Policy resistance to harm reduction for drug users and potential effect of change

Despite good evidence for its effectiveness in HIV prevention, countries such as Russia remain resistant to harm reduction. Tim Rhodes and colleagues show the obstacles to and potential benefits of changing policy on opiate substitution treatment The health harms of injecting drug use include HIV, hepatitis C, bacterial infections, overdose, and substantial excess mortality. An estimated 16 million people inject drugs worldwide, 3 million of whom live in eastern Europe.1 Around 1.5 million people are infected with HIV in eastern Europe, with most infected through injecting drug use.2 The largest European epidemics are those in the Russian Federation and Ukraine, where over a third of injecting drug users are thought to be HIV positive.1 2 One contributing factor is policy resistance to harm reduction