Criminal justice approaches to harm reduction in Europe

This chapter reviews the spread of harm reduction services in European criminal justice systems, and their evaluation. It begins with a discussion of the tensions and contradictions inherent in providing harm reduction services (which may accept continued drug use) in criminal justice settings (that do not). It then draws on research carried out for the Connections project, for its predecessor the European Network on Drug and Infections Prevention in Prisons and on the information gathered by the European Monitoring Centre for Drugs and Drug Addiction. It examines services such as needle and syringe exchange, opiate substitution and distribution of condoms and disinfectants in prisons. It also examines harm reduction services that have been developed in the context of police custody, and in the attempt to provide through-care and aftercare to drug users who pass through the criminal justice system. The chapter concludes that the tensions between harm reduction and criminal justice aims can be overcome in providing effective services to reduce drug-related harms.