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    <title language="deu">Aktuelle Situation in offenen Drogenszenen und Einfluss sich verändernder Drogenmärkte</title>
    <abstract language="deu">Offene Drogenszenen finden sich in jeder deutschen Großstadt und werfen sowohl Fragen der öffentlichen Ordnung als auch der Gesundheit auf. In&#13;
diesem Beitrag wird die Situation offener Drogenszenen in Deutschland&#13;
dargestellt und wie diese durch sich verändernde Drogenmärkte beeinflusst&#13;
werden. Es wurde ein selektives narratives Review durchgeführt.Menschen in offenen Drogenszenen befinden sich häufig in prekären Lebenssituationen und haben einen im Vergleich zur Allgemeinbevölkerung schlechteren gesundheitlichen Zustand. Die hohe Verfügbarkeit von Kokain in Europa und das möglicherweise ausbleiben von Heroin aus Afghanistan kann negative Auswirkungen auf die offenen Drogenszenen haben. Auf die Veränderungen der Drogenmärkte müssen sich die Angebote an die offene Drogenszene anpassen, wie am Beispiel Crack deutlich wird. Für ein Aufkommen von synthetischen Opioiden können bereits jetzt Vorbereitungen getroffen werden. Insgesamt sind ein diversifiziertes Hilfesystem und ein stringentes stadtpolitisches Handeln unter Beteiligung aller Akteur:innen, eine&#13;
Entkriminalisierung der Konsumierenden illegaler psychoaktiver Substanzen&#13;
sowie legale Zugänge zu Substanzen wichtige Schlüssel zu einer Verbesserung&#13;
der Lebenssituation der Menschen in offenen Drogenszenen. Drogenpolitische&#13;
Entscheidungen sollten auch mit Blick auf internationale Drogenmärkte und&#13;
deren Einfluss auf offene Drogenszenen getroffen werden.</abstract>
    <parentTitle language="deu">Suchttherapie</parentTitle>
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In\n                        diesem Beitrag wird die Situation offener Drogenszenen in Deutschland\n                        dargestellt und wie diese durch sich ver\u00e4ndernde Drogenm\u00e4rkte beeinflusst\n                        werden.&lt;\/jats:p&gt;&lt;jats:p&gt;Es wurde ein selektives narratives Review durchgef\u00fchrt.&lt;\/jats:p&gt;&lt;jats:p&gt;Menschen in offenen Drogenszenen befinden sich h\u00e4ufig in prek\u00e4ren\n                        Lebenssituationen und haben einen im Vergleich zur Allgemeinbev\u00f6lkerung\n                        schlechteren gesundheitlichen Zustand. Die hohe Verf\u00fcgbarkeit von Kokain in\n                        Europa und das m\u00f6glicherweise ausbleiben von Heroin aus Afghanistan kann\n                        negative Auswirkungen auf die offenen Drogenszenen haben. 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    <author>Simon Fleißner</author>
    <author>Larissa Steimle</author>
    <author>Heino Stöver</author>
    <author>Bernd Werse</author>
    <author>Daniel Deimel</author>
    <collection role="institutes" number="">Fakultät Sozialwissenschaften</collection>
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    <language>eng</language>
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    <pageLast/>
    <pageNumber/>
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    <issue>1</issue>
    <volume>22</volume>
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    <title language="eng">The implementation of take-home naloxone: Lessons learned from a 3-year take-home naloxone project in Germany</title>
    <abstract language="eng">Background&#13;
Take-home naloxone (THN) can prevent deaths related to opioid overdoses. Despite the first THN project in Germany in 1998, the availability of naloxone for people who use opioids (PWUO) is still scarce. We present the results of the German-wide THN-project NALtrain, which aimed to implement THN nationwide. Firstly, we present data collected during NALtrain and secondly, we use this data to critically reflect on the project and thereby draw conclusions that could inform future THN projects.&#13;
Method&#13;
NALtrain was conducted between July 2021 and June 2024. Descriptive statistical analysis of the documentation of 74 train-the-trainer events and following naloxone trainings conducted by the trained staff were carried out.&#13;
Results&#13;
864 staff members from approximately 373 organizations (mainly harm reduction services) participated in 74 train-the-trainer courses. Of the 373 organizations 123 conducted 784 naloxone trainings for PWUO and reached 2,333 PWUO, of whom 1,451 received THN. The goal of training 800 staff members was met, while the goals of reaching 400 organizations and 10,000 PWUO were missed. The implementation of THN is unevenly distributed across the German federal states, especially concentrated in Bavaria. The core learnings are that the prescription-only status of THN leads to extra organizational efforts and hinders the availability of THN for individuals with the highest risk of overdose.&#13;
Conclusion&#13;
Considering the proportion of organizations offering THN, they can still be classified as “early adopters”. These may serve as role models for the broader majority. Free available THN and centrally coordinated support of implementation including recurring follow-up can be key to a broader availability of THN in Germany. In future initiatives physicians and medical settings should be prioritized.</abstract>
    <parentTitle language="eng">Harm Reduction Journal</parentTitle>
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Despite the first THN project in Germany in 1998, the availability of naloxone for people who use opioids (PWUO) is still scarce. We present the results of the German-wide THN-project NALtrain, which aimed to implement THN nationwide. Firstly, we present data collected during NALtrain and secondly, we use this data to critically reflect on the project and thereby draw conclusions that could inform future THN projects.&lt;\/jats:p&gt;\n          &lt;\/jats:sec&gt;\n          &lt;jats:sec&gt;\n            &lt;jats:title&gt;Method&lt;\/jats:title&gt;\n            &lt;jats:p&gt;NALtrain was conducted between July 2021 and June 2024. Descriptive statistical analysis of the documentation of 74 train-the-trainer events and following naloxone trainings conducted by the trained staff were carried out.&lt;\/jats:p&gt;\n          &lt;\/jats:sec&gt;\n          &lt;jats:sec&gt;\n            &lt;jats:title&gt;Results&lt;\/jats:title&gt;\n            &lt;jats:p&gt;864 staff members from approximately 373 organizations (mainly harm reduction services) participated in 74 train-the-trainer courses. Of the 373 organizations 123 conducted 784 naloxone trainings for PWUO and reached 2,333 PWUO, of whom 1,451 received THN. The goal of training 800 staff members was met, while the goals of reaching 400 organizations and 10,000 PWUO were missed. The implementation of THN is unevenly distributed across the German federal states, especially concentrated in Bavaria. 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