P-PG /MinConf (2010) 1
11 October 2010
Achievements & Results 2007 - 2010
Report on the implementation of the
Pompidou Group 2007 – 2010 Work Programme
Introduction
The PG activities 2007 – 2010 are based on the Work Programme adopted at the Ministerial Conference in 2006. The plan of work for implementing Platform activities was developed by the Coordinators (doc. BUR (2007) 6) and other activities agreed by the Bureau. Detailed information on all activities, their implementation, expected outputs and products are available in the annual activity log-frames on the restricted website for Permanent Correspondents (PCs) at: http://www.coe.int/T/dg3/pompidou
Table of contents
Part I: Overview of activities & outcomes
Part II: Platform signals and conclusions
Ü Prevention Platform
Ü Treatment Platform
Ü Criminal Justice Platform
Ü Research Platform
Ü Ethics Platform
Ü Airports Group
Part III: Results of other activities
Ü Inter-agency Group
Ü MedNET
Ü EXASS Net
Ü ESPAD
Part IV: Cooperation with other organisations
Part V Secretariat activities
Part VI: Budgetary report
Part I: Overview of activities & achievements
PG Presidency priority: meeting policy makers needs = making the PG fit for the future
Ü Setting up inter-agency cooperation with European and international stakeholders on a regular basis
Ü Developing and implementing a concept for mid-term assessment of the PG’s work in view of set objectives and expected results
Ü Revising the structure and working methods presently used by the PG
Ü Launching a training initiative aimed at empowering policy managers and policy advisors
Ü Providing the PG and member States with a model for a TV spot aimed at preventing drug use in road traffic
PC activities & thematic debates
60th PC meeting: Coherence of policies on illicit drugs and those on licit drugs and how to integrate approaches and policies
61st PC meeting: PG-sponsored CND resolution on drugs and public health
62nd PC meeting & Mid-term Conference: 1. Strengths, weaknesses, opportunities and threats of the PG; 2. How to better meet policy makers’ needs?
63rd PC meeting: Spice, smart drugs and legal highs
64th PC meeting: 1. Feasibility of a new framework convention 2. Training needs for drug policy implementation
65th PC meeting: Preparation of Ministerial Conference
Additional results from Secretariat work:
Ü Capacity building for school-based prevention programmes in Lithuania and Ukraine
Ü Communication strategy for the Pompidou Group developed and implemented, including complete overhaul of website and restricted website sections with on-line log frames (reporting tool)
Ü Full evaluation and analysis of all Pompidou Group activities to better meet policy makers’ needs
Ü Feasibility study for a possible European framework convention on the role of promoting public health policies in the fight against drugs
Ü TV spot in 5 languages on drugs and road traffic (in cooperation with the Presidency)
Part II: Platform signals and conclusions
Ü Prevention Platform results (details p. 11)
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Activities/topics |
Expected outcome |
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Secretariat setting up internet-based support for practitioners in prevention |
Website with internet based training tools and resources set up |
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Conference on families, lifestyles and drug prevention |
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Expert group developing pilot projects to reach vulnerable families in drug prevention , good prevention practices in recreational settings and good practices in evaluation of prevention activities (follow-up to 2007 Conference) |
Öchanged to development of publications and organising conferences. Hence project on vulnerable families was replaced by expert groups |
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European Drug Prevention Prize 2008 |
þ 34 applications from 15 countries þ Jury set up |
: new website: : video award ceremony 2008 |
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Conference on concepts and methods to evaluate impact and success of prevention programmes |
Publication on methods to evaluate the impact of prevention programmes and facilitating evaluation results to stakeholders. |
þ 2010 Conference |
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Expert group exploring the impact of neuroscience, biomedical research and genetics on prevention strategies and methods |
Report including: Anticipated impact on prevention, New perspectives for prevention, Guidance on ethics issues. |
x not selected as priority |
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Conference assessing experiences with youth participation in drug prevention programmes |
Ö no voluntary contributions received, deferred to possible future collaboration with the Mentor Foundation |
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European Prevention Prize 2010 |
þ 80 applications þ 3 Prizewinners selected |
: On-line direct broadcasting of the Award Ceremony |
Ü Treatment Platform results (details p. 18)
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Activities/topics |
Expected outcome |
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Making knowledge available about how treatment systems and rehabilitation services are organised across Europe |
Improved knowledge on treatment systems taking into account national and cultural specificities. |
2 Publication on treatment systems in 22 European countries, P-PG-TT (2009) 1 |
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Identifying procedures and actors establishing and implementing treatment guidelines in Europe |
Variations in the establishment and use of treatment guidelines are analysed; Experience on effective preparation and use of guidelines is made available. |
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To improve knowledge on best practices on how to target specific patient groups |
a. Treatment targeting women (e.g. pregnant alcohol and drug users, drug users who care for children) b. Treatment targeting cocaine and other stimulants users c. Semi-coerced treatment/compulsory treatment |
x not selected as priority þ 2010 Conference þ by the Criminal Justice Platform |
: Abstracts and selected conference presentations available on PG website |
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Other possible topics for consideration |
a. e-treatment (use of modern communication technologies in treatment) b. recent findings in biomedical research in relation to treatment |
x not selected as priority x not selected as priority |
Ü Criminal Justice Platform results (details p. 22)
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Activities/topics |
Expected outcome |
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Conference on diversion schemes and other alternatives to imprisonment |
Exchange best practices and getting acquainted with the process of introducing such models into national policies- examination of preconditions for the implementation of QCT on a national level and ways to evaluate these programmes |
þ Participation in joint PF meeting |
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Trafficking in drug precursors and medical products |
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Joint investigation teams |
x not selected as priority |
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Cooperation between judiciary and law enforcement agencies |
Ö topic changed to: Preventing chemical precursor diversion þConference on the backtracking investigations, evidence collection, sanction and prevention of drug precursor diversion þConference on the prevention of drug precursor diversion through efficient networking of agencies involved |
2 Conference conclusions 2 Conference conclusions |
Ü Research Platform results (details p. 25)
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Activities/topics |
Expected outcome |
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Coherence or different approaches between licit and illicit substances in prevention, law enforcement and treatment |
1. Better understanding of the implications of policy approaches differentiating between licit and illicit drugs 2. Exploring public perception and awareness of different responses |
þ 2 PF meetings |
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Identifying more effective responses to poly-drug use |
Identified specificities to deal with poly-drug use more effectively in demand reduction |
x not selected as priority |
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Monitoring developments in neuroscience, psychology and bio-medicine |
Signals on recent developments |
þ 5 PF meetings þ Participation in joint PF meeting |
2 Publication on signals from drug research |
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Interaction and communication between science and policy-making |
Improved communication channels and formats |
in 2007, 2008, 2009 |
2 Publication on Drugs and Society (with ESSD) 2007 2 Publication on Cannabis (with ESSD) 2008 2 Publication on old and new policies, theories, research methods and drug users (with ESSD) 2009 |
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On-line Register on who does what in drug research |
þ On-line register set up in consultation with EMCDDA in 2007 þ 624 researchers and 145 projects registered by July 2010 |
: European on-line Register on drug research |
Ü Ethics Platform results (details p. 27)
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Activities/topics |
Expected outcome |
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Ethics aspects in drug screening at work and at school |
Signals on ethics implications and proposals on how to address these. Technical report on drug screening at work and general opinion on both screening at school and at work |
1-2 Oct 07 |
2 Publication with expert Recommendations and opinion |
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Contributing to a PG sponsored CND resolution |
1.Giving guidance on ethics issues in the field of treatment 2.Preparing elements for draft resolution to be discussed by ethics platform by October and submitted to the Bureau for further steps |
þ 1 PF meeting Ö abandoned in favour of pursuing a feasibility study for a European framework convention Ethics PF decided to continue work on drug testing |
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Ethical aspects of research |
1. Giving guidance on ethical issues in the field of research and neurosciences 2. Organising a hearing of the Committee with experts and representatives of the other platforms concerned (research, prevention, treatment) |
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Consequences and ethical dilemma of new ‘drug-proofing’ methods like “vaccinations” against cocaine use |
Opinion on respect of ethical aspects in the implementation of new proofing and “vaccination” methods. Guidance to accompany future outcomes of current research |
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: Web Page and publications: report on free and informed consent |
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Ethical aspects of criminal justice systems and regulatory issues |
Guidance on ethics issues in regulations and new perspectives for sanctions. First step: participation of the ethics Platform in the October conference on alternative sanctions |
x = 2 meetings but could not be completed for lack of time |
Ü Airports Platform results (details p. 33)
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Activities/topics |
Expected outcome |
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Airports Group 2007 annual meeting |
þ 4 annual meetings þ 4 coordination meetings þ 4 preparatory meetings |
2 Updated General Aviation Directory of National Contact Office 2 Updated Inventory of Drug Control Official at European Airports 2 Reviews of Drug Seizures at European Airports |
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Airports Group 2008 annual meeting |
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Airports Group 2009 annual meeting |
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Airports Group 2010 annual meeting |
Ü Other PG activities (details p. 37)
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Activities/topics |
Expected outcome |
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Inter-agency group |
Coordination of work, overlaps avoided, synergies created |
þ 4 annual meetings þ cooperation in feasibility study on possible framework convention þ new MoU with EMCDDA |
No products foreseen |
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EXASS Net, details p.36 |
Facilitating exchange of experiences and assistance to stakeholders cooperating at frontline level responding to drug problems providing experience and assistance for inter-sectoral cooperation |
þ 7 Steering Group meetings held þ 7 EXASS Net meetings held þ evaluation of activities þ cooperation with EU-Correlation |
222 7 thematic reports : internet website set up : internet resource and download on safer night life : internet resource and download on user involvement |
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Pompidou Group Training Initiative 2010, details p.50 |
Linking policy, research and practice by providing a pilot training course for drug policy managers |
þ Needs assessment for training conducted þ Feasibility of training explored and new format developed þ 2 training modules (needs assessment and qualifying) implemented þ Pilot training evaluated and follow-up proposal prepared |
222 compiled training materials needs assessment seminar 222 compiled training materials qualifying seminar 2 Evaluation report with follow-up proposal |
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Mediterranean Network, details p.53 |
Dialogue between 12 Mediterranean countries through cooperation, exchange and capacity building |
þ 3 annual training programmes , study visits and surveys in treatment, research and law enforcement þ 5 annual meetings held þ Lebanon,Jordan,Egypt committed þ 4 fact finding missions þ 2009 High-level conference |
2 Feasibility study on a Mediterranean observatory on drugs and drug addiction 2 MedSPAD school report in Lebanon and in Morocco 2 3 publications on treatment of drug users, prevention projects and proceedings |
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European school surveys (ESPAD) (support for non-EU countries for project coordination), details p.55 |
Assistance in participating in coordination meetings to implement school surveys |
þ annual contribution to ESPAD þ participation in annual meeting |
2Acknowledgement in the ESPAD 2007 report 2Press communiqué for the international report |
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Health in prisons programme (HIPP) |
Contribution to the programme |
þ participation in 3 annual meetings |
No products foreseen |
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Technical cooperation school-based prevention Programmes |
Assistance rendered in implementing school programmes |
þ trainings and study visits conducted þ 130 multipliers trained þ agreement with local authorities to implement LS trainings þ replication programme with Ministry of the Interior started |
222 training materials |
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Technical cooperation on drugs and road safety |
Assistance rendered in implementing a national strategy |
x no voluntary contributions received |
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Training young researchers on qualitative drug research and on communicating findings to policy makers |
More training into qualitative research and better use of communication to develop evidence base in policy making |
þ courses conducted 2008 & 2009 þ 24 researchers trained |
No products foreseen |
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Implementation of National Action Plans for Azerbaijan and Georgia |
Assistance rendered in implementing National Action Plan |
x PG activities not included in action plan |
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Support Network for Parents and professionals |
On-line resources created |
x no voluntary contributions received |
Ü Prevention Platform
Executive summary
Involving target groups in prevention
· effective prevention programmes cannot be implemented without involvement of school, family and community and clear definition of responsibilities of all stakeholders,
· cultural differences must be taken into account when prevention programmes are developed,
· drug prevention activities work well when combined with activities that also tackle other social problems.
