A Sin or a Health Issue? : Morality Policy Framing and the State of Harm Reduction in East-Central Europe

Aims. There are significant differences in harm reduction services availability and performance in various countries. The paper examines the state of one of the harm reduction interventions – needle exchange services – through the lenses of morality policy, attempting to establish possible relationships between policy framing and policy outcomes. Method. The research uses an explorative design with cross-country comparison. The unit of analysis is drug policy in a country, and the geographical scope includes Czechia, Hungary, Poland and Slovakia, following the maximum variation case selection procedure. Countries’ drug strategies are analysed to identify the policy frames and data on needle exchange programmes are used to assess the state of harm reduction. Results. The analysis identified health and social drug policy framing in Czechia and Slovakia, morality frame in Hungary and no frame in Poland. The availability of availability and coverage of needle exchange programmes is the highest in Czechia, followed by Slovakia, Hungary and Poland. Conclusions. The Hungarian case confirms the relationship between morality framing and poor policy outcomes, while the Czech case between health framing and effective policy. Further research is needed to establish the function of morality framing as necessary and/or sufficient condition for unsatisfactory policy outcomes.