Harm reduction in European prisons: Availability and current gaps. Civil society monitoring of harm reduction in Europe 2025

People do not stop using drugs at the prison gate, and harm reduction should not stop there either. Yet new findings from the C-EHRN Monitoring 2025 mini-report on prisons show that access to essential harm reduction services in European prisons remains limited, uneven, and far behind what is available in the general community.
Drawing on data from 38 European cities with prisons, the report reveals major gaps in prison-based harm reduction. While opioid agonist treatment (OAT) and hepatitis C testing are more commonly available, life-saving interventions such as naloxone distribution and needle and syringe programmes (NSP) remain absent in most cities. Only 1 out of 38 cities reported access to all four key harm reduction services in prison.
The report also highlights a disparity between prison and community settings: harm reduction services in prisons are reported to be less available, despite higher levels of drug-related risk among incarcerated people.
Importantly, the availability of a service does not necessarily mean access for everyone. In many settings, harm reduction services remain restricted to certain prisons or specific populations, leaving significant gaps in continuity of care and overdose prevention.
The findings point to an urgent need to move beyond fragmented or partial provision and establish national minimum standards for prison harm reduction across Europe, aligned with public health evidence and international standards.
The report also draws attention to persistent barriers to prison data collection and transparency, which continue to hinder understanding of what services exist, how they work in practice, and where urgent gaps remain. [Editor's abstract]