Barcelona, Spain: “You can’t restrict rights because someone uses drugs, otherwise, you’d have to restrict them for everyone. Poverty cannot be filtered through consumption. Much of it is connected to pain, not just recreation. Harm Reduction is a matter of social justice and rights.”
This is what Ester Aranda, a veteran in Harm Reduction programs in Catalonia, said when asked to explain why it matters to provide assistance not tied to a commitment of abstinence to people who use illicit substances.
Whether in the narrow streets of Naples, at a festival in Turin or in the outskirts of Barcelona, Harm Reduction (HR) operators have been assisting substance users for forty years, curbing overdose deaths in Europe, the transmission of deadly diseases, and routing those who want to quit to the right services. Whether drug use is recreational or problematic, these programs proved essential to protect health, dignity, and social inclusion. Over time, HR became a pillar of the European Union Drugs Strategy. Money, however, remained tight.
The project investigated the state of HR programs and services across Italy and Spain, and assessed how a fragmented financial and operational framework hinders the ability to provide essential healthcare and support to substance users. Over the course of six months and in several cities across Spain and Italy, our team spoke with operators, researchers, and substance users; joined street units, attended free parties, festivals, and street parades; visited drop-ins, rehab communities, and supervised consumption sites in marginalised communities.
In Spain, Barcelona and Catalonia stand out as European pioneers in Harm Reduction, thanks to the broad network of programs implemented since the 1990s. In Italy, where drug policies remain more restrictive and the stigma around consumption is higher, initiatives often depend on local organisations and face constant challenges. Despite the Bloc’s pledges, our investigation shows that EU funding schemes failed to support HR policies in both the examined countries.
Key findings:
- In almost all the cases surveyed, HR programs could not access European funding schemes for not meeting the requirements or because they lack the knowledge on how to apply.
- The level of integration of these services with the public sector varies considerably between regions and even neighbourhoods of the same city, regardless of the political colour of local governments.
- Operators who are also people that use drugs are an essential part of Harm Reduction teams and increase their efficacy in interacting with their target communities.
- Even where HR has been consolidated as a service rather than an experimental project, a high degree of uncertainty around money and support remains, and funds only meet a small quota of the needs of the targeted population.
Image credit: ©Julia Molins. During the Eve of St. James celebrations on July 24, 2025, in Vitoria (Basque Country, Spain), the association Ai Laket! , dedicated to promoting Harm Reduction in drug use, set up its mobile van in front of one of the 'choznas', spots where young people gather to celebrate. Inside the vehicle, a staff member analyses an ecstasy sample brought by a user a few minutes earlier, while her colleague outside distributes harm reduction information and sterile materials for safer consumption.