Youth participation
· active youth participation and involvement in drugs prevention is a reality across Europe and it should be at the heart of drug prevention policies.
· youth participation brings added value to efforts of governments and civil society to tackle drugs-related issues because: youth is an expert in the matters of its life; it helps to make interventions more relevant, timely, resourceful and attractive to the target groups, especially those difficult to reach.
· young people need to have access to a structured - but free of ideology and politics - leisure time which is offering them a large scope of activities and possibilities for their own development. Youth values creation of centres where it can engage in sports, culture, education and other areas where it can utilise its creative potential. These centres should be accessible, available and open to creative proposals from youth.
· to reach young people more effectively, more use should be made of the new technologies that young people themselves use for entertainment, information, communication, networking and friendship. Young people not only use new technology but are keenly involved in the development of new IT trends and capable of making innovative use of them.
· whether IT is used for good purposes or to assist in the dissemination of negative products or messages would depend on the level of interest governments and the civil society are ready to give to the development of young people's creative potential and therefore recognise their energy and their usefulness in drug policy development.
Prevention in recreational settings
· nightlife is an important part of the young people life and it is within this context when drugs, both legal and illegal, are abused more often.
· prevention efforts often concentrate on illegal drugs. However, most problems derive from the use of alcohol or the combination of alcohol with other drugs. Therefore, intervention should concentrate more on risky alcohol use,
· professionals and researchers should strive for innovative interventions and assessments that could be advantageous and practical for policy makers,
· there is a lack of evidence-based interventions across Europe. Some popular interventions, most of them backed by the industry, are not often the most effective, especially if they are not enforced.
· there should be, as in other sectors of prevention, a clear commitment to effective intervention. The highly frequent use of popular but ineffective interventions contributes more to the problem than to its solution, and only contributes to giving preventive efforts a bad reputation,
· more involvement of law enforcement is needed but it requires political and social support,
· community approaches are typical multi-component interventions. They tend to produce the largest and most significant effects. However, there are some issues to take into account: they can be expensive, they need political and society support and in the medium term there are often problems with compliance and sustainability,
· ‘classical’ measures –basically taxation, restriction of hours or days of sale, outlet density restrictions, sobriety checkpoints, reduced BAC limits, minimum legal purchasing age, administrative licence suspension and the like– are evidence-based and effective.
· evaluation and monitoring is an urgent need.
· new technologies open up many possibilities for interventions, such as video vigilance, ‘pub watching’, electronic age verification, or interlocks to prevent car driving by drunk drivers. But the Internet also offers possibilities for networking, information about risks, etc., that can be very useful for preventive interventions.
· it is important to focus particularly on cultural aspects.
Evaluation of prevention activities
· evaluation is essential, but is often difficult to undertake effectively
· policy makers often need quick answers; but evaluation often needs to take a long-term perspective; and in most cases this is not possible because of the constraints of short-term funding
· the evaluation of drug prevention should focus on:
· defining and promulgating quality standards for project and programmes and their implementation, and
· eliminating the programmes and practices that clearly do not work or make things worse
· different approaches to prevention require different approaches to the evaluation of prevention
· drug prevention requires a comprehensive and long-term view. Evaluation of drug prevention therefore needs also to take this perspective
· more synergy should be looked for in implementing and evaluating prevention – for example, with other social problems and risky behaviour
· communicating the complex and multifaceted picture of drug prevention to politicians, policy makers and citizens is a necessary and urgent task
· the international transferability of prevention activities is feasible and can be useful
Signals and results 2007-2010
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Involving young people in drug prevention 2 Report of the Prevention Platform Working Group meeting, Graz, Austria, 30-31 March 2007 P-PG-Prev (2007) 1 |
The conference on involving families in prevention was identified as a priority activity of the Prevention Platform for 2007 in the Working Programme 2007-2010. The working group to prepare the conference was organised with the participation of the Platform experts nominated by member States as well as consultants of the Pompidou Group.
The first meeting of the working group took place in Graz, Austria on 30-31 March 2007. In addition to preparing the prevention conference the working group was tasked by the Bureau of the Permanent Correspondents to consider priorities of the Prevention Platform work in 2007-2010 as well as to look at the concept and methods of the European Prevention Prize.
The working group suggested the following title for the conference: ‘’Families, lifestyles and drugs - reaching families in prevention’’.
The expected outcomes of the conference will include:
· recommendations on how to involve families in prevention activities
· suggestions for the pilot projects
· networking of prevention experts
Four working groups of the conference will consider such topics as: targeting vulnerable groups, universal prevention, working with migrant communities, 21st century lifestyles. The work of groups will be divided into 4 sessions to look at: current role family plays in prevention, different examples of prevention approaches, barriers and problems of involving families in prevention, cultural, social and economic context of prevention work, future intervention methods and techniques, social marketing and its applicability to drug prevention field.
The working group also identified priorities for the future Prevention Platform work in accordance with the Working Programme 2007-2010 of the Pompidou Group (P-PG MinConf (2006) 3). The priorities are:
· Involving families in prevention
· Evaluation of prevention activities
· New research findings and technological developments and their implication for prevention
In considering the concept and working methods of the European Prevention Prize the working group concluded that the Prize should be continued in its present form, participation in the prize should be extended to all Member States of the Council of Europe, the Jury should comprise 7 members and overall supervision of the Prize should be done by the Chair of the Prevention Platform.
Involving target groups in preventionConference on Families, lifestyles and drugs- reaching families in prevention, Conference, Porto, 19-20 November 2007 : Selected conference presentations available on PG website http://www.coe.int/t/dg3/pompidou/Files/porto_en.asp 2 Pilot projects descriptions P-PG Prev (2008) 3 |
Over 130 experts and professionals in drug prevention and social work from 22 countries have attended the conference on involving families in prevention hosted on 19-20 November 2007 by the Institute for Drugs and Drug Addiction of Portugal in Porto under the auspices of the Portuguese EU Presidency.
The conference titled "Families, lifestyles and drugs- reaching families in prevention" aimed at identifying barriers to successful involvement of families, providing insights into social and cultural context of involving families, developing new ways of prevention work, sharing practice and experience as well as proposing future actions. Conference participants were divided into 4 working groups: targeting vulnerable groups, universal prevention, working with migrant communities, and 21st century lifestyles.
Some conclusions of the groups are:
· effective prevention programmes cannot be implemented without involvement of school, family and community and clear definition of responsibilities of all stakeholders;
· dysfunctional families could be a victim of drug abuse as well as a cause of drug abuse and approaches to such families should vary accordingly;
· cultural differences must be taken into account when prevention programmes are developed, for example preventive interventions among migrant communities must be local and aim at specific target groups;
· new technologies provide promising ways of reaching wide audiences but should be used in combination with other preventive methods.
Participants of the conference were given an overview of the current practices in involving families in prevention, examples of prevention projects targeting vulnerable groups, suggestions on use of new technology in prevention as well as advises on evaluation of prevention interventions and use of social marketing techniques health issues campaigns. The proceedings of the conference will be available in February 2008. As an outcome of the conference, the Prevention Platform of the Pompidou Group will consider two pilot projects: television format that communicates drug prevention messages; range of prevention activities that could be delivered to families in leisure theme parks.
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Evaluation of prevention activities 2 Evaluation of prevention activities, P-PG-Prev (2010) 5 Prevention in recreational settings |
The Prevention Platform working group meeting addressed the work of the Prevention Platform in 2009-2010 and preparation for the autumn 2010 Ministerial Conference.
It was agreed that two publications would be produced to be ready to be launched at the autumn 2010 Ministerial Conference. The Working Group formed of the members of the Prevention Platform and experts of the Pompidou Group will develop the publications in close co-operation with the Prevention Platform as follows:
• a handbook for municipalities and localities that dealt with an influx of tourists and therefore might have to deal with problems related to the misuse of alcohol and illicit drugs.
• an evaluation guide to assist policy makers in deciding what prevention initiatives to support.
It was agreed to hold an extended Prevention Platform meeting spring 2010. The meeting will discuss drafts of the above publications with special emphasis on good practices in evaluation of prevention activities.
At the invitation of the Austrian Ministry of Health the meeting took place in Vienna on 9-10 July 2009 with the aim to develop frameworks for the publications on evaluation of prevention activities and prevention interventions in recreational settings. The special focus of the meeting was on evaluation of prevention activities.
Some conclusions on the barriers and limitations of evaluation:
· Prevention and evaluation terminology is vague
· Scientific evidence of what works in prevention is limited
· Prevention interventions are not adequately evaluated
· Economic, technical and epistemological limitations exist in tackling promising research questions
· Despite the lack of common terminology and standards in evaluation it remains a necessary and important element of any prevention intervention,
· There is a certain tendency among practitioner and policy makers to think that “everything must be evaluated, if something was evaluated- it is proved to be good”,
· Evaluation has its limitations, some things could not be evaluated
In order to improve evaluation of prevention interventions it is necessary to continue work undertaken in Europe in previous years. The results of this work are: Handbook on Prevention by the Pompidou Group, EMCDDA Prevention and Evaluation Resources Kit as well as EDDRA Data-Base, COST-A6 programme publications on evaluation of primary prevention.
