The programme is currently under development.
- 10 Nov. Morning: Satellites and workshops
Afternoon: Opening and plenary
- 11 Nov. Morning: Major sessions and abstract driven sessions
Afternoon: Abstract driven sessions and workshops
- 12 Nov. Morning: Major sessions and final plenary
Afternoon: Satellites and workshops
Eberhard Schatz / C-EHRN
Katrin Schiffer / C-EHRN
Jeffrey Lazarus / ISGlobal
Jiri Richter / Sananim
Marie Jauffret Roustide / Inserm
Dagmar Hedrich / Consulent
Pavel Bem / Sananim
Peter Sarosi / Drugreporter
Tony Duffin / Ana Liffey
Network representatives, contributing to the programme
Christos Anastasiou, Matt Southwell / European Network of People who Use Drugs (EuroNPUD)
Ganna Dovbakh / Eurasian Harm Reduction Association (EHRA)
Tetiana Deshko / Alliance for Public Health Ukraine (APH)
Iga Kender Jeziorska / Youth Organisations for Drug Actions (YODA)
Nick Croft / Law Enforcement and Public Health Association (LEPH)
Antons Mojalevski / WHO Europe
Zhannat Kosmukhamedova / United Nations Office on Drugs and Crime (UNODC)
Jamie Bridge / International Drug Policy Consortium (IDPC)
Dalma Fabian / European Federation of National Organisations Working with the Homeless (FEANTSA)
Emma Day / International Network on Hepatitis in Substance Users (INHSU)
Rebeca Marques Rocha / Global Parliamentarians Network to End Infection Diseases (Unite)
Milutin Milosevic / Drug Policy Network South East Europe (DPNSEE)
The conference programme aims to highlight innovative approaches in policy and practice as well as the latest research insights in the field of harm reduction.
There will be plenary and parallel sessions, round table discussions, workshops, and other presentation formats to discuss further innovative developments in policy and practice of harm reduction and foster discussion and experience exchange.
8.00 – 14.30
Pre-conference workshop programme
09.30 – 11.00
Workshop 1 - C-EHRN - C-EHRN Focal Point meeting (members only)
Chairs: Katrin Schiffer, Eberhard Schatz
Meeting for C-EHRN Focal Points only. Focal Points will discuss all matters concerning the development of the network.
Workshop 2 - Harm Reduction and Social Determinants of Health
Chairs: Marta B. Borges, Jose Queiroz
This workshop aims to enhance a debate oriented at producing recommendations for future action in Europe, which contribute to the reduction of social inequalities in health for people who use drugs and alcohol.
- How can harm reduction professionals use their expertise to influence more and better public policies for access to social and health rights?
- Can harm reduction projects such as Housing First be effective in mitigating the impact of Social Determinants of Health (SDOH)?
- How can Harm Reduction respond to contemporary challenges of intersectionality, which result in complex vulnerable situations combining ageing, drug use, mental health, homelessness, among others?
Agreeing that we need to create a comprehensive approach in health and social services on the issue of people who use drugs, we want to contribute building interventions either at national, regional or local level.
Please register via your registration account
Satellite 1 - WHO - integrated person-centred care models
Room: Main hall
Chair: Antons Mozalevski
Integrated people-centred health services means putting people and communities, not diseases, at the centre of health systems, and empowering people to take charge of their own health rather than being passive recipients of services.
While there have been many examples of integrated care models for PWUD documented in the Region, the concept of people-centred care is still perceived as new and somehow ‘theoretical’. There are many challenges arising from verticalization of disease-specific programmes, lack of coordination between services and paternalistic attitudes from health care providers towards people who use drugs.
The aim of this session is to present good practices of people-centred care services for PWUD in the WHO European Region and discuss the actions needed for WHO and Member States to strengthen integrated care approach with the focus on PWUD to be included in the Regional Action Plans for HIV, viral hepatitis and STI 2022-2030.
The session will contribute to the wide-scale multi-stakeholder consultation process on the development of the integrated Regional Action Plans for HIV, viral hepatitis and STI, which will be presented to the 72 session of the WHO Regional Committee for Europe. A report summarizing the presentation and panel discussion will be published by WHO Regional Office for Europe.
Please register via your registration account
11.30 – 13.00
Workshop 3 - C-EHRN - EuroNPUD: A Starters kit for testing in the community by the community
Chairs: Jason Farrell, Choices
Rui Coimbra Morais, Caso
The Workshop will discuss experiences of community services to facilitate HCV testing and care and present a step-by-step Starterskit, which supports community groups to establish such an intervention.
Please register via your registration account
Workshop 4 - Harm reduction in prison – an investigation
Chairs: Rafaela Rigoni, Dagmar Hedrich
Accessible for harm reduction services, working in prisons to discuss settings, approaches and challenges. The discussion will feed a paper on harm reduction in prison. Departing from the results of a survey among C-EHRN members, we will discuss the types of harm reduction work currently being done and its challenges. Recommendations for advocacy and capacity building will be considered.
Please register via your registration account
Satellite II - UNODC - HIV/AIDS Section - HIV prevention, treatment and care among & with people who use stimulant drugs
Room: Main hall
Chairs: Monica Ciupagea, Mat Southwell
For many years, the focus on HIV prevention among people who use drugs has concentrated on the injection of opiates. Compared with other drugs, the contribution made by the use of stimulants to increases in HIV infection rates is difficult to quantify, yet most evidence points towards a positive association between stimulant use, higher-risk sexual and injecting behaviors and HIV infections.
Both non-injecting and injecting stimulant drug use has been associated with sexual transmission of HIV, particularly among men who have sex with men and sex workers.The overlapping risks between key populations are not sufficiently addressed by current interventions. As a result, relevant HIV services are not tailored to the needs of specific sub-groups and remain inaccessible.
Participants in the workshop will learn more about specific situations and how to address HIV among people who use stimulant drugs, focusing on specific key populations (Men Who Have Sex with Men, People Who Use Drugs including Women Who Use drugs, Sex Workers, Transgender people).
The goal of the workshop is to increase the knowledge and capacity of participants to develop effective strategies to ensure that people who use stimulant drugs and are vulnerable to HIV have access to HIV services.
