"Clean needles and syringes and other drug use paraphernalia are provided through a network of low-threshold services, outpatient counselling facilities and vending machines. Data on the number of syringes distributed are not available for the country as a whole, but data from local syringe monitoring are available in the Land North Rhine-Westphalia and some larger cities, including Frankfurt and Berlin.
"In the Netherlands, harm reduction activities are implemented through outreach work, low-threshold facilities and centres for ‘social addiction care’, the main goal of which is to establish and maintain contact with difficult-to-reach drug users.
"The National Board of Health and Welfare and the Public Health Agency of Sweden defines the procedures that county councils should follow when setting up NSPs [Needle and Syringe Exchange Programs], which include a justification of need (e.g. an estimate of the number of potential service users), an assessment of available resources, a provision plan for complementary and additional care services (e.g. detoxification, drug treatment and aftercare), and service quality requirements.
"In total, there were 10,514 injections and 33 opioid-involved overdoses over 5 years, all of which were reversed by naloxone administered by trained staff (Table 1). No person who overdosed was transferred to an outside medical institution, and there were no deaths. The number of overdoses increased over the years of operation, due partially to the number of injections increasing over the same period of time (Fig. S1 in the Supplementary Appendix).
"Harm reduction refers to interventions aimed at reducing the negative effects of health behaviors without necessarily extinguishing the problematic health behaviors completely or permanently. Though the harm reduction model as we know it rose in prominence in the 1970s and 1980s in response to infectious diseases such as hepatitis B and HIV , its roots extend at least as far back as the early 1900s with narcotic maintenance clinics [2, 3].
"Harm reduction is a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use. Harm Reduction is also a movement for social justice built on a belief in, and respect for, the rights of people who use drugs.
"The rapid implementation of OPSs [Overdose Prevention Sites] in the province of British Columbia, Canada during a public health emergency provides an international example of an alternative to drawn-out, cumbersome sanctioning processes for SCSs [Supervised Consumption Services]. Unsanctioned SCSs provide alternative evidence to inform the implementation of SCSs that are more inclusive and responsive to PWUD [People Who Use Drugs]. Our research adds to this evidence.
"The use of MC [Medical Cannabis] as an alternative to POMs [Prescription Opioid Medications] for pain management warrants additional empirical attention as a potential harm reduction strategy. NASEM (2017) recommends more clinical trials to elucidate appropriate MC forms, routes of administration, and combination of products for treating pain, but access to MC products to fully evaluate these questions is challenging due to federal regulations.
"The effectiveness of drug consumption facilities to reach and stay in contact with highly marginalised target populations has been widely documented (Hedrich et al., 2010; Potier et al., 2014). This contact has resulted in immediate improvements in hygiene and safer use for clients (e.g. Small et al., 2008, 2009; Lloyd-Smith et al., 2009), as well as wider health and public order benefits.
"Eighteen states had laws that were categorized as least comprehensive related to the prevention of HCV transmission among persons who inject drugs. In particular, these 18 states had no laws authorizing a syringe exchange program, decriminalizing possession and distribution of syringes and needles, or allowing the retail sale of syringes without a prescription.