Evaluation should become more of a tool to make practical improvements to interventions rather than a tool to convince policy makers to fund certain interventions.
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Evaluation of prevention activities Extended Platform meeting on evaluation of drug prevention: from dogma to useful tool, Prague, Czech Republic, 30-31 March 2010 2 Report of the Extended meeting of the Prevention Platform, P-PG-Prev (2010) 5 : Selected presentations on http://www.coe.int/t/dg3/pompidou/Files/prague_en.asp |
At the invitation of the Czech Republic’s Government Council for Drug Policy Co-ordination the extended meeting of the Prevention Platform took place in Lichtenstein Palace, Prague on 30-31 March 2010. The meeting was attended by over 70 participants from 17 member States of the Pompidou Group as well as from the EMCDDA and Mentor Foundation International.
In a combination of plenary sessions and workshop groups the participants discussed limitations and possibilities of the evaluation of drug prevention, as well as shared their experiences and established professional contacts.
The findings of the meeting are the following:
· Evaluation is essential, but is often difficult to undertake effectively
· Policy makers often need quick answers; but evaluation often needs to take a long-term perspective; and in most cases this is not possible because of the constraints of short-term funding
· The evaluation of drug prevention should focus on:
o defining and promulgating quality standards for project and programmes and their implementation, and
o eliminating the programmes and practices that clearly do not work or make things worse
The signals and recommendations of the meeting:
· Different approaches to prevention require different approaches to the evaluation of prevention
· Drug prevention requires a comprehensive and long-term view. Evaluation of drug prevention therefore also needs to take this perspective
· More synergy should be looked for in implementing and evaluating prevention – for example, with other social problems and risky behaviour
· Communicating the complex and multifaceted picture of drug prevention to politicians, policy makers and citizens is a necessary and urgent task
· The international transferability of prevention activities is feasible and can be useful
It was noted that:
· The EMCDDA ‘Best Practice Portal’ is a source of sound examples of good practice
· The EU-funded ‘European Drug Prevention Quality Standards’ project will shortly be reporting
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Youth participation 2 Concept Outline “European-Mediterranean Youth Forum on Drugs Prevention” - Involving Youth in Drugs Prevention, P-PG-Prev (2009) 7 |
Based on the success of the European Consultative Forums in Ekaterinburg (2004) and Vilnius (2006) the Pompidou Group wants to promote young people involvement in the development and implementation of the comprehensive drug policies in Europe.
The present paper proposes the organisation of the European-Mediterranean Youth Forum on Drugs Prevention. The idea is to contribute to the discussions of the Pompidou Group on integrated policy on psychoactive substance. The event would gather young people from Europe and the Mediterranean Region who will exchange their views on drugs policies and who will be expected to prepare their input to the development of European drug policies and propose ways to implement them.
Through the combination of the plenary sessions and workshops the participants of the Forum will seek to:
· promote youth participation in drugs policies,
· contribute to the development of evidence-based programmes which are concerned with the healthy lifestyles and the well-being of young people,
· bridge policies, research and practice in drugs prevention,
· have a strong Eastern European and Mediterranean dimension through the participation of young professionals and youth representatives from these regions,
· promote intercultural dialogue and learning from different cultures.
It is expected that the Forum will be attended by:
· young people involved in organisations which are directly concerned with the promotion of healthy lifestyles and well-being of youth, including representatives of projects awarded with the European Drug Prevention Prize in 2004-2010,
· young professionals (researchers, practitioners and policy makers) from social, public health, law enforcement and educational fields, which are directly involved in drugs prevention,
· representatives of youth councils of national and regional/municipal level.
The participants will be able to interact with the Ministerial Conference of the Pompidou Group on several occasions including:
· the presentation of the outcomes of the Forum (opportunity to identify issues not adequately covered by existing drugs policies and suggest concrete ideas for future programmes), and
· the participation in the awards ceremony of European Drug Prevention Prize (demonstration of youth’s active role in drugs programmes).
The Forum will be run by a steering group with representatives from the Pompidou Group, Youth Sector and NGOs. This group will seek resources from the CoE funds as well as from the private funds and sponsors. The sustainability of the Forum’s outcomes will be provided through the networks of the Pompidou Group and the Youth Sector which will monitor the mainstreaming of youth involvement in drugs policies
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European Prevention Prize 2008 3 awards presented on the occasion of the PG Mid-term Conference European Prevention Prize 2010 3 awards presented on the occasion of the PG Ministerial Conference All information about the Prize, procedures and winners in 2008 and 2010 on: : http://www.coe.int/t/dg3/pompidou/Initiatives/PreventionPrize/default_en.asp |
Concept and aims
Since 2004, the Pompidou Group is awarding every two years its European Drug Prevention Prize to innovative projects which are led by young people for young people. Each prize-winner each receives a trophy, a diploma and a monetary benefit which amounts 5000 Euros.
The main objective of this prize is to recognize the importance of active youth participation in creating a better and healthier environment for all communities in Europe. A jury of young people, assisted by a group of three experts, sets the rules and procedures, examines the applications submitted and selects the prizewinners.
The European Drug Prevention Prize is therefore unique as it is a prize awarded by young people to young people:
· it rewards young people’s direct involvement in drug prevention from the setting up to the running of the project;
· the independent jury consists of young people who autonomously examine the project applications and decide upon winning projects.
Moreover, the prize promotes the advantages of youth participation in the drug prevention through:
· allowing young people to have a say in a programme or endeavour, and thus providing them with an incentive to continue this expression rather than drift towards negative ventures;
· allowing young people to take responsibility for themselves, for their peers, for their families and for others;
· bringing new perspectives and insights to drug prevention which draw upon young people’s expertise on their own social and cultural conditions;
· contesting negative stereotypes that categorise young people as lazy and indifferent to issues that concern them.
During the PG’s Work Programme 2007-2010, the European Drug Prevention Prize was awarded twice, in 2008 and 2010.
Events awards & results 2008 & 2010
In 2008, the European Drug Prevention Prize was awarded on the occasion of the Mid-term Conference on 26 November 2008 in Warsaw. Three projects from Bulgaria, Greece and the Netherlands were awarded the Prize.
In 2010, during the 15th Ministerial Conference of the Pompidou Group, three new projects will be rewarded with the Prize. Further developments have occurred in this period of time:
· a specific webpage containing all related information (prize-winners 2004, 2006, 2008, video of the Award ceremony in 2008, documentation and statistics);
· for the first time, the Prize 2010 was opened to all 47 Council of Europe member states;
· for the first time, the jury also shortlisted a number of projects they considered to be of high standard and as such deserve formal recognition.
It is also to be noted that the number of applications for the Prize 2010 has considerably increased (more than doubled). The Secretariat received 80 applications from 25 countries, when there were 34 applications in 2008, 31 in 2006 and 44 in 2004. This improvement could be attributed to the enhanced advertisement campaign made on the Prize, using the appropriate networks of stakeholders and technological tools (electronic newsletter, face book, YouTube, etc.).
Ü Treatment Platform
Executive summary
Treatment systems
As part of the activities of the Treatment Platform for the year 2008 a study has been implemented to derive what treatment options are available in the member countries of the Pompidou Group. In all, 22 countries, that is Belgium, Bulgaria, Croatia, Cyprus, Denmark, France, Germany, Hungary, Ireland, Italy, Luxembourg, the Netherlands, Norway, Poland, Portugal, Republic of Lithuania, Russian Federation, Slovak Republic, Slovenia, Sweden, Switzerland and the United Kingdom have submitted a synopsis of the treatment options available based on the following framework;
· A short statement on the context of the country, related to size and population;
· A short statement on the epidemiology of drug use, mortality and HIV/Hepatitis;
· A short history of drug treatment with a focus on changes in recent years;
· An outline of the organization of the treatment services;
· A description of the services on offer;
· A short resume of the special issues related to the country of concern;
· A short outline of the strengths and weaknesses of the services on offer;
· References.
Guidelines and recommendations in drug treatment
The Pompidou Group in cooperation with the Cyprus Anti-drugs Council held a conference on Guidelines and Recommendations in Drug Treatment in Nicosia, Cyprus on 11-13 May 2009. Over 100 participants from 21 European countries tried to tackle the issue of how to bridge the gap between clinical practice and evidence-based practice in drug treatment. The conference offered direct insights in to how guidelines and recommendations on drugs treatment are developed and implemented in Europe. The following are the findings of the conference.
Long term funding of national systems of patient registration (who are the clients to be treated?), monitoring (what kind of treatments are actually used?) and drug research (e.g. experiments on effectiveness of treatment interventions in national contexts) are necessary conditions for guidelines and knowledge-based choices.
Guidelines are costly and need long-term funding arrangements in order to enable to fulfil their function properly.
Funding rules/regulations may increase the rate of acceptance of implementation. For instance, creating (by legal arrangements and funding) systems of monitoring, benchmarking and/or performance indicators the behaviours/choices of decision makers and professionals in drug treatment may be redirected. This should be done after persuasive activities that should alter perceptions of what kind of drug treatment is "good enough" for the clients. Persuasion can also be facilitated by increased international contacts ("hearing other songs") between management and between professionals in drug treatment. These contacts should be actively stimulated.
Application of evidence-based treatment modalities should be legal or legalized.
Treatment of stimulants users
The conference on treatment of the stimulants users was held in Strasbourg on 10-12 May 2010 at the initiative of the Norwegian Directorate of Health, and it was attended by over 70 policy makers, experts on treatment and representatives of international organisations and NGOs from 20 countries of Europe.
The use of stimulant drugs is increasing and the types of stimulants circulating among the European population seem to be more differentiated than before. This results in problems for prevention, treatment and harm reduction. This conference tried to summarise important developments, problems and answers with an emphasis on treatment
Signals and results 2007-2010
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Treatment systems 2 Publication on overview of treatment systems, P-PG -TT (2009) 1 |
This publication contains the overview of the Treatment Systems of 22 member countries in the Pompidou Group, namely Belgium, Bulgaria, Croatia, Cyprus, Denmark, France, Germany, Hungary, Ireland, Italy, Luxembourg, Netherlands, Norway, Poland, Portugal, Republic of Lithuania, Russian Federation, Slovak Republic, Slovenia, Sweden, Switzerland and United Kingdom.
