Abstract: This brochure describes a set of skills that incorporate harm reduction principles and goals. The skills are described along with strategies that drug and alcohol treatment providers and other health and human service providers can implement as they integrate harm reduction in their work.

Abstract: This briefing paper for policymakers presents how new discoveries in neurobiology have the potential to transform our perception of drug addiction and its treatment, whilst also considering the ethical issues such treatment can raise. It balances an analysis of the latest developments in the field with a call for rigorous testing before implementation.

Abstract: This booklet summarises the literature on the provision of sterile needles and syringes to people who inject drugs and other related issues. The proportion of the Australian population thought to inject drugs is just under two percent, or approximately 313,500 people.1 The first case of HIV infection in a drug injector without other risk factors in Australia was detected in 1985. Needle and Syringe Programs started in Australia the following year. At that time, hepatitis C infection was already well established among drug injectors with more than half being infected.2 Workers at Needle and Syringe Programs do much more than just provide injecting equipment. They are often the first point of contact between health services and people who inject drugs. Needle and Syringe Program workers are able to provide education and information on healthcare issues and drug related harm and facilitate entry into drug treatment. Some Programs also provide primary medical care to this disadvantaged population who often have very poor health. Australian Governments invested $130 million in Needle and Syringe Programs between 1991 and 2000. This resulted in the prevention of an estimated 25,000 cases of HIV and 21,000 cases of hepatitis C among injecting drug users. The savings to the health system in avoided treatment costs over a lifetime are estimated to be between $2.4 and $7.7 billion.3 While Needle and Syringe Programs enjoy strong public support in Australia, there have from time to time been misunderstandings about their role. In the past, Needle and Syringe Programs have been accused of encouraging drug use and increasing the number of inappropriately discarded needles and syringes in public places. However, Australian and international studies have shown that neither of these concerns are supported by impressive evidence. Research has shown that Needle and Syringe Programs do not increase injecting drug use. This could be attributed to the ability of health workers to offer health information, drug education and referral into treatment. Some members of the public have also raised concerns about inappropriately discarded needles and syringes and the possibility of contracting HIV or hepatitis C from a discarded used needle. The chance of a member of the public contracting either HIV or hepatitis C from a discarded used needle is extremely low. Worldwide, there has never been a reported case of a member of the public contracting HIV in this way. Countries where Needle and Syringe Programs have been implemented have averted HIV epidemics among injecting drug users, while countries that have not implemented these measures have often experienced uncontrolled epidemics. There is strong evidence that if HIV becomes endemic among injecting drug users it can then spread to their sexual partners and children resulting in high mortality rates and large social and economic costs to the entire community. There is abundant evidence from Australia and international research of the substantial public health benefits of Needle and Syringe Programs. The Australian Medical Association supports Needle and Syringe Programs as one of a number of measures which prevent the spread of HIV and other blood borne diseases.

Abstract: This ‘Selected issue’ looks at the current situation in injecting drug use in Europe. Overall, two questions guide the report: What are the prevalence and trends in injecting drug use in today’s Europe? How do European countries try to prevent or reduce this type of drug use and the harms associated with it? Data from a variety of sources are analysed to estimate prevalence and trends in drug injecting in Europe. The most recent data point to injecting drug use remaining stable or declining in most European countries. Measures such as opioid substitution treatment and needle and syringe programmes, which aim to reduce injecting-related harms, now reach many of those who need them.

Abstract: This Annual Report provides snapshots of how the UNAIDS Secretariat and its Cosponsors worked together to strengthen the HIV response in 2009. It focuses on concrete results in the 10 priority areas that form UNAIDS’ new vision and strategy. Key achievements, statistics and country results are highlighted for each priority area. Feature stories have also been included to provide the reader with a broad overview of UNAIDS’ work and its impact in countries.