Political and economic change in Eastern Europe and the former Soviet Union brought with it many new freedoms. While this new openness gave rise to many positive developments in the region, it also had consequences - among them a surging supply of illegal drugs to meet a burgeoning demand. Drug availability expanded as organized crime networks gained strength and expanded operations. Meanwhile, the capacity of law enforcement to control illegal activity attenuated.

Overwhelming evidence now confirms a massive increase in drug use - particularly of heroin and other injectable substances - in most countries of Eastern Europe and the former Soviet Union during the past decade. Recent estimates suggest that there are currently between 2.3 and 4 million injecting drug users in the region and that the number of users is growing.

Eastern Europe has become the latest 'front-line' of the AIDS epidemic, an epidemic driven here almost entirely by injecting drug use. In 1995, HIV infections in the region of 450 million people was estimated at 30,000. HIV infections are reportedly doubling annually since 1998, and now it is estimated that more than a million people are infected.

Responding to this growing crisis is a program Drug Policy Alliance works very closely with, the International Harm Reduction Development program (IHRD) of the Open Society Institute. IHRD supports over one hundred drug user projects in more than twenty countries in Eastern Europe and the former Soviet Union, and works to influence national-level drug policies and practices by sponsoring advocacy, research, conferences and decision-maker study tours.