The training will consist of:
- a) Overview of the epidemiological situation related to HIV and stimulant drug use – presentation of the results of the UNODC literature review followed by discussion;
- b) Barriers and opportunities for addressing the specific needs of the key populations – interactive group exercise followed by plenary discussion;
- c) Overview of Chapter 5 “Implementation Considerations” of the UNODC technical guide “HIV Prevention, Treatment, Care and Support for People Who Use Stimulant Drugs” – plenary presentation;
- d) Lessons learned, evaluation, closing.
Training’s target audience:
Community representatives, programme implementation specialists, public health officials.
Monica Ciupagea, MD, Expert – Drug Use and HIV, UNODC HIV/AIDS Section
Mat Southwell, EuroNPUD
Please register via your registration account
14.30 – 16.30
Plenary opening session S1
Room: Main hall
Chairs: Eberhard Schatz, Katrin Schiffer
Introduction to the conference
Milena John, Councillor for Social Policy and Health, Municipality of Prague
Jiri Richter, Sananim
the development of drug policy and harm reduction embedded
into the broader development of societies in Europe
Alexis Goosdeel, EMCDDA
Moderated discussion – Ricardo Bapiste Leite, Global Parlamentarians Network Unite
Panellists discuss drug policy developments in the European region
European Commission, DG Justice, tbc
Senator Lynn Ruane, Ireland, Global Parliamentarian Network Unite
Jindrich Vobrovil, Institute of Rational Addiction Policies (IRAP)
Iga Kender-Jeziorska, Civil Society Forum on Drugs
Mat Southwell, EuroNPUD
Thomas Kattau, Council of Europe, Pompidou Group
Mariam Jashi, Member of Parliament, Georgia
Massimo Barra, Rome Consensus (Red Cross)
Ganna Dovbakh, Eurasian Harm Reduction Association (EHRA)
Milutin Milosevic, Drug Policy Network South East Europe (DPNSEE)
Leverage the power of data to advocate for drug policy reform:
the Global Drug Policy Index, Matthew Watt, Head of the Department of Politics, Philosophy and International Relations, Swansea University
16.30 – 17.15
17.15 – 18.30
Plenary session S2
Room: Main hall
Organiser: SO-PREP project Consortium
Chair: John Peter Kools, Trimbos Institute
Synthetic Opioids in Europe:
What is the current situation and how can countries be better prepared for a possible opioid epidemic?
The session will provide an interactive setting where experts discuss recent developments in synthetic opioids (SO) in Europe and the recommended tools and strategies that make countries better prepared and equipped to deal with emerging threats from synthetic opioids.
While North America has been experiencing an opioid epidemic for nearly a decade, highly potent SO are also a growing threat in Europe. Some European countries report an increasing availability and use of SO and related incidents. Is Europe prepared to respond to a continued increase in SO?
We present some of the latest findings of the research we conducted in the EU funded SO-PREP project. First, we attempt to answer the question: to what extent is Europe experiencing increased SO use and related incidents. Later, we discuss with experts from North America and Estonia – two regions that have dealt with an opioid epidemic for over a decade – what lessons can be learnt from their experiences. Then, we examine to what extent national health systems in different European countries are currently prepared for a possible opioid epidemic. Finally, we present a newly developed Toolkit with implementation guides for key responses to enhance national SO monitoring and response capacity.
- Introduction, John Peter Kools, Trimbos Institute
- Background of the global opioid situation, Lisa Strada, Trimbos Institute, recordedCurrent epidemiological situation in Europe, Andre Noor, EMCDDA
- Key lessons to be learned from the opioid epidemic in North America, recorded interview with Mrs Jennifer Carroll
- Experiences and lessons learned from the synthetic opioid crisis in Estonia, Mart Kalvet
- Tools and strategies for SO preparedness in Europe: a case study of 5 countries, Inari Viscari, THL
- SO Toolbox: guidance to monitor and respond to emerging threats from SO, Mikk Oja, TAI)
André Noor, Mart Kalvert, Heino Stover, Tuukka Tammi, Aljona Kurbatova
18.30 – 20.00
Dinner buffet at the venue
09.00 – 10.30
Major Session 1 - Drug policy: decriminalisation – the next logical step for Europe?
Room: Main hall
Organiser: International Drug Policy Consortium (IDPC)
Chair: Eliza Kurcevič (EHRA)
Drug policy: decriminalisation – the next logical step for Europe?
The criminalisation of people who use drugs (PWUD) compounds drug-related harms and worsens health and welfare outcomes worldwide. However, a growing number of jurisdictions have decriminalised the possession of some or all drugs for personal use, including many pioneering examples from Europe.
When done in line with the evidence and partnership with PWUD, decriminalisation has the potential to improve public health and human rights dramatically. However, when sub-optimal models are created or models prejudice some drugs over others, this potential can be missed, and new problems can emerge.
Decriminalisation policies have always been permitted within international drug conventions. There has also been increased acknowledgement and promotion of this approach in recent years – most recently from a common position for the entire UN system.
In this session, the International Drug Policy Consortium (IDPC) invites you to explore the arguments for decriminalisation and some of the complex and challenging questions which remain. Europe can become a global champion for effective, ‘gold standard’ decriminalisation approaches – just as it was for harm reduction adoption decades ago.
Marie Nougier (IDPC)
Rui Miguel Coimbra Morais (CASO Drug Users Union)
Zaved Mahmood (OHCHR)
Tore Sørensen (Norwegian Ministry of Care and Health Services)
Major Session 2 - Social inclusion and harm reduction: towards an integral approach
Organiser: Apdes and C-EHRN
Chairs: Ajang Larasati, HRI
Jose Queiroz, Apdes
Social Inclusion and harm reduction: towards an integral approach
According to the WHO, social determinants of health (SDOH) are all the contextual conditions that are present during a person’s life from birth to death. These will condition the way in which the person will relate to the world, and in what concerns health as a whole, will restrict accessibility and participation in social and health decision-making processes, having a determining role in social inequalities.