The background for the Treatment System Publication is the 2007-2010 Work Programme of The Pompidou Group which was adopted at the Ministerial Conference in Strasbourg in November 2006. The Work Programme states that one of the topics for the Treatment Platform should be “Improving knowledge on treatment systems”. At the first meeting of the new Treatment Platform in Oslo in June 2007 the platform members decided to prepare a publication on the Treatment Systems in the Pompidou Group member States. The purpose was to make knowledge available about how treatment systems are organised in the different countries to facilitate bi- and multilateral cooperation and research.
With the help of the Platform Members a “framework” was constructed, describing which parts the report from each country should comprise. The request for the descriptions from each member states was sent out through the Permanent Correspondents and finally descriptions were received from 22 member States. Professor Richard Muscat from Malta, the coordinator of the Pompidou Group Research Platform, took on the task to review the descriptions and has written an introductory chapter summing up some trends in the reports and grouping countries from different parts of Europe.
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Treatment Guidelines Conference on guidelines and recommendations in drug treatment – Bridging the gap between clinical practice and evidence-based practice”, Nicosia, Cyprus, 11-13 May 2009 2 Conference report, P-PG -TT (2009) 8 : Selected conference presentations available on PG website |
Principal observations:
· Drug treatment in European countries is still to a large extent based on tradition, belief, hope and interests of others than drug users;
· Principles of knowledge-based medicine are useful for drug treatment as in any other parts of medicine;
· Principles of knowledge-based medicine are basic for developing guidelines;
· Results of registration systems and drug research are necessary conditions for guidelines and knowledge-based work;
· Guideline development is a long-term process, requiring inputs from many kinds of expertise;
· Application of evidence-based treatment modalities should be legal or legalized.
The following paradoxes must be kept in mind in developing guidelines in drugs treatment:
Paradox I
People with drug addiction are very diverse and are often suffering from many conditions – medical, psychological and social - requiring multiple interventions simultaneously over a long period of RCT and similar effect study designs are generally considered most suitable for studying the effect of simple and relatively brief interventions on clearly defined populations.
Paradox II
Most of the evidence base for substitution treatment concerns the pharmacological part of the treatment. Most treatment for drug abuse also comprises psychosocial interventions.
Paradox III
· “Good” science rarely considers context. All human action is linked to certain contextual conditions.
· Long term funding of national systems of patient registration (who are the clients to be treated?), monitoring (what kind of treatments are actually used?) and drug research (e.g. experiments on effectiveness of treatment interventions in national contexts) are necessary conditions for guidelines and knowledge-based choices
· Guidelines are costly and need long-term funding arrangements in order to enable to fulfil their function properly
· Funding rules/regulations may increase the rate of acceptance of implementation of guidelines. For instance, creating (by legal arrangements and funding) systems of monitoring, benchmarking and/or performance indicators the behaviours/choices of decision makers and professionals in drug treatment may be redirected. This should be done after persuasive activities that should alter perceptions of what kind of drug treatment is "good enough" for the clients. Persuasion can also be facilitated by increased international contacts ("hearing other songs") between management and between professionals in drug treatment. These contacts should be actively stimulated.
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Treatment of stimulants users Conference on stimulant abuse treatment, Strasbourg, France, 10 – 12 May 2010 2 Conference report, P-PG -TT (2010) 4 : Selected conference presentations available on PG website |
Principal conclusions
· Increasing numbers of different stimulant drugs with partly known or unknown properties make monitoring and early warning important
· Information and education of target groups on stimulant drugs should be prioritized (treatment professionals, public employees, users)
· Stimulant use is vastly differentiated (e.g. in terms of the patterns of use, the situation/context of stimulant use, co-use of other substances, co-morbid mental disorders, and consequences of use)
· Basic research has improved our understanding about addiction considerably and further basic research is important for improving pharmacological treatment options
· Knowledge on effective pharmacological interventions is still insufficient
· Combination of pharmacological interventions with psychosocial treatments is necessary for increasing effectiveness in the long run
· Immunization/vaccination options are still tested without convincing results
· Maintenance (or substitution) treatment programmes for opiate dependence should also include treatment of stimulant use due to poly-drug use phenomenon
· Harm reduction interventions/strategies that are offered separately are far less effective than an integral approach that offers all kinds of interventions
Ü Criminal Justice Platform
Executive summary
Having been asked to concentrate on legislative measures aiming at supply reduction, the experts of the Criminal Justice platform examined a range of studies undertaken on the efficiency of various systems of diversionary arrangements for drug dependent offenders, including the option of “quasi-coerced” treatment, as well as the functioning and results of drug treatment courts set up in a certain number of European countries or special drug treatment magistrates with the aim to find effective responses to penal policy problems such as drug-related recidivism or i.a. overpopulation in prisons. A survey was conducted on existing legal provisions and guidelines concerning “quasi-coerced” treatment possibilities for adult drug-dependent offenders. It suggests that there is still scope for developing and refining national guidance on “quasi-coerced” treatment, i.a. by including a greater focus on reintegration, monitoring and evaluation.
The following further crucial points for attention were identified: referral and assessment processes, the appropriateness of treatment options, the consistency of procedures and reviews as well as effective aftercare arrangements. High quality of treatment seems to be a precondition, either in special or in general facilities.
The platform also approached the subject of drug-related recidivism with a view to exploring possible standards for drug-related reconviction research. It investigated existing measures in different countries to measure recidivism rates with the aim to further consider the findings of criminological and qualitative approaches to this issue.
The need to focus – in the effort to prevent drug consumption - at the beginning of the drug production chain (“No narcotic drugs without chemicals”), which means legal chemical substances, in particular the substances contained in the lists I and II of the 1988 UN Convention Against Illicit Traffic in Narcotic Drugs and Psychotropic Substances needing pre-export-notification (PEN), has been recognised. The attention of law enforcement to prevent precursor diversion with a view to preventing production of synthetic and non-synthetic drugs has been increased. The interest in backtracking investigations has improved and should be further improved. In this perspective, information exchange between law enforcement and regulatory authorities could further be speeded up, cooperation improved, also through personal networks.
Signals and results 2007-2010
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Quasi-coerced treatment Conference on quasi-coerced treatment (QCT) and other alternatives to imprisonment, Bucharest 2007 2 Conference conclusions, P-PG-CJ (2007)19 2 Guidelines on the application of QCT, P-PG-CJ (2007)21 2 Findings from a survey conducted in PG member States, P-PG-CJ (2008) 15rev1 |
Alternatives to imprisonment from a global penal policy perspective – breaking the link between drug use and re-offending: quasi-coerced treatment and the prevention of recidivism
“Coerced” treatment can be effective in reducing substance use, the risk of re-offending behaviours, and in improving social integration. It can be as effective as voluntary treatment if received in the same treatment services or regular detention. It can be a viable alternative to imprisonment.
As concerns the implementation of QCT, the following factors were highlighted:
· the majority of participants consider treatment of drug users in general terms a better option than imprisonment even though the objectives of alternatives to sanctions and of treatment options need to be further clarified;
· the established political consensus concerning the need for alternatives to imprisonment encounters obstacles in its implementation into practice;
· the human right to health implies to be given access to treatment in order to quit a drug use habit;
· the comparison of the costs of imprisonment and of residential treatment must include collateral risks of imprisonment, e.g. risk of contamination or of starting drug use in prison;
· consequences of repeat offending by drug users are particularly “expensive” for the judicial system and the community as such;
· a comparison of treatment inside and outside prison and of residential and outpatient treatment is needed;
· in drug-free prison wings, drug testing is part of the pressure to abstain from use;
· there is no clear definition of “quasi-coerced treatment”, of the delinquent behaviours that could be referred to treatment, and of the court reaction needed when treatment fails;
· after almost twenty years of diversion programmes, the main focus today is the quality of aftercare; in particular in the light of the fact that many drug addicts also suffer from severe mental health problems;
· there is a need for the setting-up of networks of QCT resource persons and to engage in training activities.
As concerns national guidance for the implementation of QCT measures, the conducted survey concluded:
· the development of national QCT guidelines from the mid-1990s onwards reflects a desire to refine processes, procedures, cooperation and outcomes relating to drug-dependent offenders;
· the roles and responsibilities between central government, regional authorities and local municipalities for the implementation and delivery of guidance on QCT systems is a complex one in some countries, less so in others;
· legislation and guidance in many countries is frequently being adapted, refined and developed in response to new knowledge, changing circumstances and shifting priorities;
· the most common principles addressed by legislation included targeting and eligibility criteria, the use of compliance monitoring/judicial review, client rights, funding, programme objectives and treatment philosophy;
· guidance was aimed at a range of both criminal justice and health professionals and addressed QCT measures at different stages of the criminal justice process;
· more knowledge on QCT practices and principles, drawing on the considerable experiences accumulated in the 11 European countries with specific national guidelines on QCT measures could be shared.
With regard to recidivism:
· a correlation between heavy drug use and prolific commission of acquisitive crime seems established pointing to a need to get drug users into treatment through the criminal justice system;
· the relationship between drug and crime should be better understood including is links to QCT and to alternatives to imprisonment in general;
· it is important to explore existing data on drug-related recidivism before devising further activities on the subject;
· it is important to investigate the existing measure in different countries to measure recidivism rates;
· findings of criminological and qualitative approaches should also be considered.
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Prevention of precursors diversion Conference on the backtracking investigations, evidence collection, sanction and prevention of drug precursor diversion, Bucharest, 2009 2 Conference conclusions, P-PG-CJ (2009) 2 rev1 Conference on the prevention of drug precursor diversion through efficient networking of agencies involved, Strasbourg, 2010 2 Conference conclusions, P-PG-Precursors (2010) 3 |
Promoting the prevention of drug precursors’ diversion through intensified cooperation among relevant national and international agencies and improved investigative tools
The Criminal Justice platform examined existing national legislation in the precursor area, licensing practices and the main mechanisms provided for inter-agency co-operation. The practice concerning markers in precursors was also discussed. The platform established a need for specific activities in the area of precursors, looking thoroughly into different co-operation methods among involved law enforcement and regulatory agencies as well as prosecutors and judges and representatives of the chemical industry. These activities acknowledged by the Permanent Correspondents led to the following results:
· there is a logical need to focus at the beginning of the drug production chain and investigate the diversion of legal chemical substances used for drug production;
· the efforts made by the chemical industry as a key player to develop precursor control in a balanced approach (identification of suspicious transactions) and in partnership with governments have to be continued and supported;
· information exchange between law enforcement and regulatory authorities as well as between specialised prosecutors/magistrates and law enforcement agencies has to be speeded up;
· further intelligence exchange and risk assessment by customs services is needed as diversion often occurs in remote links of the trading chain;
· there is an increased attention of law enforcement to combat precursor diversion used in the production of synthetic and non-synthetic drugs;
· the interest of law enforcement in backtracking investigations and other investigative and monitoring tools has improved and should be further improved;
· the following challenges have to be confronted in the near future: verification of end–use-declarations, increased use of yet non-controlled substances, trade by internet;
· in the view of the need to intensify international cooperation, the proposal to hold annual meetings on precursor matters was warmly welcome.
