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These datasets underpin the analysis presented in the agency's work. Most data may be viewed interactively on screen and downloaded in Excel format. All countries. Topics A-Z. The content in this section is aimed at anyone involved in planning, implementing or making decisions about health and social responses. Best practice. We have developed a systemic approach that brings together the human networks, processes and scientific tools necessary for collecting, analysing and reporting on the many aspects of the European drugs phenomenon. Explore our wide range of publications, videos and infographics on the drugs problem and how Europe is responding to it. All publications. More events. More news. We are your source of drug-related expertise in Europe. We prepare and share independent, scientifically validated knowledge, alerts and recommendations. About the EUDA. The objectives of the Drug-related infectious diseases DRID network are to share the latest developments on drug-related infectious diseases in Europe and to identify steps needed to improve the production, availability and use of public health-oriented information at the European level. This meeting report provides an overview of the content of the DRID meeting that took place online on October , focusing on:. Participating experts come from ministries of health, public health institutes, drugs agencies, health services, universities, research institutes and civil society. They complement preliminary findings presented during the DRID meeting. These data tell us what proportion of the study population in this case people with substance use disorder or high-risk drug users had antibodies to SARS-CoV-2 due to natural infection with the virus. These data do not tell us what proportion were symptomatic, nor the severity of the disease, but provide information on the level of transmission that occurred among that group, and what proportion remained susceptible to the infection at the time of the surveys. Lindqvist et al. When comparing this result with a seroprevalence study based on healthy blood donors in Stockholm in June Out of the participants, 4 2. This could be explained, for example, by the limited size and homogeneity of their social networks. The association remained significant when adjusting for comorbidities. Therefore, while infection rates might have been lower in some groups of high-risk drug users, the risk of developing severe forms of the disease when infected is likely to be higher than in the general population — partly due to the high prevalence of chronic diseases among this vulnerable population. Harm-reduction services and outreach programmes are once again key components to the successful implementation of vaccination campaigns among this group. The programme had initially planned to deliver doses of the AstraZeneca vaccine through this outreach team Cyprus had drug treatment entrants for drugs other than cannabis in From June to July , 40 people were vaccinated through this initiative, including undocumented migrants. Barriers to vaccination included fear of side effects. In Prague, Czechia , several initiatives from social and health services have been targeting the homeless and vulnerable people who use drugs. Prague City Hall in cooperation with day centres and outreach services organised at least eight vaccination days, with mobile vaccination teams and general practitioners visiting shelters and day care centres Janssen. By August , at least people had been vaccinated through these services. No registration or ID was required to get the vaccine. Data from Scotland suggest that considerable progress has been made in vaccinating people in contact with drug services, but coverage remains markedly lower in this group compared to the wider population. The research team found a higher uptake of vaccination among those in prison and with a history of OAT, compared to the overall OAT cohort. Identified barriers included vaccine hesitancy, logistical and organisational issues and prison transfer. The number of new AIDS diagnoses in people infected through injecting drug use also decreased over the period from 1 in to in While incidence estimates never returned to their levels, they ranged from 1. The prevalence of homelessness Predictors of seroconversion included lower education, larger network size and daily drug use. The authors concluded that the current level of prevention and treatment services was below levels that would be required to bring transmission down to pre-outbreak levels. The study team conducted a similar study in Thessaloniki , the second-largest city in the country, where 1 PWID were recruited during The authors highlighted that immediate interventions were required to control transmission. The innovative approaches included the opening of a new low-threshold medical service and AOT programme, the implementation of take-home OAT doses, the physical reorganisation of services to protect staff and clients, and the increased provision of remote services when possible. In a survey done among high-risk drug users during the pandemic , overall core harm reduction services were considered sufficient Berndt et al. However, in terms of prevention, the total number of sterile syringes provided fell from in to in In terms of testing activity, the total number of people tested for HIV during Red Cross outreach activities targeting vulnerable populations decreased from in to in However, despite high coverage of prevention measures, transmission continued to occur McAuley et al. Besides risk factors such as cocaine injecting, homeless and incarceration, sexual transmission appeared to be contributing to the outbreak. Based on the successful experience