When we talk about people who use drugs, and their life paths, it becomes inevitable the need to cross the SDOH with drug use, social and health rights as a user, rights to keep using drugs in ageing social institutions, etc.
The Session will explore ways to improve the intersection between harm reduction interventions and their relation for social inclusion and health systems in order to create more comprehensive approaches for the needs of people who use substances.
In the second part, a couple of examples will be presented, working on new pathways for social inclusion, health and harm reduction.
The WHO Social Determinantes on Health – Are health systems in Europa ready for an integrative approach? Jeffrey Lazarus, ISGlobal
Towards an inclusive approach – challenges and needs from a governmental perspective, Inês Amaro – Director of the Social Development Department, Portuguese Institute for Social Security
Recommendations for future action in Europe, which contribute to the reduction of social inequalities in health for people who use drugs and alcohol, Marta Borges – Director of the Social Emergency Unit, Portuguese Institute for Social Security
Aging drug users – the Woodstock example
Homelessness, harm reduction and integration, Kerry Brennan, Cork Simon
Women and gender perspective, Aura Roig, Metzineres
The economics of social firms – a harm reduction approach? Katrin Schiffer, C-EHRN
Substance Use Supportive Service in Antwerp, Kristof Bryssinck, free clinic
The Mainline experience, Machtheld Busz, Mainline
Major Session 3 - Monitoring the drug market and influencing policies
Organiser: Energy Control
Chair: Mireia Ventura, Energy Control
The role of harm reduction organisations in monitoring the drug market and influencing substance use behaviours and drug policy
Harm reduction organizations have in-depth insights into the illicit drug markets and drug use. Thanks to qualitative and quantitative data, they can identify trends and developments in the drug market at an early stage. Moreover, these findings can be used to raise awareness among people who use drugs as well as among different stakeholders involved in drug policy such as police, prosecutors, festival organizers etc.
This session will highlight the importance of market monitoring for harm reduction and discuss various strategies and approaches that organizations can take to gain insight into the drug market. These strategies and approaches can empower them to develop sensible measures and drug policy for recreational drug use.
- Introduction, Mireia Ventura
- The value of drug checking in market monitoring- the Zurich example, Matthias Humm, Saferparty Streetwork
- How Tripapp and drug checking services deliver information directly to users, Adrià Quesada, YODA, HnH&NEWNet
- The value of market monitoring for civil society organisations, Daan van der Gouwe DIMS/ C-EHRN
- Harm reduction strategies and substance use disorders among young people who use psychoactive substances, Jakub Greń, Institute of Psychiatry and Neurology in Warsaw
- How we successfully transformed a zero-tolerance drug policy to a harm reduction driven drug policy for festivals in Flanders (Belgium), Jochen Schrooten,VAD
Major Session 4 - Key issues during the pandemic: naloxone and overdoses
Organiser: EuroNPUD and Deutsche Aids Hilfe
Chairs: Daphne Chronopoulou, Dirk Schäffer
Key issues during the pandemic: Naloxone, Overdose Prevention and Opioid Antagonist Treatment
The COVID-19 pandemic has been a period of significant gains for people on Opioid Agonist Treatments (OAT), naloxone distribution and overdose prevention. The pandemic forced the drug treatment system to provide weekly take home doses and light touch supervision models using telehealth care systems. This experience has challenged the use of overly intrusive and paternalistic models of drug treatment and allowed people to demonstrate their ability to manage their medication and be meaningful partners in their own treatment.
This session will present an overdose implementation study, highlight new naloxone interventions in Denmark, Sweden and Bavaria (Germany) and showcase peer-led research with people in OAT to highlight concerns before reviewing EuroNPUD’s OAT Client Guide and the UK OAT Take Home Doses Advocacy Brief as tool for promoting meaningful therapeutic alliances between people with opioid dependence and drug treatment.
- S-O-S Study: UNODC-WHO multi-site implementation study on community management of opioid overdose including the use of naloxone for preventing overdose deaths, Anya Busse , UNODC firstname.lastname@example.org
- From pilot-project to national system. Implementing a National naloxone training system in Denmark, Hendrik Thiesen
- Results and experiences of the Bavarian Take Home Naloxone Pilot Project and the new German naloxone project NALTrain, Olaf Ostermann
- The quality gap! People on OAT in the Republic of Ireland highlight the limitations of traditional drug treatment models, Richie Healy
- Championing OST Literacy and Rights with the EuroNPUD OAT Client Guide, Christos Anastasiou
- Defending OAT Take Home Doses and building the advocacy capacity of people using OAT in England, Chris Hallam
Questions, answers, and discussion
10.30 – 11.00
11.00 – 12.30
Parallel Session 1 - Mainstreaming human rights and evidence-based law enforcement
Room: Main hall
Organiser: United Nations Office on Drugs and Crime
Chairs: Zhannat Kosmukhamedova and Andrei Saladounikau
Leaving no one behind: Mainstreaming human rights and evidence-based law enforcement internal policy reform to address the needs of people who use drugs
A growing body of evidence suggests that the main factors behind the disproportionately low access to HIV services among key populations include
- lack of supportive national drug policies and legislation;
- over-reliance of many national law enforcement systems on criminal sanctions and imprisonment;
- overuse of incarceration of members from key populations;
- stigma and discrimination, harassment, violence and extortion, from even state actors such as law enforcement, defence and national security personnel.
Law enforcement (LE), HIV and public health are inextricably linked; however, many LE agencies are impervious to these connections. Despite the legitimate role of LE in safeguarding public health, for many LE, understanding this role comes with challenges. Also, good policy reform proposals, including police training initiatives, are often either rejected or not fully implemented.
Therefore, in a joint collaboration with LE and HIV networks, including the representatives of the global civil society organisation (CSO) network, it is necessary to foster and promote meaningful discussions with LE agencies in order to:
- Understand the role of justice and LE sectors in the HIV response
- Understand what needs to be done to ensure that justice and LE sectors become a meaningful part of the HIV response
- Explore lessons learnt, successful and unsuccessful strategies from and beyond the HIV response through shared experiences and successful practices of systematic reform of LE internal policies, attitude change and revision of performance indicators within LE
- Share experiences and challenges in the development and implementation of alternatives to incarcerations, such as police referral schemes as well as approaches for sensitising LE/national security officers to the needs of people who use drugs
- Support trust-building and partnership development with LE/justice sectors and among LE and CSO through continuous collaboration, exchange of knowledge and experiences and development and implementation of joint solutions
The event should be a platform to exchange ideas and best practices related to the role of LE in public health response, mainly focusing on the challenges and success stories of internal policy reform within LE agencies and sustaining multisectoral trust and partnership.
