Abstract: The prescription of substitution drugs, such as methadone and buprenorphine, has become a mainstream, first-line treatment for opioid dependence, with around 700 000 of Europe’s 1.3 million problem opioid users receiving substitution treatment today. But a small minority of entrenched opioid users repeatedly fails to respond to interventions of this kind. Findings from international trials now suggest that the supervised use of medicinal heroin can be an effective second-line treatment for this small, and previously unresponsive, group. In this latest EMCDDA Insights report, experts describe the development as “an important clinical step forward”. The report provides the first state-of-the-art overview of research on the subject, examining the latest evidence and clinical experience in this area in Europe and beyond.

Abstract: The EMCDDA’s 10th scientific monograph, entitled Harm reduction: evidence, impacts and challenges provides a comprehensive overview of the harm reduction field. Part I of the monograph looks back at the emergence of harm reduction approaches and their diffusion, and explores the concept from different perspectives, including international organisations, academic researchers and drug users. Part II is dedicated to current evidence and impacts of harm reduction and illustrates how the concept has broadened to cover a wide range of behaviours and harms. Part III addresses the current challenges and innovations in the field. The core audience of the monograph comprises policymakers, healthcare professionals working with drug users, as well as the wider interested public.

Abstract: This report presents a number of contributions that relate to analysing communal wastewaters for drugs and their metabolic products in order to estimate their consumption in the community. This area of work is developing in a multidisciplinary fashion, involving scientists working in different research areas. For this reason, the contributions to this publication come from a variety of different perspectives including: analytical chemistry, physiology and biochemistry, sewage engineering, spatial epidemiology and statistics, and conventional drug epidemiology.

Abstract: Prevention is a key consideration when discussing substance use and related problems. Drug prevention is any activity that delays or reduces the use of substances. Preventing substance use potentially makes other interventions, especially targeting treatment and harm reduction, unnecessary. Evaluation of the various interventions is essential to develop and improve existing approaches and to work towards creating a best practice in drug prevention. The EMCDDA first published the Guidelines for the evaluation of drug prevention in 1998 to respond to a need expressed by professionals and policymakers to have a tool and stimulus to evaluate prevention interventions in Europe. These guidelines aimed to facilitate and encourage project leaders to evaluate their own interventions and to design them accordingly. This second edition is an updated version of the original EMCDDA guidelines, which contains new methods, concepts and examples of currently available drug prevention interventions and which provides a framework for carrying out an evaluation. The content has also been updated with developments in online EMCDDA drug prevention and evaluation resources. Since publication of the first edition, prevention professionals who continue to apply these guidelines have contributed to the increased attention given to evaluation and prevention. However, although guidance on drug prevention is available in some Member States, only a minority of interventions in the European Union have an outcome evaluation. Even large, wellfunded projects are still not fully evaluated and the availability of empirical evidence concerning prevention is weak. These guidelines are intended for professionals working in the drug prevention and evaluation field and can provide valuable guidance when planning and evaluating prevention activities. The intention to develop best practice in drug prevention, as expressed in the 2005–8 and 2009–12 EU drugs action plans, and the fact that evaluation is now widely used in Member States’ drug policy, testify to the importance placed on drug prevention and evaluation in the European Union. The aim of this publication is to raise the profile of both drug prevention and evaluation methodologies and to provide prevention practitioners with an up-to-date framework, to enable their interventions and evaluations to reach their full potential.

Abstract: Prevention is one of the first approaches to be mentioned when public debate and policy address drug use and drug-related problems. Regularly, measures of prevention are presented as a means to overcome existing or future problems. However, evidence of ‘what works’ in practice is often overlooked. Similarly, research has shown examples where preventive efforts produced no or detrimental effects. This publication will help steer efforts in the right direction. Using an empirically derived reference framework, it bridges the gaps between science, policy and practice. Based on an overview of existing standards in Europe and beyond, a number of highly respected experts from EU Member States and international organisations worked together to prepare the publication. More than 400 national experts and stakeholders were included in a Delphi panel study and in a number of focus groups, which produced in-depth discussions as well as a consensus on the most important recommendations. The European Commission provided the funding for the original project on prevention standards and its results are now published within the EMCDDA Manuals series. In this series, information, advice, and guidance are offered to professionals and practitioners. Well structured and with many useful tables and figures, this publication will help its users as they progress from a first needs assessment to the delivery of an intervention and its final evaluation. Correct implementation of prevention measures with evidence-based components and anchoring them within existing structures and services (or activities) is key to ensuring effectiveness and it helps to avoid unintended iatrogenic effects. This manual will provide valuable guidance in this respect and allow preventive interventions to reach their full potential.