Abstract: also available of this report: chapter 1-2: 50-00537 chapter 3-4: 50-00538 chapter 6-8: 50-00540 appendix 1-2: 50-00534 appendix 3: 50-00535 appendix 4-5: 50-00536

Abstract: Phase I of the Zurich Prometheus Study is a cross-sectional study focusing on an up-to-date serology for HIV and hepatitis B/C and associated risk factors for all clients in four participating clinics offering opiate substitution in Zurich, Switzerland. The mean age of the 603 respondents is 30.7 years (SD=6.2), and 38% of them are women. Seventy-five percent of the respondents have a history of injecting drug use (IDU), and over half have injected within the past six months. Lab-confirmed seroprevalence for HBV (50%) and HCV (57%) is twice that of HIV (24%). There is an 80% risk reduction for all three viral infections among those starting IDU after 1991—when harm reduction efforts were in full swing—compared to those who began before 1988—before clean needles were widely available. These findings suggest a strongly protective effective of harm reduction measures. But while a stabilization in HIV prevalence at 15% can be seen among drug users who started injecting after 1991, prevalence rates for HBV and HCV still remain several times higher. The prevalence data in this study support data showing continued high incidence rates for HBV and HCV, even among new injectors in the harm reduction era.

Abstract: This volume is the result of an EMCDDA-commissioned study carried out in 1998 and 1999 into one of the most widely discussed drug-related topics in Europe today: substitution treatment. The study was prompted by the lively debate on the issue in the mid-1990s, when Switzerland launched its first heroin trial, France began buprenorphine treatment and methadone programmes expanded rapidly throughout Europe. These initiatives led to an increased focus on substitution treatment and to the trajectories it was to follow in the future. The volume opens with a historical overview of substitution treatment, the development of methadone maintenance and other substitution services and a section on monitoring and evaluation. It closes with a series of country profiles for each of the then 15 EU Member States, all containing an introduction to substitution treatment in the country concerned.

Abstract: This publication provides information on best practice in drug prevention at European, national, regional and municipal level. It is a translation of a German study commissioned by the Federal Centre for Health Education, Cologne. While, in some sections, reference is made particularly to Germany, the publication’s conclusions are international, providing added value for a pan-European or global readership. It is hoped that the publication will help accelerate the development in Member States of quality standards for prevention projects and training requirements for prevention workers.