Skip to content
  • Menu
  • About

    About HRI

    HRI is a leading non-governmental organisation working to reduce the negative health, social and human rights impacts of drug use and drug policy by promoting evidence-based public health policies and practices, and human rights based approaches to drugs. Read more about HRI’s history.

    Vision and Mission

    Our vision is a world in which individuals and communities benefit from drug laws, policies and practices that promote health, dignity and human rights.


    Meet our staff at HRI


    HRI is governed by a nine person Board of Directors, elected for three-year terms of office by our membership at our Annual General Meetings. Read more about HRI governance.

    News and Announcements

    Read the latest announcements and updates from HRI.

    What is harm reduction?

    Harm reduction refers to policies, programmes and practices that aim to reduce the harms associated with the use of psychoactive drugs in people unable or unwilling to stop. The defining features are the focus on the prevention of harm, rather than on the prevention of drug use itself, and the focus on people who continue to use drugs.

    Harm reduction definition and principles in 11 languages

    Contact Us

    Please feel free to contact us if you have any questions or queries about our website, our work, membership or the international harm reduction conference.


    HRI benefits from the generous support of the Open Society Foundations, the European Commission, the Elton John AIDS Foundation, the MAC AIDS Fund, UNAIDS, the World Health Organization, the UN Office on Drugs and Crime, the World Bank, The Robert Carr Networks Fund and the Swiss Government.

    Harm Reduction International Awards

    HRI presents a number of awards at outr international conference to acknowledge the contributions of outstanding groups or individuals in the field.

  • Our Work

    Evidence for advocacy

    HRI produces groundbreaking research and policy analysis informing advocacy across our sector.

    Spending where it matters

    Funding for harm reduction services is dangerously short while billions are wasted on drug enforcement. HRI works to assess resourcing needs and advocates for a reinvestment in health.

    Human rights-based policy

    Human rights abuses and drug enforcement go hand in hand. HRI challenges laws, policies and practices that generate harm.

    Sector strengthening

    HRI builds advocacy coalitions and supports emerging harm reduction networks to strengthen the international harm reduction sector.

    International conference

    Harm reduction is a global movement. Our biennial gathering is the International Harm Reduction Conference, convened by HRI.

  • Global State of Harm Reduction

    Global State of Harm Reduction

    Our flagship publication is the biennial Global State of Harm Reduction report. First published in 2008, it involves a coordinated effort across practitioners, academics, advocates and activists to map global data and responses to HIV and hepatitis C epidemics related to unsafe injecting and non-injecting drug use. It is the only report to provide an independent analysis of the state of harm reduction in the world. The information collated within the report is stored and regularly updated on an interactive e-tool for researchers and advocates.

    The Global State of Harm Reduction report is supplemented by regular thematic reports and advisories on key issues and emerging challenges. Please search our Resource Library for more information or join our e-list for regular updates.

    Interactive e-tool

    Global State of Harm Reduction’ e-tool is an interactive resource containing up-to-date information on harm reduction policy and programming around the world. Users can select countries or regions and create tables for an at-a-glance guide to the current state of harm reduction worldwide.

  • International Conferences

    International Conferences

    The 24th International Harm Reduction Conference will take place in Kuala Lumpur, Malaysia, 18–21 October 2015

    Sign up for e-updates or visit the website regularly for more information.

    You can still access the 2013 conference site for an idea of what to expect.

    Conference Archive

    Explore past international harm reduction conferences dating back to 2000.

  • Resource Library

    Resource Library

    Use our extensive resource library to search for HRI, NGO and academic reports, articles and presentations, including materials from past international conferences.

    Harm Reduction Journal

    Harm Reduction Journal,, is an open access, peer-reviewed, online journal whose focus is on the prevalent patterns of psychoactive drug use, the public policies meant to control them, and the search for effective methods of reducing the adverse medical, public health, and social consequences associated with both drugs and drug policies.

  • Support Us

    Membership & Donations

    HRI is a membership based organisation with over 8,000 members worldwide. Read more about individual and organisational membership here.

    We rely on trusts, grants, membership fees and donations to continue our work. To make a donation or pay membership fees, please use our secure payment page.

    Or why not fundraise for us with ‘Discover Adventure’?