Sustainable partnership of Law Enforcement Agencies and Civil Society Organizations in Poltava (video), Mr Roman Drozd, CSO «Light Of Hope», Ukraine
Police diversion services based on the close partnership of CSOs and the Ministry of Internal Affairs (video), Mr Alexei Grosu, Deputy Chief of the National Police Inspectorate, Republic of Moldova
Alternative measures to incarceration for people who use drugs: Partnership of CSO and the Investigative Committee (video),
Irina Statkevich, CSO Positive movement, Belarus
Legal aspects of cooperation between law enforcement agencies and CSOs for harm reduction. National Instruction on Interaction between the Ministry of Internal Affairs and CSOs, Sergii Rudyi, UNODC NPO Ukraine
Importance of partnership between law enforcement agencies and CSOs as the human rights and evidence -based HIV response. Conclusion remarks, Andrei Saladounikau
Panel discussion with all speakers
Parallel Session 2 - Peer-led harm reduction
Organiser: European Network of People Who Use Drugs
Chair: Magdalena Harris
Peer-led Harm Reduction
Governments signed a new Global AIDS Strategy in 2021 that commits the world to community-led organisations delivering 30% of the HIV response. Community outreach and peer-led harm reduction are highly effective and efficient models for distributing harm reduction commodities and promoting safer drug taking practices. In addition, the COVID-19 pandemic has created a renewed focus on public health responses. Many observers have noted how community-led organisations have been critical to sustaining access to harm reduction for people living on the margins.
This session aims to
• showcase models of peer-led harm reduction with a particular focus on Peer-to-Peer Distribution of Naloxone (P2PN) and Peer-to-Peer Needle and Syringe Programmes (P2PNSP).
• support the launch of EuroNPUD’s new Technical Briefing on Peer-to-Peer NSP.
Richard Popp (UK)
Peer-to-Peer NSP – reviewing the Bath UK pilot and launch of EuroNPUD Technical Briefing on P2PNSP
Emilia Piermartini (Portugal) CASO and ItaNPUD
P2PNSP and the response to COVID-19: reflections on the Italian and Portuguese experiences
Antoniu Llort (Spain-Catalan) CATNPUD
Peer Needle Patrol and NSP Machines – community solutions to injecting issues
Lynn Jeffries (Ireland) UISCE
Using peer-to-peer distribution of Naloxone (P2PN) to educate and mobilise the peers in Republic of Ireland. George Charlton
Magdalena Harris, researcher
Summary and reflections on the opportunities of peer-led approaches with people who use stimulant drugs
Questions, answers and discussion
Parallel Session 3 - Girls power in HR2: womxn leadership to ensure access to Harm Reduction
Organiser: Re Generation, Eurasian Harm Reduction Association (EHRA), Metzineres, ENPUD
Chair: Irena Molnar, RE Generation
Girls power in HR2: womxn leadership to ensure access to Harm Reduction and Human Rights protection for womxn who use drugs
Women who use drugs are still frequently overlooked in their access to broad harm reduction meaning health and social care despite the complex harms, stigmatisation and structural violence they face. A substantial increase in gender-sensitive services is necessary to appropriately address their needs . Women who use drugs are often caught up in a vicious cycle of gender-based violence and drug use where the stress and trauma of violence perpetuate the women’s drug use, and the actions and behaviours associated with drug use expose them to heightened risk of violence which grows tremendously due to COVID-19 restrictions, lack of job and lockdown. The reproductive and health rights, protection of standards of living and parental rights of WWUD are violated .
In response to discrimination, right violation and injustice activists from all over the Europe build the Narcofeminist movement. Narcofeminists support the ideology of FEMINISM, intersectional feminism in particular, which focuses on the intersection of different female identities and tries to look at how women and others, including trans and gender non-conforming people with different experiences face discrimination.
Womxn- lead harm reduction organisations are developing gender sensitive and gender transformative services, all over the broad Europe manage to improve access to health, legal protection and social care services for women who use drugs in case of violence – directly via improving a service of their own or building partnerships and providing capacity building for service providers.
Objective of the session is to promote womxn-lead harm reduction and activism and to provide interactive platform for experience sharing about:
- Barriers for women to access harm reduction and ways to overcome it in different subregions of the Europe
- Ways to counteract gender based violence toward women using drugs in the context of COVID-19
- Gender sensitive women-lead harm reduction approaches
- Narcofeminism and womxn activistm – building movement and finding allies among human rights and feminist movements
During the panel artist from the Metzineres team will be doing a graffiti or editing the animated movie, with the new ideas that could come from the panel
- Why women-led initiatives and services are needed and How do they work? Aura Roig, Metzineres
- Help impossible to ignore: basis needs and barriers in access to health and social care services and shelters in case of violence for women using drugs in the EECA region, EHRA
- Sexism Free Night – project involving nightlife promotes, NGOs and academia – promoting safer and more egalitarian nightlife enviroments for all, Irena Molnar, RE Generation
- Self-care and saftey protocols, supervision and mutual support for Narcofeminist leaders: mental health during Covid-19, Olga Belyaeva, ENPUD with participation from Alla Bessonova
- Overcoming stigmatisation of women using drugs in media and social care programmes in Ukraine, Halyna Kornienko, All-Ukrainian union of women using drugs VONA
Mothers who use drugs: stigmatised and parenting, Alexandra Gurinova, Deutsche Aids Hilfe
Parallel Session 4 - Monitoring and quality standards for harm reduction
Chair: Dagmar Hedrich, consulent
Katrin Schiffer, C-EHRN
Importance of civil society monitoring and Quality Standards for policymaking and advocacy
Quality Standards (QS) are crucial to improving harm reduction services’ quality and bridging the gap between science and practice. However, the extent and ways in which QS for harm reduction are known, implemented in daily practices, and monitored, varies substantially.
