A Sociohistorical Overview of Harm Reduction Development in Croatia

Harm reduction is viewed as a public health aspect of drug policy in Croatia. The development of needle exchange programs and opioid substitution therapies are discussed herein by sketching the basic contours of the Croatian social and cultural context in which these activities have taken place over the past several decades. Along with the critical reflection of the approaches in which drug use in Croatia is considered in the matrix of anomie and disorganization explanations, two phases were identified in the development of harm reduction programs. The first phase marked the initial establishment of these programs in the context of strong growth in the number of heroin users in the 1990s, while the second phase allowed for the further development of these programs during the 2000s. It has been shown that, in contrast to anomie and social disorganization related approaches, the economic and political development trends of Croatian society are not clearly unambiguous in relation to the development of harm reduction programs, thus indicating that consideration of harm reduction development is more appropriate to link to the decentralization of related activities and the incorporation of these programs into intravenous drug use population's social insurance. In this way, immediate and non-patronizing access to the intravenous drug use population throughout Croatia is enabled. However, although embedded in the prohibitionist government's drug policy, the current implementation of the harm reduction programs in Croatia is still characterized by the unpredictability of official drug policy action as well as the general changes in drug use, with problems associated with the use of new psychoactive substances representing the greatest challenge.