Harm reduction dates back to the 1980s and the HIV epidemic. The first efforts to reduce infections among people who inject drugs were initiated by users themselves in Western Europe. The phenomenon of injecting drug use and the resulting health harms was particularly present in urban areas, and they played a key role in introducing new interventions and expanding the range of services aimed at PWUD (needle and syringe exchange programs, substitution treatment). The 1990s saw the development of harm reduction programs, growing acceptance of this approach, recognition of the effectiveness of interventions and cost-effectiveness of programs, and consequently integration of activities into health care systems, as well as into drug policy guidelines of the European Union and other countries of the Western world (United States, Australia). Harm reduction is an integral part of official policy in the United Nations (WHO, UNAIDS) and global public health institutions. Nevertheless, in many countries in the world, people who use drugs are denied access to basic health services, sentenced to draconian penalties (including the death penalty), and denied the right to life and health simply by using drugs. In most countries with harm reduction programs, their scope and quality is insufficient.

Poland was the first country in the region to introduce harm reduction interventions (needle and syringe exchange, opioid substitution treatment). The programs developed in the 1990s. The amendment to the Act on Counteracting Drug Addiction in 2000 was a turning point in terms of access to services. The introduction of criminalization of possession of substances for personal use resulted in a gradual outflow of clients and a decrease in the number of services. Restrictive drug laws, the dominant abstinence model of drug treatment, and the stigmatization of people who use drugs prevent the development of this approach and the reform of the treatment system.

The coverage and access to harm reduction is very low in the country. Only about 15% (in the group of problem opioid users) of those in urgent need of support can receive it. Legal regulations prevent the implementation of interventions that are key to protecting the health and lives of people who use drugs, such as safe injection sites and naloxone programs. Harm reduction is included in the National Program on Counteracting Drug Addiction, an agenda of the Ministry of Health – the National Centre on Counteracting Addictions finances and actively supports harm reduction programs. However, they function on the periphery of the aid system and the harm reduction philosophy still arouses controversies among people working in the field of addictions.

Currently there are five harm reduction programs in Poland – in Warsaw (Prekursor Foundation, Jump 93), Krakow (Drop-in Krakowska 19), Wroclaw (Salida Foundation) and Gdansk (Prekursor Foundation).