Substance use & misuse
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Syringe exchange in Germany is clearly linked to a recent shift of local responses to drug-use(r) associated problem. Since the end of the 1980s, metropolitan communities in Northern and Central Germany-concerned by the emergence of "Open Drug Scenes," increasing HIV and mortality rates among drug users, and drug-use-related property crime-began to favor measures of survival-oriented drug-user help. While the Federal Government still favors repression and law enforcement efforts, they nevertheless made syringe exchange explicitly legal in 1992-some 5 years after the creation of local Syringe Exchange Programs. ⋯ Another major problem continues to be the drug-use situation in prisons. Although injection drug use is common in prisons, injection equipment is not legally available for the 10,000 injecting drug users imprisoned at any given time. Two of Germany's 220 prisons started an experimental syringe exchange in 1996.