This session aims to introduce the different quality standards available for Harm Reduction in Europe and discuss the state or art of its implementation and monitoring, focusing on a civil society perspective. Some of the questions that we aim to debate are what types of QS are needed and valuable for the Harm Reduction field and how can we strengthen its monitoring and implementation in Europe.
Wouter Vanderplasschen (Gent University)
Dijana Jerkovic (Gent University, FENIQS)
Ganna Dovbakh (EHRA)
Matej Kosir (UTRIP)
Rafaela Rigoni (C-EHRN)
Peter Sarosi (CSFD)
Parallel Session 5 - Synthetic Cannabinoids – a threatening trend challenging harm reduction organisations
Organiser: City of Zürich
Chair: Dominique Schori, Saferparty Streetwork
Drug-checking organisations have increasingly reported synthetic cannabinoids as adulteration in herbal cannabis in Europe since 2020.
Attempting to treat low-THC cannabis with synthetic cannabinoids to sell it on the black market deceptively is very dangerous for users. As a result, a substance with a comparatively low potential for harm becomes a new psychoactive substance (NPS) with a high risk of overdose.
The workshop will focus on the causes and origins of the phenomenon, its spread in Europe and the different strategies of harm reduction organisations.
Dominique Schori (Chair – Saferparty Streetwork)
Pieter Oomen (Trimbos Institute)
Mireia Ventura (Energy Control)
Jurek Afanasjew (protestkit.eu)
12.30 – 14.00
14.00 – 15.30
Parallel Session 6 - Drug Consumption Rooms: advocacy and the reality check
Room: Main hall
Organiser: International Network of Drug Consumption Rooms (INDCR)
Chair: Marie Jauffret Roustide (INSERM)
Roberto Perez Gayo (C-EHRN)
Drug Consumption Rooms: advocacy and the reality check
Born from the opioid crisis in the late 1980s / early 1990s, as Europe’s open drug scene emerged, a couple of cities established drug consumption rooms (DCRs) to tackle the health and public order threats for the individual and the general public.
Over the past 30 years, some cities have managed to overcome the opiate and HIV epidemics with their drug strategy, improving life quality in the city.At the same time, many countries have not yet introduced this measure, while a couple of countries are ready to open such a facility now or in the near future.
The session will discuss critical factors for the success or failure of implementing drug consumption rooms, and advocates will address their (success) stories to get a DCR on track in their country/city.
Pushing boundaries and crossing borders, Tony Duffin (Ana Liffey Drug Project)
The UK first (unsanctioned) safe injection facility: notes from a van, Gillian Shorter
Drug Consumption Rooms in Lisbon: Preliminary results and community, client and professional perceptions
Hannah Taylor (Grupo de Altavistas am Tratamentos)
Ines Pereira (Ares do Pinhal)
DCRs since 20+ years – what are the challenges?
Jorn Dekker (de Regenboog Groep)
Zürich: Janine Lanz (City of Zürich)
Parallel Session 7 - Supporting person-centred choice in determining treatment options
Organiser: International Network on Health and Hepatitis in Substance Users (INHSU)
Perrine Roux (INSERM)
Mauro Guarinieri (INPUD)
Supporting person-centred choice in determining treatment options for people with opioid dependence
Until recently, opioid agonist treatment has been restricted to oral medications administered once-daily and in some countries via a supervised dosing treatment model (predominantly methadone or buprenorphine; alone or co-administered with naloxone). The introduction of injectable extended-release depot buprenorphine formulations (either once-weekly or once-monthly) could represent a significant development as it lightens treatment-associated constraints (e.g. daily dosing, frequency of clinic/pharmacy visits).
In some settings, COVID-19 physical distancing restrictions have also resulted in positive changes and flexibility to the delivery of drug treatment, including increased availability of takeaway methadone and buprenorphine. However, some people have difficulties ceasing injecting or are in situations with an adulterated drug supply (e.g. fentanyl). It is then also important to provide other injectable formulations (e.g. daily buprenorphine, hydromorphone, and heroin) or safe-supply options (e.g. hydromorphone). So, people are attracted to care and to reduce risks associated with injecting practices. The introduction of new extended-release buprenorphine formulations, the availability of other formulations, and changes in the flexibility of delivery for opioid agonist therapy is likely to benefit people accessing services as well as service providers.
However, opioid-dependent people have different characteristics and preferences that may influence treatment needs and outcomes. To avoid a negative experience, people must be empowered to make informed decisions about their treatment through accurate information and informed consent. Decisions around treatment options for opioid dependency must consider patient preference and choice while also ensuring retention in care and improved patient outcomes.
- Demonstrate the impact personal choice can have on drug treatment outcomes.
- Provide a summary of the evidence supporting innovative options for the treatment of opioid dependence.
- Discuss the benefits, concerns, and barriers to implementing different strategies for the treatment of opioid dependence to facilitate greater patient choice and uptake.
- Demonstrate the impact COVID-19 has had on approaches for the treatment of opioid dependence from both a clinical and affected community perspective
Marc Auriacombe (University of Bordeaux)
Judy Chang (INPUD)
Barbara Broers (Geneva University Hospitals)
Magdalena Harris (London School of Hygiene & Tropical Medicine)
Mat Southwell (EuroNPUD)
Parallel 8 - NPS and mental health: humbug or an alarming situation?
Organiser: Eurasian Harm Reduction Association (EHRA)
Chair: Ganna Dovbakh, EHRA
NPS and mental health issues: humbug or an alarming situation? The EECA example.
In recent years, the growing use of new psychoactive substances has exacerbated the threats to the health of people who use drugs. These threats include overdoses, more risky drug use practices (such as frequent injections, sharing drug use equipment, etc.), the spread of HIV and other infectious diseases, and mental health issues.
Research conducted with people who use new psychoactive substances in 8 Eastern Europe and Central Asia region countries showed that one of the most common consequences among people who use new psychoactive substances is mental health issues. These include paranoia, aggression, psychosis, panic attacks, parasuicide and other mental health issues. The research respondents stated that mental health issues were rarely a case while using ‘traditional’ drugs. However, it has become an alarming issue in the last few years, especially with the use of synthetic cannabinoids and synthetic cathinones.