Ü Research Platform
Executive summary
The research platform’s mission is to support better the use of research evidence in policy and practice thus facilitating the development of evidence-based policy. The platform undertook its mission by looking at the interaction between science, policy and practice by initiating the following activities:
· Collating the signals from the psychological, sociological and biomedical field
· Examining the interaction between the different research disciplines involved in drug addiction
· Examining the shift from a policy on illegal drugs to a policy on psychoactive substances
· Improving the access to information and knowledge
· Improving the communication on research findings
Signals and results 2007-2010
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Monitoring developments in neuroscience, psychology and bio-medicine 2 ISBN Publication “From a policy on illegal drugs to a policy on psychoactive substances” an overview on the situation in 17 different European countries Interaction and communication between science and policy-making 2 ISBN Publication on “Signals from drug research” 2 ISBN Publication on Drugs and Society (with ESSD) 2007 2 ISBN Publication on old and new policies, theories, research methods and drug users (with ESSD) 2009 Who does what in drug research in Europe? : European on-line Register on drug research: www.pgregister.coe.int/pompidou |
By exploring these different topics through exchanging of experience and discussion, the research platform reached the following outcomes:
Collating the signals from the psychological, sociological and biomedical field
The signals from the psychological field showed that in the past ten years, the concept of addictive personality has been largely rejected and that a number of personality traits commonly observed in drug abusers do not express inevitably pathological processes. The research concluded that behavioural disinhibition is actually the most important personality dimension related to drug abuse. Disinhibitory personality traits not only have been well validated as predictors of substance use, but are also related to an earlier age of onset, poly-drug use, chronic/heavy use, conduct and antisocial personality disorders, substance dependence severity, HIV risk behaviours, psychiatric symptoms. Sensation seeking and impulsivity, appear to be the personality traits that better predict drug use patterns. Impulsivity has been defined as a tendency to make rapid behavioural changes regardless of negative consequences or the loss of a postponed reward of greater intensity. Sensation seeking has been defined as a personality trait characterized by the tendency to seek out varied and novel sensations and experiences.
Therefore, bringing together researchers in education sciences and psychology researchers to work on educational models was recognised as a good methodology.
The recent signals from the biomedical field show that psychiatric disorders are inextricably linked with substance abuse, with the psychiatric disorder occurring first. Consequently, substance abuse does not arise as a result of lifestyle but may be attributed, most likely, to the presence of anxiety and, to a lesser extent, depression.
Examining the interaction between the different research disciplines involved in drug addiction
Cohort, longitudinal studies seemed crucial and would help interaction between the different disciplines. They are lacking because they cost money.
It emerged that inter-disciplinarity is difficult to promote unless calls for tender include the need for teams from different disciplines to get together to reply to a common theme by drafting a project that includes the means through which the theme may be addressed.
Evolving from a policy on illegal drugs to a policy on psychoactive substances
This review among 17 countries shows that policy is influenced by proximal factors: civil society, science and practice and distal factors: political ideology and ideology, theory and experiment and outcomes and evidence-based. It also shows that science per se plays a minor role in the decision-making process. Since the research platform aims at the support of evidence-based policy, three issues need to be addressed: coordination of research efforts, the access to information (this is done partly through the research register), the communication of findings to policy makers and the public at large (this is also done partly through the intensive summer school on qualitative research).
The follow-up project is “what is the background for an integrated policy on psychoactive substances versus a single drug policy in Europe: a multiple case-study in seven countries”: It contains a literature review on integrated versus single drug policy and an empirical pilot survey on integrated versus single drug policy. It aims at finding the definition and the organization of an integrated policy and will look at the countries which have implemented an integrated drug policy to see which results they have achieved.
Improving access to information
At the Conference on “linking research, policy and practice, lessons learned, challenges ahead in 2004, the lack of exchange of information and knowledge on drug research was identified as a major deficiency. Therefore, the research register was launched on the PG internet site in 2007. Now, 624 persons have registered and information on 145 research projects have been entered.
Communication of findings
Intensive training course on qualitative drug research: The aim of this course is to enable young researchers to expand their knowledge concerning qualitative drug research and provide them with some proficiency in communicating research findings to agencies and policy makers. The courses took place in Amsterdam in August 2008 and 2009 and were organised by the European Society on Social Drug Research ESSD. (More information is available under the section devoted to ESSD Summer course in this document.
Executive Summary
The goal of the Platform on Ethical Issues and Professional Standards is to lead discussion and give opinions on ethical and professional issues in specific drug and drug-abuse related areas.
Since its establishment the Platform has dealt in particular with ethical problems connected with drug testing in schools and the workplace and the ethical issues raised by research on addiction.
Signals and results 2007-2010
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Ethical aspects of research 2 Opinion on ethical questions raised by immunotherapy of addiction - The example of the "vaccine" against cocaine, P-PG-Ethics (2010) 6 rev 2 The ethical issues raised by "vaccination" against certain drugs - Summary of the Committee's reflections (Appendix 1), P-PG-Ethics (2009) 2 rev2 2 Ethical questions relating to immunotherapy for addictions: analysis of a selection of articles published in the European general press (Appendix 2), P-PG-Ethics (2010) 9 2 Informed and conscious consent in medical research involving drug dependent persons and drug users - ethical challenges (Appendix 3), P-PG-Ethics (2009) 15 rev2 |
Publications
In September 2008, the Platform published an opinion on drug testing at school and in the workplace and all of the reports produced in connection with its work, particularly a survey of the situation in European schools and a comparative study of Europe’s relevant national legislation.
All of the Platform’s publications and reports can now be consulted on the Pompidou Group website at www.coe.int/pompidou.
Drug testing at school and in the workplace
Drug testing has been a subject of debate for several years in many European countries, some of which are contemplating launching campaigns in schools and workplaces. The recurrence of these discussions and the importance of the question, especially in terms of choice, freedom and safety, prompted the Platform to look at the matter in more detail.
After presenting an initial review of its work at the Ministerial Conference in November 2006, it adopted an opinion in March 2008 and presented its conclusions to the Permanent Correspondents of the Pompidou Group a month later.
Introduction
The Platform has considered the case for instituting policies on testing, their ethical implications and their possible outcomes or benefits by way of prevention and treatment. It has drawn on the international conventions safeguarding human rights, studied relevant national legislation and practice, scrutinised the market for sale of screening tests via the Internet, looked into the educational role of schools and workers’ rights and responsibilities and established an ethical framework for its work.
Drug testing in schools
There is no proof that testing has any preventive or deterrent function and the experts have stressed that testing does not shield a young person from being caught up, at some point in time, in a situation of psychoactive substance abuse. They have also expressed concern about the risk of stigmatisation and exclusion to which pupils who test positive may be exposed. They point out that schools and teachers are there to educate children not to police them. The Platform considers therefore that the precautionary principle is not a sufficient argument to warrant the infringement of pupils’ privacy and the school’s true function that drug testing would represent.
Drug testing in the workplace
The Platform considers that testing may be tantamount to an invasion of the worker’s privacy, even though the danger – to the worker personally and to co-workers – of being under the influence of a psychoactive substance could possibly warrant such testing. It recommends that states should adopt common standards to define occupations at risk and legislate on the independence and professional secrecy of occupational medicine.
Testing on recruitment
The Platform points out that international conventions recognise each person’s right to work in principle and prohibit discriminatory recruitment.It highlights the risk of stigmatisation and points out that unemployment can be one of the factors that triggers problematic consumption. The Platform considers that drug testing on recruitment cannot be justified by the precautionary principle as it would relate to the potential incapacity of employees to do their job although it poses no threat to their own health or that of other people.
In all the situations, the Platform stresses how unreliable the tests are and how difficult it is for a non-professional to interpret them.It also notes that while the market in tests freely sold on the Internet is thriving and profitable, it has also contributed to advances in means of concealing substances’ effects.
In conclusion, the Ethics and Professional Standards Platform considers drug testing to be acceptable only where it is conducted by health professionals bound by confidentiality requirements who wish to refine their diagnosis or if it is performed in response to a request from a law enforcement or judicial body in the precise framework of what is authorised by law. All other testing procedures in schools or the workplace pose an ethical problem from the viewpoint of international, universal and absolute rights.
The role of insurance companies
The Platform has also studied the legislation, regulations and practices adopted in the member states with regard to testing by insurance companies.In the ten countries which have supplied information there are major differences in the measures to protect fundamental rights in the light of insurance companies’ legitimate interests, and shortcomings in the regulation and supervision of these companies’ practices.
The Platform submits that it would be a good idea for these practices to be harmonised at European level so that a proper balance can be struck between the need for insurance companies to collect relevant information and the need to promote social cohesion.
This work on insurance has resulted in an addendum to the opinion on testing, which was adopted in March 2008.
The ethical issues connected with research
Since 2008, the Platform has also been considering the ethical issues connected with research on addiction and drugs. In October 2008 it held a round table discussion on the subject, attended by representatives of other platforms and external experts. As a result of the discussion, it was possible to identify the main categories of specific ethic problems, which have served as a basis for the Platform’s work in this area since.
More specifically, it has looked into questions of choice and consent and, lastly, the emblematic issue of immunotherapy for addiction (or “vaccines” against certain drugs, particularly cocaine).
This work has enabled it to contemplate the use that is made of research findings, the risks of simplification or manipulation, the legitimacy of choices and the specific requirements that need to be met and balances that need to be struck in this field.
Choice – a key issue in drugs policy
Choice is a key issue for decisions related to drugs policies, operations and research. When framing drug policies, there is a whole range of legislative, social and educational choices that have to be made when deciding about the type and diversity of laws and measures to be imposed on, or made available to, any given group of people.
