The state of harm reduction in prisons in 30 European countries with a focus on people who inject drugs and infectious diseases

Abstract Background People who inject drugs are often imprisoned, which is associated with increased levels of health risks including overdose and infectious diseases transmission, affecting not only people in prison but also the communities to they return. This paper aims give an up-to-date overview on availability, coverage policy framework prison-based harm reduction interventions Europe. Methods Available data selected responses prisons were compiled from international standardised sources combined a questionnaire survey among 30 National Focal Points European Monitoring Centre for Drugs Drug Addiction determine level estimated interventions. Results Information about harms limited heterogeneous. Cross-country comparability hampered by diverging national collection methods. Opioid substitution treatment (OST) available 29 countries, remains low (below 30% need) half responding countries. Needle syringe programmes, lubricant distribution, counselling safer injecting tattooing/piercing scarcely available. Testing offered mostly upon entry, uptake While infections high human immunodeficiency virus (HIV) tuberculosis, hepatitis B C less provided. Health education as well condom distribution usually available, provision nearly Post-release linkage addiction care majority implementation partial. Interventions recommended be provided release, such OST initiation, take-home naloxone testing infections, rarely 21 countries address strategic documents, upon-release appear 12. Conclusions Availability limited, compared community. There gap between recommendations ‘on-paper’ availability their actual implementation. Scaling up throughcare can achieve important individual public-health benefits.