Needle and Syringe Programmes and Other Drug Consumption Paraphernalia in Germany: Results from a Survey on Dispension of Harm Reduction Materials in Low Threshold Drug Services in 2018

Purpose Germany is committed to the global public health goal of viral hepatitis elimination by 2030. Harm reduction measures among drug users are a central component to reduce the transmission of HIV, hepatitis B and C. There is no up-to-date information for Germany on the number and geographic distribution of drug services dispensing drug use paraphernalia- as well as on the type and number of dispensed paraphernalia per year. Both questions were to be answered with the project for data year 2018. An additional goal was to estimate whether the 2020 WHO target of 200 needles/syringes dispensed per person per year was met. Methods Drug services that potentially dispense drug use paraphernalia were identified using the German Centre for Addiction Issues database, online listings of syringe vending machines and drug consumption rooms, and through project partners. Dispensing services answered a questionnaire on the type and number of paraphernalia dispensed, number of people served, and budget available. The number of dispensed paraphernalia was analysed descriptively, as well as the number of persons served, and the mean number of needles/syringes per opioid user per federal state for 2018. Results In total, 2,158 potentially dispensing services were identified, of which 475 (22%) responded and confirmed the dispensing of consumption paraphernalia. These were accounted for by 280 organisations (with more than one service attached) and single services, of which 155 (55%) responded to the questionnaire on type and number of paraphernalia dispensed. Geographic coverage was very heterogeneous. On average, 119 syringes and 156 needles were dispensed per person in 2018. The WHO 2020 target of 200 needles and syringes dispensed per person was achieved by 19 and 17 of the counties with information provided, respectively, in 2018. Low-threshold facilities and drug consumption rooms play a key role in the distribution of consumption equipment. More than one-third of dispensing services reported insufficient budget to provide supplies as needed. Conclusion The data collected can serve as an initial overview regarding the nationwide supply situation. In 2018, only a few counties achieved the WHO 2020 target of 200 needles/syringes dispensed per person. An increase in the distribution of paraphernalia also in structurally weaker regions is recommended in order not to jeopardise the goals of the hepatitis elimination strategy. A new wave of the survey is planned for 2022.