Correlation Correlation European DATA REPORT Eropean Harm Reduction R C Network C Network CIVIL SOCIETY MONITORING OF HARM REDUCTION IN EUROPE, 2019 DATA REPORT 1 CIVIL SOCIETY MONITORING OF HARM REDUCTION IN EUROPE, 2019 ® Correlation – European Harm Reduction Network, 2019. This publication of Correlation – European Harm Reduction Network is protected by copyright. Reproduction is authorised provided the source is acknowledged. Recommended citation: Tammi, T., Rigoni, R., Matičič, M., Schäffer, D., van der Gouwe, D., Schiffer, K., Perez Gayo, R., Schatz, E. (2020): Civil Society Monitoring of Harm Reduction in Europe, 2019. Data Report. Correlation European Harm Reduction Network, Amsterdam. Correlation – European Harm Reduction Network c/o Foundation De REGENBOOG GROEP Droogbak 1d 1013 GE Amsterdam The Netherlands www.correlation-net.org This project has been supported by the European Commission. Correlation - European Harm Reduction Network is co-funded by the European Union 2 Correlation European DATA REPORT Harm Reduction C Network CIVIL SOCIETY MONITORING OF HARM REDUCTION IN EUROPE, 2019 DATA REPORT 3 CIVIL SOCIETY MONITORING OF HARM REDUCTION IN EUROPE, 2019 CONTRIBUTORS Editor: The data network: Graham Shaw Albania: Genci Mucollari, Aksion Plus Austria: Alexandra Karden & Barbara Siokola, Scientific expert group: Suchthilfe Wien Tuukka Tammi (THL), Dagmar Hedrich (EMCDDA), Belgium: Peter Blanckaert & Tessa Windelinckx, Sam Shirley-Beavan (HRI), Perrine Roux (INSERM). Free Clinic Bosnia and Herzegovina: Samir Ibisevic, PROI Expert groups: Overdose Bulgaria: Anna Lyubenova, Initiative for Health Dirk Schäffer, Deutsche Aids Hilfe (Coordinator) Croatia: Karla Glažar, Udruga Vida Ximene Rego, Apdes Czech Republic: David Pešek, Sananim Cedric Chavet, Regenboog Groep Denmark: Henrik Thiesen, Health Team for Homeless Heino Stöver, Frankfurt University for Applied Science Finland: Mika Mikkonen, Ehyt ry; Juha Sedergren, Elisabeth Avril, Gaia Juho Sarvanko, A-klinikkasäätiö Jean Paul Grund, Stop Overdose Now France: Marine Gaubert, Federation Addiction Olaf Ostermann, Condrobs Georgia: Marine Gogia, Georgian Harm Reduction Mika Mikkonen, Ehyt ry Germany: Dirk Schaeffer, DAH Greece: Marios Atzemis, Positive Voice Expert groups: New Drug Trends Hungary: Peter Sarosi, Rights Reporter Foundation Daan van der Gouwe, Trimbos Institute (Coordinator) Ireland: Tony Duffin, Ana Liffey David Pasek, Sananim Italy: Susanna Ronconi & Antonella Camposeragna, Mireia Ventura, Energycontrol Forum Droghe Magali Martinez, OFDT Latvia: Ruta Kaupe, Dialogs Karsten Toegel-Lins, Legal High Inhaltsstoffe Luxembourg: Jean-Nico Pierre, JDH Bartosz Michalewski, Monar Krakow Montenegro: Marija Milic, Juventas Dawn Russell, ALDP Macedonia: Silvana Naumova, HOPS – Healthy Options Juho Sarvanko, A-klinikkasäätiö Netherlands: Sara Woods & Ingrid Baker, Mainline Alex Buechli, Active Nightlife Norway: Ole Jørgen Lygren, Prolar Poland: Grzegorz Wodowski, Monar Expert groups: Hepatitis C Portugal: Teresa Sousa, Apdes Mojca Maticic, University Ljubljana (Coordinator) Romania: loana Pînzariu, Carusel Astrid Leicht, Fixpunkt Russian Federation: Janine Wildschut & Anke Van Dam, AFEW Tessa Windelinckx, Free Clinic Scotland: Dave Liddell, Scottish Drug Forum Ruth Zimmermann, Robert Koch Institute Serbia: Nebojša Đurasović, Association Prevent Erika Duffel, ECDC Slovakia: Dominika Jasekova, Odyseus Marie Roustide-Jauffret, INSERM Slovenia: Katja Krajnc, Stigma Spain: Patricia Colomera, Creu Roja Correlation EHRN office: Sweden: Niklas Eklund, Sotckholm Brukarforeningarna Eberhard Schatz, Katrin Schiffer, Rafaela Rigoni, Switzerland: Dominique Schori, Infodrog Roberto Perez Gayo, Ion Raulet, Jason Farrell United Kingdom: Zoe Carre & Amar Ali, Release Ukraine: Olena Voskresenska, AFEW-Ukraine 4 Correlation European DATA REPORT Harm Reduction C Network Figure 1 Countries taking part in the C-EHRN monito Table 7 Drug-user groups who are allowed HCV ring survey 2019 ....12 treatment with new drugs .... 46 Figure 2 Level of cooperation between CSOs and Table 8 Where PWID can be tested for HCV antibo policymakers (country level) .... 24 dies? .... 50 Figure 3 Assessment of EMC DDM country report Table 9 In case HCV treatment is accessible by information .... 34 PWUD in your country, where are they trea Figure 4 OD prevention at current policy level .... 61 ted for HCV? .... 52 Table 10 Is there a clear linkage-to-care protocol/ Map 1 Level of cooperation between CSOs and guidelines so that people diagnosed with policymakers (country level) .... 23 HCV are referred directly to care manage Map 2 Level of cooperation that C-EHRN Focal ment? .... 53 Points have with policymakers .... 