyone involved in drug policy or healthcare. It will offer a comprehensive overview of current developments and trends related to nitazenes and explore practical responses at European, national, and local levels.

. Upon registration, you will receive a confirmation email with details on how to join the webinar.

Nitazenes in Europe – How should we prepare?

At its bi-annual gathering the European harm reduction movement addressed the multiple challenges of our time: rising populism, shrinking space for civil society, changing drug markets and changing needs of people who use drugs. Watch our film we produced at the conference!

The 6th European Harm Reduction Conference took place at the Palace of Culture and Science in Warsaw, Poland, on 2-4 December 2024. As Alex Lakhov, director of the European Network of People Who Use Drugs (EuroNPUD) mentioned in his speech, to have this conference at this venue, built during Stalin’s years to represent totalitarian power, is a message of defiance. It would make Stalin furious to see that people discuss human rights under the roof of his former palace. Unfortunately it is not only the architecture of totalitarianism that survived but the spirit of Stalin is also alive and well. Civil society activists face the new threats of populism and repressive policies across Europe. The Drugreporter team filmed some key moments and interviewed several participants to learn how harm reductionists respond to new challenges in various European countries – please watch and share our conference video!

The conference marked the 20th anniversary of its main organiser, the Correlation European Harm Reduction Network (C-EHRN). On this occasion, the network published a report with the title “

“, highlighting a selection of key people and organisations. It is my honour that as one of the founder of Drugreporter, I am one of them. Happy birthday Correlation!

Opening Session + Polish Drug Policy: Persistence and determination towards drug law reform and putting people who use drugs at the centre.

Global paradigm shift: navigating human rights in drug policy reform

Medication assisted therapies in EECA: status and progress

Legally grey? Discovering loopholes in the national laws for drug checking services

Scaling up HIV and HCV prevention treatment and care in community-based settings

Think Global, Act Local – the important role of cities in innovating drug policy and practice + Wrap-Up Session

Satellite Event: Dealing with drugs II – Cities and the international pursuit of sensible regulation

How to regulate substances: detailed blueprints for local level experiments

Correlation – European Harm Reduction Network

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