Abstract
Aims. There are significant differences in harm reduction services availability and performance in various countries. The paper examines the state of one of the harm reduction interventions – needle exchange services – through the lenses of morality policy, attempting to establish possible relationships between policy framing and policy outcomes. Method. The research uses an explorative design with cross-country comparison. The unit of analysis is drug policy in a country, and the geographical scope includes Czechia, Hungary, Poland and Slovakia, following the maximum variation case selection procedure. Countries’ drug strategies are analysed to identify the policy frames and data on needle exchange programmes are used to assess the state of harm reduction. Results. The analysis identified health and social drug policy framing in Czechia and Slovakia, morality frame in Hungary and no frame in Poland. The availability of availability and coverage of needle exchange programmes is the highest in Czechia, followed by Slovakia, Hungary and Poland. Conclusions. The Hungarian case confirms the relationship between morality framing and poor policy outcomes, while the Czech case between health framing and effective policy. Further research is needed to establish the function of morality framing as necessary and/or sufficient condition for unsatisfactory policy outcomes.
Highlights
The harm reduction approach to drug use, still relatively new compared to the other three pillars of drug policy, has already secured a well-established position in many developed countries, especially in Western Europe
In order to shed some light on the potential reasons for the above-mentioned differences, this paper examines, through the lenses of the morality policy framework, the state of harm reduction services for people who inject drugs (PWID) in the Czech Republic, Hungary, Poland, and Slovakia
This paper has attempted to identify the relationships between the framing of drug policy as a health, morality, security, or economic issue, and the outcomes of harm reduction policies in the Czech Republic, Hungary, Poland, and Slovakia
Summary
The harm reduction approach to drug use, still relatively new compared to the other three pillars of drug policy (law enforcement, treatment, and prevention; McCann, 2008), has already secured a well-established position in many developed countries, especially in Western Europe. The European Union even goes a step further, calling in its Action Plan on Drugs 2017–2020 for ‘[s]cal[ing] up where applicable, availability, coverage and access to risk and harm reduction services, e.g. needle and syringe exchange programmes, opioid substitution treatment [and] opioid overdose management programmes’ (Council of the European Union, 2017: 7) Notwithstanding this international agreement about the role of harm reduction in drug policies, significant differences in the availability of various interventions across countries can be observed. The analysis will focus on needle and syringe exchange programs (NSPs) for people who inject drugs
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