Even though sometimes mental health issues can occur due to drug use, it does not mean that this is the only and primary factor that can cause mental health issues.
This session aims to exchange views and discuss how to accurately respond to mental health issues among people who use new psychoactive substances without harmful consequences to the community, in the context of the current social, political, and economic situation in countries of Eastern Europe and Central Asia.
The objectives are:
- to present findings of the studies on new psychoactive substance use in Eastern Europe and Central Asia region, focusing on mental health issues;
- to present views and insights of practitioners working with people who use new psychoactive substances and mental health;
- to discuss the possible interconnection between drug use and mental health issues;
- to discuss whether some of the mental health interventions should be included in the harm reduction package; and
- to propose public health responses and interventions for people who use new psychoactive substances.
- Introduction, Ganna Dovbakh, EHRA
- Basic Needs and Barriers in Access to HIV Related Medical and Social Services for People Who Use NPS/Stimulants in Moldova and Ukraine: focus on mental health, Zhannat Kosmukhamedova, (UNODC)
- Use of NPS in EECA region: threat to public health or temporary trend? Eliza Kurcevic, EHRA
- Statement on people who use drugs and mental health, Mauro Guarinieri, INPUD
- Possible public health responses and interventions for people who use NPS. Do we need to include mental health within harm reduction package? Antons Mozalevskis, WHO Europe
Panel discussion on possible harm reduction and public health response to mental health issues among people using drugs, specifically among those who use NPS
Parallel Session 9 - Chemsex challenges: Slamming, community stigma, and human rights abuses
Organiser: European Chemsex Forum
Chairs: Nia Dunbar and Ben Collins
More European health/addiction professionals and community peers see the rise of injecting drugs during chemsex in LGBT+ communities. Smokers mix with slammers. Bisexual men share their experience with other – sometimes female – swingers. Slammers are now more active at “regular” chemsex parties. Slamming is now less dependent on sexual preference or gender identity.
Among a sizable minority of chemsex users, increases in slamming, physical harm, and mental stress; limited culturally sensitive, community services and intraminority gay community stress; and human rights abuses interact. Accordingly, chemsex use becomes more problematic and normalised whilst its users become more marginalised.
While it is challenging to measure the numbers of people engaging in chemsex and slamming, we do know some users want better harm reduction and/or want to quit. They say they need professional guidance, but many barriers limit successful interventions.
For example, police and government interventions, especially in Eastern Europe, compound the problem.
Integrating multidisciplinary chemsex teams into broader care programs within trusted sexual health clinics with more digital interactions could help MSM assess their sexual problems better and respond better to their structural needs.
Presenters from Eastern and Western Europe will share their research regarding trends in chemsex use, stigma, and government responses.
A panel discussion among the presenters, the European Chemsex Forum secretariat, and session participants will focus on key issues and solutions, focusing on digital responses.
Parallel Session 10 - Objects or subjects? Youth in drug policy and harm reduction services
Chair: Iga Jeziorska, YODA
Objects or subjects? Youth in drug policy and harm reduction services
‘A Better Tomorrow for the Worlds’ Youth’ was the title of the 2016 United Nations General Assembly Special Session on drug policy.
Was it just a slogan?
Protecting children and youth is often a crucial argument of policymakers to adopt and implement harsh drug regulations. However, on the other hand, young people are hardly involved in a meaningful way in the policymaking processes on local, national, and international levels. Even more importantly, in many countries, the youth is one of the key vulnerable populations with limited access to various services, especially harm reduction.
This session will address the controversies mentioned above in several European countries. The participants will discuss various dimensions of the youth access to harm reduction, from legal barriers and public policy to media narrative and public opinion. Focusing on the differences between Western and East-Central European political systems, economic development and culture, and engaging the audience in a discussion, we will try to find some answers regarding the determinants of youth access to harm reduction in various regions in Europe.
Eliza Kurcevič (EHRA)
Teodora Jovanovic (ReGeneration)
Beatrix Vas, (Youth RISE)
15.30 – 16.00
16.00 – 17.30
Major Session 5 - Peer work and research - securing an ethical partnership
Room: Main hall
Organiser: APDES and European Network of People Who Use Drugs (EuroNPUD)
Chair: Alexis Goosdeel, EMCDDA
Research provides an essential means of capturing and learning from the experience of people who use drugs. Quality standards urge the meaningful participation of research study populations which is particularly important when studying marginalised populations and researching the process and effectiveness of peer work itself. APDES led an EU-funded project developing and researching peer work called Peer2Peer.
Their learning and recommendations are to:
• explore ethical research processes and standards with people who use drugs.
• consider the ethical development of peer work to support scale-up.
• reflect on the meaningful participation of people who use drugs in research projects.
Jose Queiroz (Portugal) APDES
Designing studies about peer work that meaningfully involve people who use drugs in the design and delivery of the research – the experience of the Peer2Peer Project
Justyna Struzik (Poland) Country Researcher
Learning about starting out with peer work – the Polish experience Peer2Peer
Marta Pinto (Portugal) Country Researcher APDES
Studying a well-developed peer work programme – the Portuguese experience Peer2Peer
Louise Vincent (USA) Urban Survivors Union – USU
When drug user rights organisations set standards for partnerships with research agencies. Learning from the US experience. (pre-recorded), Ernst Wisse Harm Reduction Coordinator MDM (Netherlands)
Introduction to the process and recommendations of the Global Peer Work Consultation.
Video: Global Peer Work Consultation Feedback – 5-minute advocacy video.
Q&A and discussion
Major Session 6 - On track? Hepatitis elimination and the role of harm reduction
Organiser: C EHRN
Chair: Jeffrey Lazarus, IS Global
Marinella Kloka, Praksis
This session will address the current situation regarding the elimination of hepatitis C (HCV), including the impact that COVID-19 has had on testing, linkage-to-care and for people who use drugs.
Presenters will discuss innovations in community-led interventions, and the impact community-driven models can have on HCV care and on breaking down stigma and discrimination beyond improving testing and treatment access.