In all such decisions, the ethical principles of respect for the person, beneficence for the individual and society and justice must be taken into consideration
At the same time, different intervention levels and personal options also involve varying degrees of choice. This applies to professionals, who base many of their decisions on scientific data, individuals, whose first choice is to take or not to take drugs or to stop taking them, and to drug addicts, who make choices about their consumption levels, whether to seek care or treatment and whether to take part in research.
Work on this subject began in early 2009 and as the issues are so fundamental and complex, it was not possible to complete it before the ministerial conference. The Platform has suggested to the Pompidou Group that this work should continue under the new programme for 2011 to 2014.
Informed and conscious consent in medical research
Informed, conscious and free consent is the main guarantee of a patient’s rights and a protection against arbitrary and possibly harmful medical treatment or other activities. It is important for all subjects of medical research, but especially important for people who are dependant on various substances and whose level of consciousness and ability to make a free choice is often very limited.
The work on this issue was linked to the work on “vaccines” and will appear as an appendix to the publication on the subject.
Ethical questions raised by immunotherapy for addiction – the example of ocaine “vaccine”
The Platform considers that the prospect of “vaccines” for addictions to some substances raises fundamental issues, which call for some thought about human rights and ethics, particularly as these “vaccines” will have the power to interfere with the preferences of individuals and affect their physical and psychological state. Furthermore, the rapid developments that may take place will prompt industrial lobbying and require politicians to take crucial decisions.
The Platform’s work in this area is intended to make it possible to discuss and come to conclusions about the issues before any decisions are taken on them, and, when that time comes, to provide the authorities with reliable information and considered opinions which help them to make the right choices.
Ethical issues
Immunological treatments or “vaccines” are designed to alter human beings’ receptiveness to given substances, especially cocaine and nicotine and, in some cases, amphetamines and heroin. Work in this area began in 1992 and has expanded considerably in recent years. Clinical trials have been conducted in the United States and several European countries to assess the tolerance and the effectiveness of future “vaccines” but the most recent findings have not yet been published. The research work has generated enormous interest though.
The Ethics and Professional Standards Platform considers that the anticipated availability of drug “vaccines” opens up interesting prospects in terms of treatment but the implications have not yet been sufficiently investigated and weighed up. The use of the word “vaccine” is unfortunate and leads to misunderstandings about the mechanisms involved and to unfounded expectations. The Platform warns against the temptation of giving simple or simplistic answers to complex questions and points out that all use of such “vaccines” should in any case take full account of the psychological and social background of the persons concerned.
The impact on addicts
The administration of immunological treatment raises questions both about the effect that it will have and the circumstances in which it is administered, including questions of consent and the legitimacy of possibly coercing persons into treatment.
The Platforms points out that the greatest possible care should be taken to ensure that the privacy and freedom of persons being treated are respected as they are likely to be subjected to considerable pressure from bodies such as judicial authorities to accept the administration of a “vaccine”.
Considering that “vaccines” will not directly reduce the user’s craving for a drug such as cocaine, the experts believe that users may increase their consumption so as to counteract the effect of the antibodies generated by the “vaccine” or use other stimulants or alcohol instead. They also point out that, even if a person manages to stop taking any form of stimulant, this does not necessarily remedy the underlying personal problems which may be the cause of their drug use. Particular attention must therefore be paid to the impact of the potential alteration of the psychological state of people treated through the regular administration of a “vaccine”.
The impact on other stakeholders
The development of these treatments generates expectations and reactions among various other members of society, which are disseminated in particular by the media. They affect the general public (who see the hope of a “cure”), the manufacturers of “vaccines” (who see a lucrative market), the authorities (who see a means of eliminating the need for other activities) and research workers (who see the promise of fame or funding). The attitudes and actions of these social categories should therefore be carefully scrutinised to ensure that they do not use “vaccines” as a way of promoting their own interests under the guise of helping people or promoting the public interest.
Conclusion
If “vaccines” have a role to play in treating drug abuse, it has not yet been fully defined. And if such a role were to be established, its use would have to be subject to the same ethical principles which underlie individual autonomy, showing due regard for the fundamental rights enshrined in international treaties.
As to preventive treatment, the Platform does not see any justification for this, and considers that it should not be considered under any circumstances.
Consequently, it calls for immunotherapy treatments for addictions to be treated with the utmost caution and warns against exaggerated expectations and possible side effects. It considers that if “vaccines” were put on the market, very strict application frameworks would have to be set up to avert the risk of misuses.
The Platform’s Opinion, a summary of its ideas, a press survey and the report on free and informed consent were published in October 2010. These can all be consulted on the Pompidou Group website at www.coe.int/pompidou.
Quasi-coerced treatment
At the request of the Criminal Justice Platform, the Platform looked into the specific issues raised by quasi-coerced treatment. Following an initial discussion at the Cavtat Round Table in October 2008 and the participation of its rapporteur in a meeting of the Criminal Justice Platform in September 2009, the Ethics Platform drew up a list of questions raised and began drafting some replies, as well as establishing the overall ethical framework for its discussion.
The work started, but not completed, before the ministerial conference could also be continued under the new work programme.
Executive Summary
The Co-operation Group of Drug Control Services at European Airports is a well-established forum for the exchange of practical information on concealment and detection techniques and operational practice among control officers working in European international airports. They meet annually in a plenary session. A coordination body meets once a year, exchanging information on relevant activities of other international agencies in the field, in particular those linked to programmes of the European Union.
On the basis of a regular review of drug seizures made by customs and police authorities at European airports, the Group analysis new developments in trafficking trends and modi operandi, thereby deepening the level of co-operation among drug control services. In 2009, the Group also undertook joint control operations, one with regard to heroin trafficking from Afghanistan, one concerning trafficking of drugs to and from Dubai.
On the basis of the established fact, that airport employees play a role as facilitators to drug trafficking crime, the Group looked for modalities to address this type of criminality through a harmonised, international, multi-agency approach. The Group explored national initiatives taken with a view to staying in control of the airport crime risk, which include new forms of cooperation with authorised private companies represented at the airports.
In the issue of drug trafficking risks through general aviation, the Group continued its awareness rising role.
The Group identified the need for a systematic application of profiling of passengers on regular and low-cost flights and of air cargo. This target would be helped by the following:
· legal access to data from air companies;
· the collection of representative data;
· the rapid exchange of data between different services responsible for drug trafficking.
The Group explored possibilities to facilitate controlled deliveries with regard to their legal framework and operational implementation, in case of need also by using the assistance offered by EUROJUST.
The Group compared ‘modi operandi’ between trafficking of human beings, money laundering and trafficking in drugs and drug precursors from a multidisciplinary perspective (police, customs, border guards) with the objective to identify criminal organisations involved in trafficking and to share relevant knowledge and experience with other sectors of the Council of Europe as well as international organisations involved (UNODC, Interpol, Europol and the WCO).
The Group highlighted the need to focus – in the fight to prevent drug consumption - at the beginning of the drug production chain (“No narcotic drugs without chemicals”) and trade in legal chemical substances. It recognised the need to promote increased cooperation among relevant agencies on a national and on an international level with the aim to prevent drug precursor diversion.
Signals and results 2007-2010
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Annual Meetings of the Airports Group 2 Annual meeting report 2007, P-PG-Airports (2007) 4 fin 2 Annual meeting report 2008, P-PG-Airports (2008) 8 2 Annual meeting report 2009, P-PG-Airports (2009) 14 2 Annual meeting report 2010, P-PG-Airports (2010) 11 |
Review of drug seizures in Europe
In 2006 the members of the Airports Group carried out 5,419 drug seizures in air traffic or mail, accounting for 31,349 kg. The figures remained stable compared with 2005. Cocaine was still the most seized type of drug, but there has been an increase in heroin seizures. The largest number of seizures was made in mail consignments, while the largest quantities were seized in baggage and on the person.
The 100 % checks in the Netherlands have proved successful and cocaine seizures in that country have decreased since this approach was implemented. As in 2005, Spain seized the largest quantity of cocaine. For cocaine, the most frequently used concealment method was “in baggage”, and the quantity of cocaine seized even increased. In more than a third of cases the cocaine was hidden in the structure of the baggage.
In 2007, here was a slight decrease in the number of seizures as well as the quantity seized for several types of drug. Major, single seizures influenced the statistics from one year to the next. Mail consignments continue to be used for drug smuggling despite a drop in the smuggled amounts. The largest quantities of drugs were seized using the concealment method in baggage.
Afghanistan appeared again in the statistics of 2007 as departure country for heroin going to European airports. In 2008, the number of seizures and quantities for heroin rose again. Most heroin seizures were made in the United Kingd om and there was an increase in the number of seizures and the quantities seized. The largest amounts of heroin were seized in baggage, while most seizures were made in mail consignments. Heroin was not often concealed in personal effects. There was a decrease in the number of cases where heroin was smuggled on the body. Heroin was most frequently smuggled from Pakistan to the United Kingdom, with regard to the quantity seized Turkey-United Kingdom was on top.
Between 2007 and 2009, seizures of ecstasy continued to decrease. The Netherlands was the country issuing the most reports. Belgium reported the largest quantity owing to a large seizure.
In 2008, the number of seizures of hashish more than doubled compared to the previous year. The quantity increased by 61 %. The most frequent concealment methods for hashish were baggage and mail. Hashish transported by air is mainly smuggled from South Africa and India. Findings with regard to marihuana are to a large extent influenced by the high level of reports issued by the United Kingdom. African countries were well represented as source countries.
Access to Personal Name Register data, profiling and rapid exchange of information
The Airports Group repeatedly recognised the need for an information exchange system on seizures made providing equal access for all law enforcement agencies. The representative of RILO explained the non-operational functioning of the CEN information network and underlined its restricted access; open only to customs authorities, according to standard rules. Changes in the access rights can only be decided by the appropriate body of the World Customs Organisation.
The Airports Group acknowledged that in the combat against illegal drug trafficking successful profiling methods require easy access to relevant data and rapid exchange of information.
In this respect, a Belgian proposal of a common international information exchange system for operational purposes with a view to improving data collection, data comparability and data analysis for strategic, operational and tactical purposes, was examined between 2004 and 2007. Meanwhile, the system has been implemented by all police units at EU-borders in Belgium (see, air and railroad). A consensus on the extension of the implementation of the proposed system to other Airports Group members could however not be established. The coordination committee had therefore recommended keeping the item on the agenda only as a point of information.
As concerns the European Council initiative for a Framework Decision on the use of Personal Name Register data for law enforcement purposes, the Airports Group holds that PNR data of passengers should also be accessible for intra-European flights (not only extra-European flights) as these flights are also used in the illegal trafficking of drugs. It also considers that the definition of "organised crime» should cover illegal trafficking in drugs which also constitutes a form of organised crime.