of HIV treatment delivery for PWID, the PreP service model relied on four elements: 1 active case finding by outreach sexual health nurses at homeless and addiction services and through partner notification; 2 flexible location for baseline assessment and monitoring with remote doctor review; 3 supervised dispensing at community pharmacies alongside OAT and reporting of adherence breaks; 4 follow-up by sexual health nurses. Preliminary results indicate that adherence was high, showing the feasibility and acceptability of the programme in the context of an outbreak, and regular HIV serology monitoring in patients receiving PreP showed no HIV seroconversion. The service relies on multi-agency, resource-intensive outreach provision, and should be used in conjunction with treatment as prevention, HIV testing programmes, needle exchange services and a comprehensive ART programme. In Sofia, Bulgaria , reports indicate that the pandemic seems to have worsened a situation that was already deteriorating with respect to harm reduction funding. This comes after the Global Fund ended its financial support to harm reduction services in It consequently led to a disruption in needle and syringe programmes, and a reduction by more than half in the number of PWID being tested annually. The National Centre of Public Health and Analysis is organising a meeting with stakeholders and decision-makers to initiate legal changes in order to ensure sustainable financial support for harm reduction services. The importance of reaching a good coverage of harm reduction services for PWID was re-emphasised. Slovakia has long recorded one of the lowest HIV prevalence rates among people who inject drugs in Europe. The national expert reported that, in , the yearly seroprevalence study conducted among 61 patients of drug treatment centres in Bratislava identified three HIV-positive cases for the first time among this group since All have been referred to treatment. The preliminary investigation showed that the patients had a history of methamphetamine injecting, but concluded that the most likely mode of transmission was sex between men 2 and heterosexual transmission 1. While the absolute number of new cases identified is still low, they highlight the importance of maintaining a high level of prevention and testing accessibility for a population that accumulates risk factors. In the United States , after a steady decline during —, the number of HIV diagnoses among PWID increased during —, with 2 reported diagnoses occurring nationally in , as reported by the CDC expert. Polydrug use opioids with methamphetamine or cocaine was one of the characteristics described across outbreaks recently investigated by the CDC response team. Other similarities included injecting multiple times per day, homelessness or unstable housing, recent incarceration and exchange of sex for money or goods. Most outbreaks occurred in metropolitan areas, where harm-reduction services were offered. Responding to these outbreaks was labour-intensive, with key components including increasing HIV testing through contact tracing; testing in syringe services programmes, emergency departments and jails; and outreach testing and efforts to improve the ability of PWID to access, link to and be retained in services such as harm-reduction, PrEP, HIV and drug treatment expanding services into new geographic areas, flexible appointment times, assistance with transportation, co-locating and integrating services. In addition to infections from human immunodeficiency virus HIV and viral hepatitis, PWID are at increased risk for acquiring invasive bacterial infections, including infective endocarditis. Infective endocarditis is defined as an infection of the endocardial surfaces of the heart and can be fatal if left untreated. PWID are at higher risk of infective endocarditis due to potential direct inoculation of bacteria into the bloodstream through non-sterile injecting equipment and injected drugs; direct mechanical damage due to impurities present in injected drugs. A case-control study conducted in Ontario Shah et al. The authors underline that the components of the hydromorphone capsules that provide the controlled release increase survival of Staphylococcus aureus Kasper et al. The study findings highlight once again the importance of maintaining high levels of effective and cost-saving public health interventions such as the provision of sterile injecting material to prevent severe bacterial infections. Few recent studies were conducted in Europe, but a retrospective study conducted in a referral hospital in Sweden in Asgeirsson et al. The authors concluded that a high proportion of infective endocarditis cases in PWID involved left-sided valves, prosthetic valves, or are caused by microorganisms other than Staphylococcus aureus. The infectious diseases department at the Rabta Hospital in Tunis conducted a retrospective study among 28 PWID who were admitted between and for infectious diseases other than viral infections. The mean age of the patients was 32 and all but one were males. The mean number of years of drug use at the time of hospitalisation was 8 years, ranging from 1 to All patients were treated with appropriate antibiotics and five underwent surgical treatment. All studies emphasised that approaching PWID affected by infective endocarditis without discrimination and offering them the possibility of cardiac surgery when indicated, together with necessary harm reduction services and drug treatment, are crucial components of case management. The elimination barometer for hepatitis B and C among people who inject drugs is designed to support countries affiliated to the EMCDDA in monitoring their progress towards the Sustainable Development Goal 