The session will also provide an overview of the changes to the national strategies, plans, and guidelines for treating hepatitis C in people who inject drugs and the need for decriminalisation to ensure access to testing and treatment.
Finally, presenters will engage in a panel discussion asking whether there is more innovation to come?
What are the next steps in advancing decriminalisation to enhance the health of people who use drugs?
Has COVID-19 forced a new way of working? What have we learnt and where to now?
HCV elimination – where are we now? Antons Mozalevskis (WHO)
COVID-19 and the impact on HCV testing and treatment, Thomas Seyler (EMCDDA), recorded
Do national hepatitis plans address the needs of people who use drugs and the question of decriminalisation, Mojca Matičič (University of Ljubljana), recorded
HIV and HCV screening in Asian Migrant populations within a harm reduction programme in Lisbon during the pandemic, Linda Goncales, Ares do Pinhal
The REACH_U Project – Peer and Nursing-led Point-of-care HCV testing and treatment in outreach work, Carlos Morgado, Crescer
A peer-led mobile HCV clinic outside the urban center, Elvin Dahl, proLAR Nett
Enhancing the HCV treatment and care cascade – treatmentof HCV at an OAT clinic in Stockholm, Martin Kåberg, (Stockholm Needle Exchange)
Treatment of hepatitis C in PWID: The Czech road to cure, Sonja Frankova, Department of Hepatogastroenterology, Institute for Clinical and Experimental Medicine, Prague.
Major 7 - Monitoring and implementation of Quality Standards in Harm Reduction in CEECA
Organiser: Eurasian Harm Reduction Association (EHRA)
Chair: Masha Plotko, EHRA
Monitoring and implementation of Quality Standards in Harm Reduction – state of art, challenges and the way forward
During the transition from the Global Fund to state funding harm reduction (HR) due to harm reduction being accepted only as HIV prevention, medical and not social service, the governments tend to support only the medical part of the program. As a result, available packages and quality of harm reduction services while transitioning are decreasing even if services are supported. Indicators accessing the efficiency of HR programs in the CEECA region are usually numeric (for example, number of clients, number of people tested, number of syringes/condoms distributed) and lack qualitative data. Accessibility, client satisfaction with the program, and the influence on the client’s life (quality of life, reintegration into society) are not part of the evaluation.
- approaches and place of community-led monitoring in ensuring access to and quality of programs;
- sufficient funding and calculation of the unit cost based on peoples‘ needs
- basic quality criteria and comprehensiveness of packages of harm reduction services
Pre-recorded presentations for the session:
We suggest all session participants to watch video presentations in advance to have a live discussion during the session.
- Harm reduction during transition: changes in packages, unit costs and quality of services (Maria Plotko, EHRA)
- Challenges of transitioning – Is Ukraine could be considered as a good example for the region? (Evgenia Kuvshinova, Ukraine) – Balkan countries: how harm reduction transited to state funding and what needs to be done next? (Irena Molnar, Serbia)
- Community led monitoring in EECA and lessons learned (Vitalij Rabinchuk, Moldova)
- Harm reduction where Global Fund has never been (Magdalena Bartnik, Poland)
- Flexible harm reduction (Machteld Busz, Netherlands)
- Role of clients and civil society in harm reduction development (Marine Gaubert, France)
Facilitated discussion with panellists
Question 1: What is the ultimate goal of harm reduction based on quality standards (QS), IDUIT and other international recommendations: HIV or HCV response? Health and wellbeing of people using drugs? Human rights protection? Social justice?
Question 2: Who defines the actual available package of harm reduction services, and what does it depend on?
- National standards and unit costs or quality standards
- Available resources
- Our niche or partnership with other services
- Capacities of staff
- What could harm reductionists do to make a package of services comprehensive?
Question 3: Role of community and civil society in monitoring and advocating for the quality of harm reduction services?
Machteld Busz, Netherlands
Irena Molnar, Serbia
Vitalij Rabinchuk, Moldova
Magdalena Bartnik, Poland
Marine Gaubert, France
Major Session 8 Preventing drug-related morbidity and mortality - guidance on drug equipment
Chairs: Dagmar Hedrich, consulent
Astrid Leicht, Fixpunkt e.V.
Preventing drug-related morbidity and mortality – guidance on drug equipment
To prevent drug-related harms, in particular the transmission of blood-borne viruses, skin and soft tissue infections, and overdose, people who use drugs (PWUD) need to be informed about risks and be provided with the correct information and adequate materials to mitigate against them.
This session will focus on the role that drug equipment and materials play in this context. The session kicks off with an update on the latest evidence of effectiveness of interventions to prevent and control infections among PWUD, addressing the results of new modelling studies on the effectiveness of combination interventions and the role of drug equipment, namely low dead space syringes and needles. The social and structural determinants of acquiring injecting-related bacterial and fungal infections, a common complication associated with significant morbidity and mortality, are addressed in the subsequent presentation.
Current work on the production of a guide to inform European service providers about harm reduction equipment will be described, including a process to obtain regional priorities in the provision of such equipment. Examples of the practice of drug equipment distribution will be described, highlighting achievements and shortcomings.
In the final part of the session a panel will discuss how researchers, service providers and PWUD can ensure that hygienic and fit-for-purpose drug equipment is available to all who need it.
- The effectiveness of interventions to prevent infection transmission among PWID: State of the art
Norah Palmateer, online, Glasgow Caledonian University
- Developing localised guidance on harm reduction equipment and materials Launch of : “Harm reduction equipment: a technical guide” (outlook on EMCDDA guide), Catherine McGowan, LSHTM
- Crack pipes: Reducing health harms and promoting engagement among the most marginalised, Magdalena Harris, LSHTM
- Good (and bad) practice of drug equipment distribution, Jason Farrell, Choices; David Pasek, Sananim, Astrid Leicht, Fixpunkt e.V., Magdalena Harris, LSHTM
Panel discussion – Getting it right: How can we ensure that the right equipment is purchased?