As concerns law enforcement agencies with direct access rights to personal name registers, the Airports Group considers that customs services fighting organised crime should be among the authorised agencies to access PNR data with a view to insuring effective risk assessment. Furthermore, the Airports Group thinks that PNR data should be accessible for authorised agencies on-line via the airline passenger reservation system. Data sharing among national central agencies (PIUs) should be made feasible.
Concerned to avoid overlap, the Airports Group identified a need to further explore technical and political pre-conditions for setting up a common international database and information exchange system of this kind, with the participation of representatives of RILO WE, WCO and INTERPOL.
Organised crime across European airports
The Airports Group continued its work on airports crime on the basis of the results of Project Horizontal in the framework of which the term of airport crime was elaborated and defined. The recommendations made concerned:
· possible weaknesses in the baggage regulations;
· the elaboration of training tools for staff concerned;
· identification of persons with access to restricted areas with a lifestyle incompatible with their income declared for tax purposes, including businesses, staff and income, addresses and type of residence, assets and liabilities, cars, boats, recoveries;
· identification of best practices in the field of preventive measures against airport crime.
The Airports Group studied best practices in the prevention of airports crime and compared modi operandi used by different criminal organisations involved at chosen European Airports and underlined the urgent need to establish a multi-agency approach involving new forms of cooperation with the private companies operating at the airports.
With regard to money laundering, the Airports Group examined systems introduced with regard to suspect cash flows travelling the opposite direction to the drug trafficking routes and a number of indicators to identify suspect persons. Often, the concealment methods used underline the suspect origin of the money. In order to make drug trafficking economically less attractive, the suspect cash flows have to be intercepted and appropriate investigation methods developed.
As regards trafficking in human beings, the Group looked into modi operandi used by trafficking organisations which may be comparable to those used for trafficking in drugs with a view to identifying the organisations involved.
Chemical profiling of drugs and drug precursors, backtracking investigations, preparation of criminal charges and seizure made
The Airports Group examined chemical profiling concepts used in a certain number of countries and methodologies used for profiling and evidence collection as well as the integration of relevant and comparable data into a database accessible to the law-enforcement system.
The Group also looked into results and seizures made during national operations in the area of precursor trafficking to South America and Africa and into the investigation methods used, mainly via the tool of controlled deliveries.
The Group decided to ask RILO to include in a separate chapter drug precursors in the annual analysis of drug seizures made.
In general terms, the Group took note of the increased attention of law enforcement to prevent precursor diversion with a view to preventing production of synthetic and non-synthetic drugs.
The Group became aware that closer cooperation links between law enforcement, magistrates, regulatory authorities and the private sector are needed.
Regular review of tools
Passenger Control Handbook
2 P-PG- AIRPORTS (2004) - which has been made available on the restricted website
Handbook on carrying out checks on general aviation
2 P-PG- AIRPORTS (2003) – which has been made available on the restricted website
The Airports Group successfully updated the elaborated tools. Relevant information was transmitted by member States on:
Directory of Drug Control officials at European airports (“Airports brochure”)
2 P-PG- AIRPORTS (2008)1
2 P-PG- AIRPORTS (2009)9
Directory of National Contact officers in General Aviation (“General aviation brochure”)
2 P-PG- AIRPORTS (2008) 7
2 P-PG- AIRPORTS (2009)1
Ü EXASS Net
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EXASS Net The European network of partnerships between stakeholders at frontline level responding to drug problems providing experience and assistance for inter-sectoral cooperation |
Executive summary
As a follow-up the an initiative of the 2006 Finnish EU Presidency EXASS Net was set up by the PG in 2007 to create a link between existing inter-agency partnerships bringing together different stakeholders such as institutions, municipalities, service providers, NGOs and individuals to help respond to drug-related problems more effectively.
The overall aim of the Network is to facilitate the exchange of knowledge and experiences about what is happening at frontline level in individual countries and promote good practice; in particular understanding failures and misconceptions, identifying barriers to cooperation and facilitating know-how transfer and mutual support.
Expected and achieved results 2007 - 2010:
Ø Network set-up and running (2007) - achieved
Ø Regular Network meetings held (from 2007) – 7 full and 7 Steering Group meetings were held
Ø Analytical report on the functioning of partnerships (2008)
Ø Training materials prepared (2008 - 2009) – changed to thematic background documents
Ø Training course organized (2009) – priority was given to field visits across participating countries
Ø Process evaluation carried out (2010) – achieved and in addition initial impact assessed
Ø Innovative means of communication (2010) – inter-active website since 2008
Evaluation conclusions
EXASS Net has created added value by having had an impact in the sphere of work of the participants. The following is a list of examples where EXASS Net activities inspired participants to concrete action in their work context:
· Review/revision of activity or programme
· Initiating a new activity or programme
· Providing input for policy development
· Help to resolve problems
· Staff motivation
· Input for development of work plan
The main conclusion after for years of EXASS Net that can be drawn is that practice connected cooperation between stakeholder and consequent action coupled with political commitment can increase policy impact significantly.
The main effect for the policy level (added value of EXASS) is that EXASS Net was capable of effectively linking policy management and practice, as the above examples show. This is a contribution to increase the efficacy/effectiveness of policy implementation.
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Responding to drug-related health problems Constituting meeting of EXASS Net, Helsinki, Finland, 26-27 April 2007 at the invitation of the Finnish Ministry of Social Affairs and Health 2 Report of the 1st EXASS Net meeting, P-PG-Coop (2007) 3 |
Developing practical tools for effective cooperation
Based on existing experience it is useful to identify a standard checklist for the planning, implementation, monitoring and evaluation of partnership structures.
Such a checklist would include the following components:
In order to facilitate the better performance and management of partnerships some useful keywords and concepts to consider include:
Location/ Duration/ Background/ Pilot of the action/ Key partners/ Key objectives/ Activities/
Budget/ Significant impact/ Elements of success/ Obstacles, inadequacies/Perspectives/
Further information
Creating direct links between participating partnerships to obtain and render mutual assistance: the issue of communication
The development of practical means of communication between partnerships in order to exchange ideas and good practice is essential. The development of website linkages can be useful in this respect. However, the need for appropriate translation is a challenge which must be addressed. A number of important points arose in discussion in relation to communication:
· Technology has an important role to play
· It is possible to develop links between websites but the issue of translation arises
· Problems require simple, practical answers
· Translation can be provided in informal ways
· Partnerships should consider the role undergraduates could perform in adapting programmes
· Partnerships should consider the available languages which already exist within their membership
· Consideration should also be given to developing links to ‘free translation services’
Monitoring and evaluation
A number of difficulties arise in attempting to evaluate partnerships. In the health context there are some critical indicators such as infection or death. However, it is difficult to compare with the situation ten years previously. In some countries (Frankfurt-Germany) there are monitoring systems in existence for injecting facilities.
It is necessary to be realistic about evaluation. Although evaluation is important, it can never be perfect. It was also suggested that there was a need for a standardization of evaluation tools. Partnerships can be evaluated in a number of ways – through financial management or the evaluation of treatment outcomes for example. A further observation on this theme pointed to the way in which partnership structures can become burdened with bureaucracy through the need to produce plans, recording processes and similar paperwork.
Leadership in partnership
Differences in leadership can also have an impact on the success of partnership structures. In some countries it can be a government department or a mayor. A common finding was that leadership is lacking, or where a power vacuum is created, the police tend to step in and drive the partnership. Finally, it was noted that sometimes services must be imposed in certain areas, but in such circumstances active and visible leadership is required.
Managing resistance to harm reduction responses
A common finding from different partnerships is the way in which negative media publicity or local public reaction can undermine the establishment of local harm reduction initiatives. The ‘Not In My BackYard’ (NIMBY) phenomenon appears to be commonly encountered. A number of different approaches have been adopted. These include the following:
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Drug and Alcohol Action Teams and continuity of care 2nd EXASS Net meeting, Preston, United Kingdom, 22 – 24 October 2007 at the invitation of the Lancashire Drug and Alcohol Team (LDAAT) 2 Report of the 2nd EXASS Net meeting, doc ref: report 2nd EXASS Preston |
Background
The West Lancashire Multi-Agency Problem Solving Team, established in 2003, is a successful frontline multi-agency partnership. Such an approach is not a common feature of the operational response to drug problems in many parts of Europe. The difficulty of information sharing between different agencies, in particular the relationship between health/social care and criminal justice partners, has been resolved by a series of protocols and regular updating of these. The effective results are an example that organisational priorities can co-exist in a partnership model.
Observations on:
Partnership approaches
Equally the ability and policy of police to exercise discretion when tackling drug users was a crucial element in making the model in Lancashire operational on a constructive partnership approach. The police have offender management units and differentiate in their approach to offenders depending on the seriousness of the offence and the particular offender, adopting an enforcement, rehabilitative or multi-sectoral approach/response depending on the circumstances.
Co-location is a further essential element of effective multi-agency working. Having people working in one office is very important since it reduces delays in communication, decision-making and services delivery. It also helps to break down cultural barriers between agencies and enhances the development of information-sharing protocols.
It is also important to establish partnership approaches in an appropriate framework legislation to help overcome barriers resulting from different professional approaches and sometimes competing professional objectives or priorities.
Building systems of communication between partnerships
An important issue in relation to the development of partnership structures and processes relates to the issue of communication. The simplest solution is often to use already established, easy and common systems like a web site supplemented by a discussion forum, e-mail list, SMS-list etc in a combination that is deemed possible and feasible for partners needs. However, this requires a critical mass in order to be cost-effective and functional. Further IT solutions can include:
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Tackling open drug scenes 3rd EXASS Net meeting, Frankfurt/Main, Germany, 26 – 28 May 2008 at the invitation of the City of Frankfurt’s Department for Drugs 2 Report of the 3rd EXASS Net meeting, doc ref: report 3Rd EXASS Fra PDF |
Background
Frankfurt faced an open drug scene in a city park and around the main railway station during the late 80s and early 90s that was of a dimension without precedent: at an average 700 and up to 1000 injecting drug users were present on this scene day and night. Zurich and Frankfurt were the most affected cities in Europe by the number of injecting drug users in open drug scenes. Intensified repression and policing of the situation led to an on-going displacement of the scene which finally ended up in the gardens of the well to do districts of the City.
There were nearly 6000 registered drug users (being recorded by the law enforcement agencies) at the time with a dark field estimated 3 or four times as high. Throughout the period of intensified law enforcement, the number of registered drug users increased as did drug related crimes, in particular property offences. Annual drug-related deaths reached nearly 150 per year in this time.
