Methods and definitions

The EU Member States, Bulgaria and Norway have in 2004 for the first time used a standardised format to collect the data on needle and syringe availability through specialised needle and syringe programmes (NSPs) and through pharmacy sales: the Standard Table 10 – Syringe availability (http://www.emcdda.europa.eu/?nnodeid=5777) and data for the year 2003 were reported. Updated results for the year 2005 will become available in the Statistical Bulletin 2007.

This data collection tool includes information on the availability of different types of needle and syringe programmes (NSPs) in the country, including pharmacy-based programmes, and on the number of syringes provided at these programmes, as well as on pharmacy-sales and on syringe provision via vending machines. It includes data on the number of syringe provision points, defined as individual locations or physically distinct outlets where syringes are available for free or against payment, e.g. the number of community pharmacies.

While data on quantity and types of syringe provision points that are offered provide important background information, it is essential to interpret syringe availability in its national context, in particular with regard to the estimated prevalence level of drug injecting, the density of the national pharmacy network, the availability of syringes in pharmacies as well as pharmacists attitudes with regard to syringe sales to drug users.

Information on the number of client contacts and the number of individual clients that make use of needle and syringe programmes are also collected with Standard Table 10, but as this information is patchy or unavailable in many countries, it is not presented here. The EMCDDA is carrying out further developmental work to increase the availability and quality of these data together with interested national focal points. For more information on EMCDDA harm reduction data collection see: http://www.emcdda.europa.eu/?nnodeid=4823.

Expert rating on strategies to prevent infectious diseases

A structured review of policies, interventions and quality of harm reduction services to reduce infectious diseases among drug users was conducted in the form of a questionnaire survey among National Focal Points in 2004. The instrument can be downloaded at: http://www.emcdda.europa.eu/?nnodeid=5777. It was recommended to involve a national expert group in the completion of the questionnaire. As part of the survey, expert ratings about policy priority and extent of use of selected response strategies at national level were requested

Experts selected three national policy priority responses among eleven pre-selected strategies or among other priority strategies they had added to the list. National experts also assessed the extent to which these measures were de facto in use in their countries by classifying each as ‘predominant approach’, ‘common’, ‘rarely used’ or as ‘not in use’.

The figure presents the results of the expert ratings on priority and on extent of use of the pre-selected responses (in percent of valid replies). Only five countries made use of the option to add further strategies, however as these were very heterogeneous, they are not presented here. Priority ratings for the pre-selected responses were provided by experts from 23 EU countries plus Bulgaria and Norway. Countries not supplying these ratings were Ireland, Cyprus, Lithuania and the Netherlands. Ratings on the 'extent of use' were provided by experts from all 25 EU countries plus Bulgaria and Norway. The French and Flemish Communities in Belgium provided separate ratings, bringing the total maximum number of valid replies to 28.

Expert ratings on strategies to reduce drug-related deaths

A structured review of policies and interventions to reduce acute drug-related deaths in place at national level in the EMCDDA Member States was made through a questionnaire survey among National Focal Points in 2005. The instrument that was used can be downloaded at http://www.emcdda.europa.eu/?nNodeID=1333. Twenty-one countries followed the EMCDDA’s recommendation to involve a group of national experts in responding to the questionnaire. As part of the survey, expert opinion about the extent to which five selected response strategies aiming at the reduction of drug-related deaths were in use in their country. Additional strategies could be added. Answer options were: ‘not in use’; ‘rarely, uncommon’; ‘common but not predominant’; and ‘predominant’ approach.

Figure NSP-4 presents the results of the expert ratings on extent of use of the pre-selected responses (number of countries in the different rating categories). Valid replies were available from all EU countries except Slovak Republic and Cyprus, and they were provided by experts from Norway, Bulgaria, Romania and Turkey – a total of 27 countries.