Celebrated each year on 7 May, International Harm Reduction Day promotes science and human rights based public health policies and highlights successful practices that contribute to reducing drug related harms in society. Opioid agonist treatment (OAT) is an internationally recognised and proven practice of treating opioid use disorders, reducing the spread of blood-borne diseases and supporting long-term recovery of people coping with addiction.
Nonetheless, steady rise in opioid overdose deaths and a large disparity between countries in terms of access to opioid agonist treatment point to persisting challenges in reaching vulnerable groups in need of treatment. Availability of treatment varies between 20% and 80% of those in need Europewide. People living in rural areas, populations at risk of discrimination, such as women, minors, migrants and detained persons are experiencing even greater difficulties to receive this type of treatment, which is often bound to lengthy authorisation schemes.
International Harm Reduction Day is an opportunity to remind states of the need to ensure compliance of national regulations with international human rights obligations regarding access to health care and prevention of discrimination. To assist legislative and administrative authorities in this review process, in 2018 the Pompidou Group developed guiding principles for regulating opioid agonist treatment at national level.
At the initiative of the Swiss Federal Office of Public Health, a group of health and legal experts analysed legislative provisions which imped access to care. They went even further and identified necessary measures and criteria for the appropriate use of agonist medicines used in treatment in line with ethical standards, international law, scientific knowledge and best medical practice. The resulting publication ‘Opioid Agonist Treatment. Guiding principles for legislation and regulations’ was since then made available in 8 languages (Arabic, Czech, German, English, French, Italian, Spanish, Russian) due to high demand by national policy makers.
The Guiding Principles contain global and coherent recommendations for certification and control of medicines used in opioid agonist treatment, the training and supervision of healthcare professionals administering them as well as the monitoring and coordination of the care system between the different sectors involved in treatment. The publication also promotes recognition of the medical nature of opioid agonist treatment and accurate communication through the use of neutral, precise and respectful terminology, which will facilitate the implementation of modernised regulations.