Harm reduction services in the Netherlands: recent developments and challenges.

The Dutch Harm Reduction Network, part of the Trimbos Institute has received funding from the Ministry of Health, Welfare and Sports of the Kingdom of the Netherlands. No pharmaceutical grants were received in the development of this study. The Netherlands were among the first countries in the world to implement harm reduction services for PWUD, especially herpin and crack cocaine. This included needle and syringe exchange, methadone maintenance treatment and low-threshold services, followed by drug consumption rooms and heroin prescription. These services and their developments are not systematically and regularly monitored., updated information on these service was lacking since. Therefore a new inventory was conducted in 2021. To update the knowledge on current state of affairs of major harm reduction services, professionals working in (17) drug consumption rooms, (53) substitution treatment facilities, (17) units for medical heroin prescrition and professionals involved with (29) needle exchange outlets were interviewed using a semi-structured questionnaire. Besides, a number of stakeholders returned a questionnaire instead.

The total number of PWUD making use of harm reduction services have stagnated or even decreased somewhat in recent years; An increase of (labour) migrants from Central and Eastern Europe visiting harm reduction services is witnessed; Service users are aging, thereby developing somatic health problems; There is growing need for services targeting GHB users among service beneficiaries Stigmatisation and discrimination of PWUD hinder access to treatment. Harm reduction services in the Netherlands have been adapted to changes in population, routes of adminstration and of drugs of choice. Regular monitoring of state of affairs within these services is essential to continue to address changing needs of PWUD.