In an embrace of harm reduction principles, the Portuguese government has approved the establishment of safe injection sites for drug users and is working to have needle exchange programs in prisons by 2008, Medical News Today reported on August 30. The moves come as part of a package of measures designed to "reduce the consumption of drugs and diminish their harmful social and health effects," the Portuguese government said.

Portugal now follows the lead of Australia, Canada, Germany, and Switzerland, where working safe injection sites are in place. The sites have been shown to help slow the spread of diseases like hepatitis C and HIV/AIDS, reduce overdoses, reduce criminality, help drug users achieve more stable lives, and help some of them connect with treatment and/or counseling services.

While, according to the European Monitoring Center on Drugs and Drug Abuse, Portugal's drug use rates are low by European standards, the country does have an injection drug-using population, mostly around heroin. About one-third of a sample of treatment patients in Portugal reported drug injection as their preferred route of administration.

Portugal decriminalized drug possession in 2000, although drug sales remain illegal. But even if Portugal is not ready to take the giant step of ending drug prohibition, the actions of its government since then show that it continues to move in a progressive direction on drug policy issues.

Prevention Point Pittsburgh, the sole needle exchange provider in the Pittsburgh area, is one step closer to being allowed to continue to operate after the Allegheny County Board of Health Wednesday approved regulations formalizing its operation. The exchange program had come under attack in April, when county council members questioned its legality in what was in large part a bureaucratic spat between the council and the health board.

"We're incredibly pleased," Renee Cox, executive director of Prevention Point Pittsburgh, told the Pittsburgh Post-Gazette Thursday. "All in all, it's worked out well. It does grant us a little more permanency now that we have formal regulations."

It was a bumpy ride, though. After county council members complained in April, the health board in May drafted regulations that would have required people exchanging needles to give their names and other identifying information and would have banned "secondary exchanges," where people pick up needles and then distribute them to others not in the program. The board heard those complaints.

"They restored anonymity of exchangers, which is absolutely fundamental to the operation of the needle exchange," Cox said. "They also allowed for secondary exchange, which will expand the reach of this small program."

The new regulations must still be approved by the county council.