3. Under five building blocks, it brings together 10 epidemiological indicators and corresponding targets related to people who inject drugs for the European Union, Norway and Turkey, following the WHO monitoring frameworks. For each indicator, the EMCDDA elimination barometer provides contextual information, references and definitions, an infographic showing national data, the related WHO target and an achievement status: how many countries have reached the target. Based on data, there is no indication that the European Union had reached the targets, and indicators from all five building blocks still require higher quality and completeness to efficiently guide and assess public health interventions. This section provides an update on some of these aspects. Participants were homeless individuals over 18 years of age; completed a questionnaire and provided a blood sample. In terms of risk factors, injecting drugs in the last 30 days, a history of incarceration and having a tattoo made by non-professionals were common. Two thirds of those with HCV were aware of their infection and none reported being on antiviral treatment. Among the barriers to HCV care was the lack of health insurance, which was reported by more than two thirds of those with viraemic HCV. The high infection rate and exposure to risk factors among this vulnerable group call for improved cooperation between harm reduction, infectious diseases and homeless medical services, together with targeted interventions for the homeless. The new guidance will also indicate that linkage to care following HCV diagnosis and adherence to treatment can be improved by cooperation between providers, integrated care approaches and peer mentoring. Low dead space syringes are designed to reduce the amount of fluid left in the hub i. Low dead space syringes were included in an EMCDDA project that gathered the evidence, expert interpretation and local implementation consideration on 11 types of harm reduction equipment. Besides low dead space syringes, the review included acidifiers, bleach and chlorine tablets, filters, cookers, water, foil, pipes, wound care kits, fentanyl test strips and naloxone. Drug consumption rooms DCR are places in which drug users can use illicit drugs under the supervision of medically trained staff. They exist in several European countries and are usually located in areas where there is an open drug scene and injecting in public places is common. Their primary goal is to reduce morbidity and mortality by providing a safer environment for drug use and training clients in safer forms of drug use. In terms of injecting risk behaviour, the results of the cohort study suggested that PWID using a DCR medium to high frequency are less likely to report sharing injecting material, less likely to inject in public spaces and less likely to report abscesses compared to PWID who do not use DCR or who report a low frequency of utilisation. The same cohort study did not find any significant difference in HCV testing. The authors concluded that the corresponding healthcare savings make DCR a cost-effective intervention. While PWID face the highest risk of HCV infection through sharing injecting material, HCV infection is also possible when using drugs through other modes of administration — especially using crack pipes Fischer et al. The harm reduction device comes with disposable tips to reduce microbial contamination and a cellulose filter. The team organised a national consultation involving three types of stakeholders: beneficiaries and NGOs client level , health professionals provider level , policymakers system level. Homelessness, comorbidities and discrimination in hospitals were identified as major factors preventing PWID with chronic HCV from getting the care they need. Proposed solutions included the development of a treatment manual for blood-borne infections for staff of drug treatment agencies, the implementation of mobile health units with diagnostic capacity to reach areas beyond large cities, the expansion of rapid tests and dried blood spot testing in drug treatment services, and the assessment of the feasibility and cost-effectiveness of the one-stop-shop approach for HCV elimination in Greece. The decentralised initiative to link HCV-infected drug users to care in Vienna, Austria , continued and expanded. As a second step, the project team started to work with pharmacies, allowing drug users to receive their HCV medication together with their OAT medication on a daily basis in one of over pharmacies in Vienna and Lower Austria. By the end of , patients had started treatment as directly observed therapy, had completed it, with documented sustained virologic response SVR for Another pathway for testing and linking drug users to care in Vienna is through the health authority centres, where the 6 OAT patients renew their long-term OAT prescription every month at least until the first lockdown in March The project team noted that linking these patients to care proved more difficult than expected. In Lisbon, the mobile outreach programme including two mobile units of the Ares do Pinhal NGO provides harm reduction and healthcare to a population of 1 drug users. The team has had experience with different HCV models of care. In , a protocol was established with specialised services in hospitals. Appointments and transport to the hospital were organised by Ares do Pinhal, while follow-up and directly observed therapy were carried out in the mobile units. On 3 May , the EMCDDA launched its first bilateral technical cooperation project with Georgia, which aims at enhancing the national responses to drug-related health and security threats. The EMCDDA4Georgia project is funded by the European Union and will focus primarily