Harm reduction drug policy in Israel: what has and still needs to be accomplished?

The leading formal drug policy in Israel is the traditional approach of abstinence, probation, and punitive measures based on three main pillars: 1) Enforcement, 2) Treatment and Rehabilitation, and 3) Prevention. However, under the treatment pillar, Israel has adopted a number of harm reduction services, focused mostly on heroin addicts and people who inject drugs (PWID). These include Methadone Maintenance Treatment (MMT), Buprenorphine Maintenance Treatment (BMT), and Needle and Syringe Exchange Programs (NSEP). More specialized services are designated mostly for addicts who frequent the largest open drug scene in Tel-Aviv. These include a health clinic, an emergency apartment for female addict sex-workers, and a First Step center. Even so, the harm reduction approach has remained controversial, stigmatized, and is considered a sub-category for total-abstinence treatment in Israel.

This presentation follows the evolution of harm reduction interventions in Israel among heroin addicts and its lack of a comprehensive, well-planned formal harm reduction drug policy. Additionally, this presentation expresses concern over the uncertain future of Israel's comprehensive and balanced treatment and harm reduction policies caused by the structural changes in abolishing the Israel Anti-Drug Authority (IADA), the central body in Israel promoting and coordinating all national policies related to treatment and harm reduction.

Conclusions and Recommendations: Implement a comprehensive multidisciplinary harm reduction drug policy ; Focus on expanding and developing more services for Opioid Substitution Therapy (OST) patients and PWID and a national effort to reduce high levels of stigma and discrimination against them; Encompassing other common substances, and focusing on populations such as adolescents and young adults that engage in other types of substances use as cannabis, ATS and hallucinogenic.