Goosdeel Alexis
EUDA, Praça Europa 1, Cais do Sodré, 1249-289, Lisbon, Portugal.
Harm Reduct J. 2024 Dec 19;21(1):219. doi: 10.1186/s12954-024-01130-7.
Harm Reduction, conceptualized by Russell Newcombe in the late 1980s, has revolutionized how drug use, individuals who use drugs, and drug policies are understood globally. Emerging from the HIV/AIDS crisis, Harm Reduction sought to address the dire rates of drug-related infections and the overwhelming burden on healthcare providers. Early initiatives, such as Opioid Substitution Treatment (OST) and needle exchange programs, were met with resistance but gradually established new standards of care, transforming attitudes toward people who use drugs and prioritizing human-centered, rather than solely medical, approaches.
This paper explores the evolution and expansion of Harm Reduction from an HIV/AIDS prevention strategy to a broader framework adopted across Europe. Although ideological barriers initially slowed adoption, Harm Reduction principles have gained acceptance, notably through EU policies promoting drug-related harm reduction and the United Nations' 2024 resolution. Through initiatives such as OST, needle exchange programs, drug consumption rooms, and drug-checking services, the European Union has demonstrated progressive success in reducing drug-related deaths and infectious diseases. The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) has supported this evolution by providing extensive data, scientific evidence, and policy recommendations that guide national approaches. More recently, advancements in hepatitis C treatment have created opportunities for improved health outcomes among individuals who use drugs, fostering their role as active partners in healthcare processes.
Today's increasingly complex drug landscape, characterized by high substance availability, poly-drug use, and drug-related violence, necessitates a redefined approach to Harm Reduction. With the transformation of the EMCDDA into the European Union Drug Agency (EUDA), the agency's mandate now includes a proactive focus on anticipating, alerting, responding to, and learning from emerging drug-related challenges. Strengthening collaboration with civil society will be crucial in evolving Harm Reduction to meet future needs, ensuring that EU drug policies remain inclusive, adaptive, and aligned with the diverse realities faced by individuals who use drugs.
减少伤害由拉塞尔·纽科姆在20世纪80年代末提出，彻底改变了全球对药物使用、吸毒者和毒品政策的理解。减少伤害源于艾滋病毒/艾滋病危机，旨在解决与毒品相关感染的严峻发生率以及医疗服务提供者的沉重负担。早期举措，如阿片类药物替代疗法（OST）和针头交换计划，曾遭到抵制，但逐渐确立了新的护理标准，改变了对吸毒者的态度，并将以人为本而非单纯以医疗为中心的方法置于优先地位。
本文探讨了减少伤害从艾滋病毒/艾滋病预防策略演变为欧洲广泛采用的更广泛框架的过程。尽管意识形态障碍最初减缓了其采用速度，但减少伤害原则已获得认可，特别是通过欧盟促进减少与毒品相关伤害的政策以及联合国2024年的决议。通过诸如阿片类药物替代疗法、针头交换计划、毒品消费室和毒品检测服务等举措，欧盟在减少与毒品相关的死亡和传染病方面已取得逐步成功。欧洲药物和药物成瘾监测中心（EMCDDA）通过提供广泛的数据、科学证据和政策建议来指导国家层面的做法，支持了这一演变。最近，丙型肝炎治疗的进展为改善吸毒者的健康状况创造了机会，促进了他们在医疗过程中作为积极伙伴的作用。
当今日益复杂的毒品形势，其特点是毒品供应充足、多药滥用和与毒品相关的暴力，需要重新定义减少伤害的方法。随着EMCDDA转变为欧盟毒品局（EUDA），该机构的任务现在包括积极关注预测、警惕、应对和从新出现的与毒品相关的挑战中吸取教训。加强与民间社会的合作对于发展减少伤害以满足未来需求至关重要，确保欧盟毒品政策保持包容性、适应性，并与吸毒者面临的各种现实情况保持一致。