    Contact Us

    Harm Reduction International
    Unit 2C09 Southbank Technopark
    90 London Road
    SE1 6LN  

    Tel: +44(0) 207 717 1592
    Fax: +44 (0) 207 922 8822
    Join us on facebook at: Harm Reduction International
    Or join us on Twitter at: HRInews


    Sign up to receive email updates, report launches, harm reduction advisories and information about the forthcoming international harm reduction conference

Western Europe - Regional Overview

  • Print
  • Bookmark and Share

Harm reduction forms an integral component of HIV and drug policy and programmes within most Western European countries. Almost every country with reported injecting drug use has key harm reduction interventions in place. Several countries also include drug consumption rooms, syringe vending machines and the prescription of injectable OST and pharmaceutical heroin among their harm reduction interventions. However, there remains much variation in harm reduction coverage. Some countries, such as Cyprus and Greece, currently reach low proportions of injecting populations with sterile injecting equipment and opioid substitution therapy. Even within countries with long established services, large areas are not covered and constraints on funding pose barriers to increasing access to these services. Furthermore, other drug-related health harms, such as viral hepatitis and overdose, remain leading causes of death among people who inject drugs.

Harm reduction programmes in prisons are less widely available. Whereas many countries prescribe OST to prisoners in some institutions, the availability of sterile injecting equipment is more limited. The current European Union drug strategy and action plan are explicitly supportive of harm reduction and many Western European countries are amongst the most vocal in support for harm reduction in international fora.

Get Adobe Flash player

This page requires Flash Player version 9.0.45 or higher.

* Please refer to the table below for ranges, where these are available. The maps display midpoint averages only.

Western Europe - Regional Overview
Country/territory with reported injecting drug use People who inject drugsa HIV prevalence amongst people who inject drugsb Hepatitis C antibody (anti-HCV) prevalence among people who inject drugsc Hepatitis B surface antigen (anti-HBsAg) prevalence among people who inject drugsd Harm reduction response
NSP1 e OST2 f DCRg
Andorra nk nk nk nk N N N
Austria 17,500 (12,000–23,000)h 0.7–5.3 43.4–65.3 nk Y(31) Y(B,M,O) N
Belgium 5,125 (3377–7829) 3.4–6 (s) 28.1–80j (s) 0–2.8 (s) Y(69)(P) Y(B,H,M) N

467 (418–539)3 i

0–1.3 51.3 1.7 Y(1)(P) Y(1)(B,O)
Denmark 12,754 (10,066–16,821)j 2.1f 52.5 1.3ggk 4 Y(135)l Y(B,H,M) N
Finland 15,650 (12,200–19,700) 0.7j(s) 60.5j nk Y(40) Y(B,M,O) N
France 122,000m 5.1–8f (s) 41.7j (s) 4.8 (3.4–6.2)n 4 Y(532)(P) Y(19,484)(B,M,O) N
Germany 94,250 (78,000–110,500)3 3.4h 75o 7.2 (6–8.4)p 4 Y(250) Y(2,786-6,626)(B,H,M) Y (27)
Greece 9439 (8110–11,060)3q 007-0.8 48.7–68.8 2.9–3.6 Y(6)(P) Y(17)(B,M,O) N
Iceland nk nk 63r 4 nk N Y(B,M) N
Ireland 6289 (4694–7884)s 5.8v 74.6 (72.3–76.9)3t 0h 4 Y(32)(P) Y(332)(B,M,O) N
Italy 326,000o 11.5 58.5 5.1 (0.9–9.3)u 4 Y Y(B,M,O) N
Luxembourg 1485 (1253–1919)g 2.4 71.8–90.7v 3.9 v Y(8) Y(B,M,O) Y(1)
Malta nk 0 36.3 Y(7) Y(≥2)(B,M) N
Monaco nk nk nk nk N N N
Netherlands 2390 (2336–2444)3 w 0j (s) 47.6–67.4 (s) 1–13 (s) Y(175)5(P) Y(B,H,M) Y(40)
Norway 10,238 (8810–12,480)3 2.4 69.9 0j (s) Y(29)rr(P) Y(B,M) Y(1)
Portugal 10,950–21,900 3 dd 4.9–17.2 36.5–83.1 2–3.4 Y(1620)(P) Y(B,M) N
Spain 83,972x 32.3 79.6 (73.3–85.9) 4 g 3.6 (1.8–5.3)gg Y(2274)(P) Y(497-2,229)(B,H,M) Y(7)
Sweden nk 2j (s) 59.7j 2.3t Y(2) Y(B,M) N
Switzerland 31,653 (24,907–38,399) 1.4 78.3gg z4 4gg Y(101)(P) Y(B,H,M,O) Y(7)
Turkey nk 0.5 5.3j (s) 5.2gg N N N
United Kingdom 133,112 (126,852–143,278)3 bb 0–4.3j (s) 26.1–61.2 8.9 (0–17.8)cc 4 Y(1,523)(P) Y(B,H,M,O) N

