Background: The measures taken to contain the COVID-19 pandemic have led to significant changes in people’s daily lives. This paper examines changes in substance use during the first lockdown (March–July 2020) and investigates mental health burdens in substance users with increased consumption of alcohol, nicotine or tetrahydrocannabinol (THC) in Germany compared to users with unchanged or reduced consumption. Method: In a cross-sectional online survey, 2369 people were asked about their mental health and their substance use during the first lockdown in Germany. Results: Of the participants, 28.5% increased their alcohol use, 28.8% their use of tobacco products, and 20.6% their use of THC-containing products during the pandemic. The groups with increased alcohol, nicotine, and THC use during the first lockdown reported more depressive symptoms and anxiety. Individuals who reported increased consumption of alcohol or nicotine were also more likely to experience loneliness and have suicidal thoughts and were more often stressed due to social distancing. Conclusion: Alcohol, nicotine and THC increased in a subgroup of consumers who reported to have more mental health problems compared to individuals who did not increase their consumption. This increased substance use could, therefore, be understood as a dysfunctional strategy to cope with negative emotions during the lockdown.

This study aimed to examine timebound prison healthcare governance amendments and current structures in Europe two decades after the World Health Organization (WHO) Declaration on Prison Health as part of Public Health adopted in Moscow on 24 October 2003 (Moscow Declaration), which recommended prison health care be closely linked with public health systems to ensure quality prison health care, connected health surveillance, and continuity of care. We present here a regional evolutionary mapping of the Council of Europe Member State transfer of prison healthcare governance to the auspices of the Ministry of Health. The European Committee for the Prevention of Torture database and WHO Regional Office for Europe Health In Prison European Database were scrutinised for Council of Europe (CoE) Member State status regarding the Ministry responsible for prison healthcare governance and if this had changed since the adoption of the Moscow Declaration in 2003. As of October 2023, completed transfer of governance to the Ministry of Health nationally is documented in 13 CoE Member States and in one CoE Member State candidate (Kosovo). Partial transfer is documented in Spain (Catalonia and Basque Autonomous Community) and Switzerland (cantons of Geneva, Valais, Vaud, Neuchatel, and Basel-Stadt). Three CoE Member States operate joint governance of prison health care between Ministries (Malta, Portugal, Türkiye). Transfer is a lengthy process (up to 10 years). Successful transition requires political commitment, cooperation, needs assessment, resourcing, and evaluation. Monitoring of cost and prison healthcare standards, due process for complaints, and cooperation with independent/Committee against Torture inspections is critical.

Zusammenfassung: Das Medikament Naloxon ist ein Opioidantagonist, der innerhalb von Minuten die (atemlähmende) Wirkung von Opioiden im Körper aufhebt. Naloxon kann dadurch zur Reduktion von Todesfällen bei Opioidüberdosierung beitragen. „Take-Home Naloxon“ (THN) ist eine Maßnahme, die vom European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) und der Weltgesundheitsorganisation (WHO) empfohlen wird. Dabei werden Opioidkonsumierende und deren Angehörige, Freunde oder Bekannte im Umgang mit Naloxon geschult und für den Notfall mit dem Medikament ausgestattet.Bisher wird THN in Deutschland überwiegend von einzelnen Einrichtungen der Suchthilfe umgesetzt. Damit das Potenzial von THN voll genutzt werden kann, ist es notwendig, die Maßnahme in Deutschland flächendeckend zu etablieren. Insbesondere in (niedrigschwelligen) Suchthilfeeinrichtungen, psychiatrischen Einrichtungen, im Rahmen von Opioidsubstitutionsbehandlungen und im Justizvollzug kann THN in das Angebot aufgenommen werden.Dieser Diskussionsartikel greift die bisherige Entwicklung von THN in Deutschland seit 1998 auf, zeigt die Schwierigkeiten und Hindernisse einer flächendeckenden Umsetzung und stellt dar, wie THN als wirkungsvolle Public-Health-Maßnahme auch in Deutschland gelingen kann. Besonders relevant ist dies angesichts der seit 10 Jahren steigenden Zahl von Drogentodesfällen.

Decision-making is an essential part of social work practice. Intuition is one possible basis for these decisions, but relying solely on it might not always be the best choice. No overarching framework for social work exists on how to deal with intuition. By building on the work of Kahneman and Klein, who describe conditions for successful intuitive-reasoning, the aim of the article is thus to offer such a framework for further research and reflection on social work practice. It can be used as a guideline for social work practice and social care policy to improve intuitive-reasoning of social workers.

Prisons in Europe remain high-risk environments and conducive for infectious disease transmission, often related to injection drug use. Many infected people living in prison unaware of their infection status (HIV, hepatitis C). Despite all Council of Europe (CoE) member states providing community needle and syringe programmes (NSP), prison NSP are limited to seven countries. The study aim was to scrutinise the Committee for the Prevention of Torture and Inhuman or Degrading Treatment (CPT) reporting of periodic and ad hoc country mission visits to prisons, with an explicit focus on the extent to which member states are/were fulfilling obligations to protect prisoners from HIV/hepatitis C; and implementing prison NSP under the non-discriminatory equivalence of care principle. Socio-legal review. A systematic search of the CPT database was conducted in 2024 with no date restriction. All CPT reports were screened in chronological order with the terms; “needle”, “syringe”, “harm reduction” and “NSP”. Relevant narrative content on prison NSP operations, including repeat CPT reminders and any official/publicly expressed reasons for not implementing is presented. CPT reporting reveals limited prison NSP provision in selected prisons visited on mission, with little change in status over time, despite documented evidence of prior observations around absent/insufficient harm reduction measures and explicit (often longstanding) recommendations to address deficits. Reasons for not implementing prison NSP include; existing availability of opioid substitute treatment, lack of evidence for injecting drug use, for security and maintenance of order, and contradiction with prison protocols sanctioning drug use. Prison health is public health. Regular research and evaluations of prison NSP in Europe are warranted. Future CPT visits should also continue to assess availability and standards of provision; recommend where appropriate including when opioid substitute treatment is already provided, and in line with broad availability of community NSP in Europe.