on knowledge transfer and capacity-building in the areas of drug monitoring, reporting, prevention and treatment. There were an estimated 52 PWID in Georgia in , a third of whom inject opioids buprenorphine, heroin while ephedra plant product Otiashvili et al. The country launched its HCV elimination programme in and has developed an advanced information system, which links screening, laboratory diagnostics and treatment data allowing for monitoring of the HCV continuum of care Averhoff et al. It allows the National Centre for Disease Control to monitor the continuum of HCV care among the 10 people receiving methadone substitution treatment in the country. The data showed that the WHO targets among OAT patients were reached, paving the way for micro-elimination in this population. Together with Iceland Olafsson et al. Impactful scale-up requires political and financial commitment including sustainable funding of harm reduction services and the ability to negotiate affordable medicines with the industry , coordination across stakeholders and tackling discrimination. In terms of concrete implementation guidance, the evidence-based and theoretically informed recommendations for scaling up HCV testing and treatment for people who inject drugs from NHS Tayside in Scotland is an additional useful resource for countries, regions or cities looking to reach the elimination goal. The interim WHO guidance also proposes absolute mortality targets. In a systematic review and meta-analysis of all-cause and cause-specific mortality among people using extramedical opioids Larney et al. Extramedical opioid use was defined as the use of heroin and other illicitly manufactured opioids and the use of pharmaceutical opioids outside the bounds of a medical prescription. The pooled standardised mortality ratios the ratio of mortality risk among those exposed to extramedical opioid use and the age- and sex-matched population for EMCDDA countries were These data provide a first baseline against which to assess the progress towards the mortality targets, but more studies are needed to monitor cause-specific mortality among drug users. Study designs in which to invest include record linkage of administrative data retrospective studies , prospective cohort studies among people who inject drugs or prospective cohort studies among people with viral hepatitis. The WHO Regional Office for Europe is developing an eight-year strategic document that will integrate regional action plans for HIV, viral hepatitis and STIs, focusing on health system delivery and people-centred healthcare services, as well as disease-specific actions with special attention to key populations. It has launched a wide consultation process that should lead to the endorsement of the plan by September The proposed strategic directions include a shared vision to disease responses nested in universal healthcare coverage, a health system approach, as well as new coverage and impact targets for Despite the multi-dimensional challenges posed by the COVID pandemic, harm reduction and drug services as well as national public health agencies have shown resilience and have adapted to the health crisis to guarantee service continuity for drug users, including the provision of services for the prevention and control of drug-related infectious diseases. Harm reduction and drug services have also shown to be essential services in combating the COVID pandemic by providing information, prevention equipment and shelter to their clients, by implementing safety protocols, and since , by being actively involved in the COVID vaccination campaign. This is particularly important as studies have shown that people suffering from drug addiction are more likely to face severe COVID outcomes if infected. However, disruption of prevention measures and reduction of face-to-face interactions with the most vulnerable clients — even if temporary and limited to the first lockdowns — might have had negative consequences on the risk of transmission of drug-related infectious disease such as HIV, viral hepatitis and invasive bacterial infections. The reduction of distributed sterile equipment reported by some countries and the drop in HIV and viral hepatitis testing activity in have put an additional strain on an existing fragile situation, with some signals suggesting increased HIV transmission. In this context, the commitment of the region to reach the infectious diseases-related sustainable development goals implies that Member States unsure sustainable funding and support for harm reduction and drug services in order to scale-up provision and access to integrated and people-centred healthcare for drug users. Arendt, V. Asgeirsson, H. Averhoff, F. Berndt, N. Binka, M. Fischer, B. Grimshaw, C. Haussig, J. Kasper, K. Larney, S. Lazarus, J. Simplifying models of care to enhance the hepatitis C cascade', Journal of Internal Medicine 5 , pp. Lindqvist, K. Lyss, S. S—S, doi McAuley, A. Metcalfe, R. Olafsson, S. Otiashvili, D. Paraskevis, D. Ongoing HIV transmission following a large outbreak among people who inject drugs in Athens, Greece — Schmidbauer, C. Shah, M. Sypsa, V. Tavoschi, L. Vlahov, D. Wang, Q. Wurcel, A. Homepage Quick links Quick links. GO Results hosted on duckduckgo. Main navigation Data Open related submenu Data. 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Background and objectives The objectives of the Drug-related infectious diseases DRID network are to share the latest developments on drug-related infectious diseases in Europe and to identify steps needed to improve the production, availability and use of public health-oriented information at the European level.

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How can I buy cocaine online in Chorzow