nk = not known

(s) = sub-national data

a Unless otherwise stated, data are sourced from Mathers B et al. for the Reference Group to the UN on HIV and Injecting Drug Use (2008) Global epidemiology of injectinga drug use and HIV among people who inject drugs: a systematic review, Lancet, 372(9651):1733–1745.

b Unless otherwise stated, data are sourced from European Monitoring Centre on Drugs and Drug Addiction (EMCDDA) (2012) Statistical Bulletin 2012: Table INF-1. Prevalence of HIV infection among injecting drug users in the EU countries, Croatia, Turkey and Norway, 2010 or most recent year available,

c Unless otherwise stated, data are sourced from EMCDDA (2012) Table INF-2. Prevalence of HCV antibody among injecting drug users in the EU countries, Croatia, Turkey and Norway, 2010 or most recent year available,

d Unless otherwise stated, data are sourced from EMCDDA (2012) Table INF-3. Prevalence of markers for HBV infection among injecting drug users in the EU countries, Croatia, Turkey and Norway, 2010 or most recent year available,

e The number in brackets represents the number of operational NSP sites, including fixed sites, vending machines, pharmacy-based NSP sites and mobile NSPs operating from a vehicle or through outreach workers. (P) = needles and syringes reported to be available for purchase from pharmacies or other outlets, and (NP) = needles and syringes not available for purchase.

f The number in brackets represents the number of operational OST programmes, including publicly and privately funded clinics and pharmacy dispensing programmes. (M) = methadone, (B) = buprenorphine, (BN) = buprenorphine-naloxone combination, (H) = heroin-assisted therapy, (O) = any other form (including morphine and codeine).

g DCR = drug consumption room.

h Year of estimate: 2000

j Year of estimate: 2006

k Year of estimate: 2007.

l Year of estimate: 2003.

m Year of estimate: 1999.

n Year of estimate: 1992–1995.

o Year of estimate 2004.

p Year of estimate: 1992–1994.

r Year of estimate: 1990–1993.

s Year of estimate: 1996.

u Year of estimate: 1990–91 and 1992–93.

v Year of estimate 2005.

x Year of estimate: 1998.

y Year of estimate: 1999–2001, 2003.

z Year of estimate: 2002.

bb Year of estimate: 2004–2010.

cc Year of estimate: 1996–2000.

dd According to the 2009 WHO, UNODC, UNAIDS target-setting guide, <100 syringes distributed per person who injects drugs per year is considered low coverage; 100–200 is medium coverage, and >200 is high coverage.

ee Austria, Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Luxembourg, Netherlands, Portugal, Spain, Sweden, UK.

ff Based on estimates derived from EMCDDA regional divisions, which may be different than those of HRI in this report. For more information, please see

gg The two strategies included a ‘combined model’ where all services are provided within a central location by a multi-disciplinary team, and a ‘collaborative’ model, characterised as client-centred and informal, which involves collaboration of service providers and outreach teams to deliver treatment in a location convenient to the client.

1 EMCDDA (2012) Statistical Bulletin 2012: Table HSR-4. Needle and syringe programmes (NSPs) Part (i). Year of introduction of needle and syringe programmes (NSPs), types of programmes available in 2010 and number of sites, Accessed 17 July 2012.

2 Mathers B et al. (2010) HIV prevention, treatment, and care services for people who inject drugs: A systematic review of global, regional, and national coverage, Lancet, 375 (9719) 1014–28.

3 EMCDDA (2012) Statistical Bulletin: Table PDU-102. Prevalence of problem drug use at national level, Accessed 17 July 2012.

4 Nelson PK, Mathers BM, Cowie B, Hagan H, Des Jarlais D, Horyniak D & Degenhardt L (2011) Global epidemiology of hepatitis B and hepatitis C in people who inject drugs: results of systematic reviews, Lancet, 378(9791): 571–583.