25 Table 11 Does your government monitor the number/ Map 3 Are the drug-user groups active in the field proportion of people who progress through of HCV (political) awareness raising in your each stage of the HCV cascade of country?.... 56 care?.... 54 Map 4 Availability of take-home-naloxone .... 63 Table 12 State of OD prevention at the policy level Map 5 DCR status in Europe .... 78 by country .... 62 Map 6 Availability of prison post-release OST Table 13 Countries reporting THN in 2019: C-EHRN referral .... 87 and EMCDDA surveys .... 64 Map 7 Evaluation of first responders to OD Table 14 Who is in charge of THN programmes?.... 68 situations .... 87 Table 15 Costs and types of naloxone available in THN programmes .... 69 Table 1 Comparison between levels of national Table 16 Legal status of naloxone in countries where cooperation and satisfaction at the THN is available .... 71 organisational level .... 27 Table 17 Groups for which THN is accessible .... 72 Table 2 Current state of relations between C-EHRN Table 18 Naloxone training .... 73 Focal Points and EMCDDA Table 19 Plans to increase naloxone access .... 76 Focal Points ....31 Table 20 Legal framework to allow for DCR experi Table 3 What is the most relevant medical HCV mentation .... 80 treatment guideline in your country? .... 39 Table 21 Availability of naloxone in prisons .... 83 Table 4 PWUD in the guidelines and impact of the Table 22 OD prevention responses upon guidelines .... 40 prison release .... 85 Table 5 Are there new drugs for treatment of hepa Table 23 Groups targeted for OD prevention and titis C (direct acting antivirals, DAAs) availa education .... 90 ble in your country? If yes, are they accessi Table 24 OD prevention and fentanyl .... 92 ble? .... 43 Table 25 At the moment, what are the 3 predomi Table 6 In case they are accessible, is there an nant new substances used in your country/ official policy on Restrictions for the use of region/city .... 100 new HCV drugs? .... 44 5 CIVIL SOCIETY MONITORING OF HARM REDUCTION IN EUROPE, 2019 CONTENTS PREFACE ........................................................................................................................................................................9 ABBREVIATIONS ..................................................................................................................................................................10 EXECUTIVE SUMMARY ........................................................................................................................................................13 INTRODUCTION ..................................................................................................................................................................15 REPORT STRUCTURE............................................................................................................................................................18 CHAPTER 1. PARTICIPATION OF CIVIL SOCIETY ORGANISATIONS IN POLICYMAKING ...................................................................21 Introduction ...................................................................................................................................................................22 Cooperation between CSO’s and Policymakers .....................................................................................................22 Cooperation Mechanisms ......................................................................................................................................22 Evaluating Cooperation ..............................................................................................................................................23 How respondents evaluate cooperation with policy makers in their country ..................................................23 How respondents evaluate the cooperation between their organisation and policymakers ......................24 Level of satisfaction with exchange mechanisms ....................................................................................................26 How CSO’s contribute to the production of relevant data ....................................................................................30 Relationship among C-EHRN Focal Points and EMCDDA Focal Points ..............................................................30 How C-EHRN Focal Points collect and evaluate data (on overdose) ...............................................................31 Conclusions ...................................................................................................................................................................34 Monitoring .................................................................................................................................................................34 Policy