Reception at city hall, hosted by the mayor of Prague, Sananim and C-EHRN
09.00 – 10.30
Major Session 9 - The Czech HR Narrative: from decriminalisation to comprehensive services
Room: Main hall
Chair: Pavel Bem, Global Commission on Drug Policy
The Czech HR Narrative: From Decriminalization to Comprehensive Community Based HR Services
The Czech Republic represents an interesting narrative in designing and implementing HR paradigm which could be interpreted as a “model one”, at least in post-soviet countries of Central and Eastern Europe.
The former Czechoslovakia was the first country in Europe decriminalizing the possession of any illicit drug for personal use. This became a robust basis for further introduction of HR philosophy and services across the country.
As all CEE countries, young democracies were extremely sensitive with regards to public health policies to fast political changes which were traditionally endangering achieved results. One of these political shifts has lead in the CR to recriminalization act with negative unintended consequences. After a long political debate and presented scientific data on negative effects, a compromise solution was found such that introduced a criminal offence of personal drug possession in a “greater than small amount”.
Country specific HR aspects of the Czech drug policy are still open for further discussion:
- how should we deal from HR perspective with the health and social risks linked to the use of Pervitin and other psychoactive substances;
- do we really need safe injecting rooms having very favorable data on HIV and other communicable diseases;
- are we at risk of newly emerged synthetic opioids scene in Europe?
- Specific attention must be given to social and political function of medical cannabis movement
- What message based on 30 years of HR experience in the Czech Republic could be used for HR advocacy in other Western European, CEE countries as well as in Central Asia?
– 30 years of HR in the Czech Republic. From where to “where”? Pavel Bem
– Paleontology of Czech HR, Viktor Mravcik, National Drug Commission
– “Fight” for the decriminalization in the CR: 30 years of continuous protection of fundamental HR paradigm, Jindrich Voboril, or
– Josef Radimecky, Former drug Tzar
– Medical cannabis as a specific topic for HR advocacy (in memoriam of Tomas Zabransky), Tomas Sadilek
– HR in day-to-day practice: Czech HR “shadows” from Jungian archetype perspective, David Pasek, Sananim
– HR challenges for Pervitin (and other stimulants) users, Jakub Minarik, Addictology Clinic Prague
Major Session 10 - Sex workers and the threat of law enforcement
Organiser: European Sex Workers Rights Alliance (ESWRA)
Chair: Jules James, ESWRA
Decriminalisation of sex work is recognised as the best legal framework to protect the rights of sex workers and ensure their access to health and justice. However, sex workers’ lives are often impacted by other forms of criminalisation and legal oppression, particularly poverty and migration. Racialised communities, in particular, face high levels of policing, profiling, abuse and violence at the hands of the police and other state authorities. The criminalisation of abortion, LGBTI identities or drug use also creates webs of legal oppressions for many sex workers.
This session will explore the direct impact of these laws and policies and how sex workers organise to challenge them and support one another. Sex workers’ activists from the UK, the Netherlands, Romania, and Poland will share community-led mutual aid and solidarity initiatives and reflect on what ‘decriminalised futures’ could look like.
Elena M (SexWorkCall)
Ava Caradonna (SWARM)
Dinah Bons (Trans United)
Magda Ferreira (GAT)
Joana Canedo (GAT)
Jules James (ICRSE)
Major Session 11 - Nobody Left Outside Initiative - Digital tools – opportunities ahead to serve marginalised populations?
Chair:Roberto Perez Gayo, C-EHRN
Digital tools – opportunities ahead to serve marginalised populations?
Coronavirus has accelerated the rise of digital health, a broad concept including solutions for telemedicine and teleconsultation, remote monitoring, connected devices, digital health platforms and health apps. The concept also covers the related health data analysis and application in systems based on big data. Digital health and e-health policies are not new. They have been a strategic EU health priority for years. Even before the pandemic, the potential of digital health technologies to make health systems and services more effective was widely recognised.
Digital technologies have the potential to improve care, for example, by collecting, analysing and making use of reliable data – if the right conditions are created. However, societies are diverse, and it is crucial to ensure that the data used to inform algorithms reflects this diversity.
The digitalisation of our societies is creating digital gaps that can negatively affect people’s lives. For citizens already facing social and/or health exclusion, the digitalisation of our societies represents a significant challenge and brings the risk of increasing existing health inequalities.
In this session, the speakers will relate current thinking around digital health innovation to its implications for equitable access for marginalised and underserved communities. Based on examples from policymakers, data experts, technological startups and civil society organisations, this session will explore the relationship between digital, social and health inclusion, current policies regarding digitalisation, use of data and data collection. It will also discuss how to ensure access to health care services for marginalised communities and practical examples of how these tools are already used.
10.30 – 11.00
11.00 – 12.30
Plenary session S3
Chair: Milena John, Councilor for Social Policy and Health, Municipality of Prague,
Pavel Bem, Global Commission
This session is supported by the Alliance for Public Health, Ukraine
Fast track cities on harm reduction – local interventions make the difference
Local authorities have a crucial role in addressing public health, urban security and social cohesion. They are at the forefront of reducing harm and implementing inclusive measures to tackle the unintended consequences of drug use for the individual and the public. At the same time, cities operate in the legal and social framework of national policies and facing contextual challenges such as economic downfalls, migration or – just recently – the struggles with a global pandemic.
Therefore, the response on the city level asks for a broad range of services from the low-threshold and harm reduction services up to innovative programmes in the recreational area, from law enforcement up to inclusive and human rights-based policies.
The session will discuss experiences, challenges, and ways forward with majors and local authorities from different regions and backgrounds for mutual learning and exchange.
The Global Commission on Drugs
European Federation for Urban Safety
Austin O’Carroll, Clinical Lead for the ‘Dublin Covid-19 Homeless Response’
Saving lives in the time of COVID-19. Case study of harm reduction, homelessness and drug use in Dublin, Ireland.
Mara Luz Brügger
From open drug scene to social space management and co-existence
Fast track cities – why it makes sense
The work of the the Ukrainian Public Health Alliance, Levgen Kushnir
Moderated conversation with mayors and city officials from European cities, hosted by the mayor of Prague
12.30 – 13.00
Optional: Workshops, Satellite Sessions