On the political level, Frankfurt’s bid for the seat of the European Central Bank (ECB), the presence of the open drug scene directly in front of all major banks, as well as the occurrence of the drug scene in gardens and green spaces of the inner city, are seen as key factors for bringing about change towards more innovative drugs policies. However, on the level of concerned stakeholders at frontline level (law enforcement, judiciary, social and health services etc.) it was the sheer dimension of the phenomenon that led to a new, innovative and concerted effort.
The ‘Monday Round’ of decision makers in key positions of the above mentioned stakeholder agencies, as well as the ‘Friday Round’ bringing together professionals working at frontline level were the informal institutions that created the cooperation in partnership and moved this forward over the past 15 years.
The four pillar concept: (1) prevention, (2) treatment, (3) securing survival + harm reduction, and (4) repression and law enforcement, developed by this inter-agency partnership of stakeholder agencies, is still in place today. The number of registered drug users has been reduced by over 30 % and drug related crime is equally down by significant numbers as statistics show. Drug-related medical emergencies are down from an average of 60 per day to approx. 12 per week. And above all, the number of drug-related deaths p.a. fell from 147 (1991) to 24 (2005).
A variety of low threshold services are established in various parts of town, dealing with different types of drug use and associated health and social problems. There is virtually no more visible open drug scene in Frankfurt. The passage from the railway station to the city centre has become safe again and the park in the banking district is clean and frequented by families and children again. Today’s main concern of public nuisance in the park is fast bicycle riders.
Observations
The programmes and interventions developed under the four pillar approach 15 years ago are still functional today with little modifications. Changes in drug cultures, consumption patterns, like poly-drug use etc. were successfully addressed by the existing approach. Flexible responses are ensured through specific projects in which different frontline services and professionals regularly engage. Professionals and other drug workers delivering frontline services show a continued high level of motivation. These factors, together with the statistical indicators on drug use and crime, suggest that the approach and the applied low-threshold services have worked and are still working. This is further corroborated by the fact that the concept has not been dropped by any city government during the last 15 years despite various changes across the political spectrum.
Approaches that push or force drug users into services and treatment had not worked in Frankfurt. It appears to be a key strength that the post 1992 approach seeks to facilitate an infrastructure of services and interventions that allow drug users to manage themselves. This infrastructure provides various entry ways into stabilisation, maintenance, treatment and eventually abstinence. It allows the drug user to be channelled into a passageway of life situation improvement based on his readiness to do so. The system also provides for the most problematic groups of chaotic drug users who have multiple therapy failures and suffer from HIV/AIDS, hepatitis etc., by providing a heroin medication programme.
A high degree of discipline among drug users was observed when visiting different projects and low threshold services around town. Most professionals working with drug users attributed that to the fact that (1) rules are clear and simple, (2) not too many rules, (3) sanctions are not unreasonable, (4) in the event of failure there is a path to return. Above all, drug workers concluded that it was the concept of voluntary participation and the fact that the services offered a true improvement for the life situation of the drug users led to an overall more disciplined behaviour. Drug users feel that the services offer them something they need and want; consequently they are willing to accept the conditions, even if it is sometimes hard for them to comply with them.
For the short term future the Drugs Department of the City of Frankfurt looks to a further consolidation of available services for drug users. One of the priorities is to increase the availability of heroin treatment following the successful trial phase. In the medium term different types of services will require further adaptation to evolving consumption patterns and drug scenes/cultures. Several practitioners expressed concern about the growing number of refugees with drug use related problems. This target group is often difficult to reach with the existing capacities and competences of staff. In addition a high level of reluctance to accept formal help, including emergency interventions, is observed among this target group. Based on a deeply rooted general fear of official organisations help offered is frequently initially rejected.
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Inter-agency cooperation on national level 4th EXASS Net meeting, Moscow, Russian Federation, 30 – 31 October 2008, at the invitation of the Federal Drugs Control Service of the Russian Federation (FDCS) 2 Report of the 4th EXASS Net meeting, P-PG-Coop (2008) 10 |
Background
The Federal Drugs Control Service of the Russian Federation (FDCS) is tasked to coordinate and implement comprehensive measures in combating illicit drugs and trafficking on the levels of demand and supply reduction. It is staffed with 40.000 professionals working throughout the Russian Federation, who are organised in different departments dealing with operational, conceptual and coordination tasks. The FDCS was created by presidential decree; it has executive powers and reports directly to the President of the Russian Federation. It coordinates relevant activities between federal government authorities and exercises an implementation and coordinating function at regional level throughout its branch offices. In addition the FDCS is the interface for international cooperation with the Russian Federation in the field of illegal drugs.
Activities
The programme included visits to different institutions at federal and municipal level on the 1st day of the two-day meeting.
Treatments offered at federal level were presented at the hospital of the National Research Centre on Addictions where discussions with the head doctors on access to treatment, treatment approaches, through-care treatment and case follow-up were held. A tour of the hospital wards gave an opportunity for brief exchanges with staff.
At the level of local authorities the Moscow Scientific and Practical Centre on Addictions was visited. The Centre provides emergency care, in-patient treatment and out-patient rehabilitation services. A comprehensive treatment and care approach merges a variety of physiotherapeutic measures with counselling and a variety of technical interventions (electrically induced sleep, hydro-thermal treatment etc.).
The Moscow State Technical University presented its contributions to health-protection and drug abuse prevention strategies. A new drug testing device based on the bio-resonance method with the capability of demonstrating the previous use of a variety .of psychotropic substances, including alcohol and nicotine, was demonstrated. One of the acclaimed features was said to include the capability of tracing substance use over more than the previous two months.
The second day of the meeting was dedicated to presentations by different government bodies (FDCS, Ministry of the Interior, Education Ministry, National Research Centre, Federal Service for the Execution of Prison Sentences etc.) on the approaches to dealing with the different dimensions of drug related problems. These included presentations on:
Ø Measures and practical results of activities in the framework of the anti-drugs strategy of the Russian Federation;
Ø Epidemiological data on substance addiction;
Ø Organisation of treatment services in the penitentiary system;
Ø Tendencies in prevalence rates in the Russian Federation
Ø The role of law enforcement in tackling and combating narcotic drugs use
Inter-agency co-operation by the FDCS in organising and implementing modern methods and forms of drugs prevention and social rehabilitation was outlined, as were the main prevention activities and strategies employed in the educational sphere.
An overview of the Pompidou Group’s work, including presentations of the Pompidou Group’s Life Skills Training Programmes, and the Pompidou Group’s work on telematix was followed by presentations on the work and objectives of the European Forum for Urban Safety /Democracy, the Cities & Drugs Network (DC&D), and the Correlation Network.
Observations
The centralised coordination at federal level of all demand and supply reduction policies creates a uniform and interventional approach for the whole country. A uniform national anti-narcotics policy is implemented at regional level by operative units and through branch offices with executive powers whose task it is to ensure that local and regional authorities comply with the national action plan and its implementation.
The combination of physical therapy orientated elements and psychological counselling approaches are a core element of the treatment and rehabilitation programmes which were demonstrated in the clinic and centre which we visited. This approach apparently allows patients to be stabilised and enter a period of abstinence that can last several months while in institutional care.
Experimental therapies recently developed in Russia, such as the transmodulation therapy, are not seen as relevant and suitable treatment methods and are not further pursued by the medical establishment.
Substitution treatment is illegal under present Russian legislation except for experimental pilot projects on a small scale that are scientifically approved, controlled and supervised. There was no information available whether such a project had been implemented or planned so far. Practitioners stressed the point that substitution treatment could easily be misunderstood by practitioners as a quick-fix therapy and thus lead to the effect of massive over-prescribing coupled with a lack of necessary accompanying psycho therapy.
It became apparent that patients with alcohol problems are treated in the same clinics together with those suffering from the addiction of illegal drugs. In this sense it appears to be a concept that allows for a poly-drug use approach in treatment, as far as cases of alcoholism and opiate addiction are concerned. Information on how addictions of prescription drugs, performance enhancing drugs etc. are concerned was not available since they were not treated in the institutions visited.
Patients often tend to relapse in situations after they have left in-patient treatment and returned to their native environment, particularly when this is at a significant distance away. Similar corroborating experiences were reported from the penitentiary system where patients had abstained often 3 – 6 years and then relapsed shortly after release.
In general the concept of through-care is mainly based on the availability of medical information exchanged by involved treatment institutions. An adequate follow-up treatment or through-care cannot always be ensured since there is no obligation by the patient to follow up the treatment after release from hospital or prison. In addition the transfer of case related information between professionals is facing its limitations.
Community-based care facilities like the municipal centre of the city of Moscow can better integrate patients after in-patients therapy into subsequent out-patients follow-up programmes because of community proximity and the availability of out-patients and in-patients services under one roof.
Religion is seen as a protective factor in dealing with drug addiction and is consequently incorporated into integrated treatment approaches as for example applied in the Moscow municipal centre.
While the treatment in the centres visited in Moscow is free of charge, this might not be possible to ensure throughout all regions and municipalities. This is taken into account by offering care to all people irrespective of their regional origin. However vast geographical distances make it difficult for many problematic drug users, in particular those most in need and at the same time being at great risk to themselves and communities, to seek help.
At the same moment the centre regularly has significant vacancies despite admissions and treatment being free of charge, including all drugs (equally retro-viral drugs needed by HIV/AIDS infected patients). Professionals attribute this to the registration system which can trace the fact that an individual has received treatment. It was said that this inhibits many people in need of help, and again in particular those in most need of help, to seek the assistance offered.
Private clinics offering therapy to patients are said to have greatly reduced in numbers. Allegedly these were mainly profit driven and not focused on therapeutic results. In addition professionals felt that the people in the Russian Federation have more confidence in the state and its services and by tradition are more suspect of privately offered alternatives.
Relations with NGOs were of no significant relevance to the professionals encountered during the visits, nor do NGOs appear to play a significant role in the overall stakeholder cooperation at federal level facilitated by the FDCS. One possible explanation was the fear of organisation trying to promote (safe) drug use and actively lobbying for harm reduction methods which are presently illegal in the Russian Federation.
Drug testing in schools, university and the army were explained to form the main basis for specific primary and secondary drug prevention. It was said to be a medium-term goal to introduce drug testing in schools and universities on a broad scale. Experiences with drug testing of army recruits had apparently delivered results that were encouraging to justify an expansion of this method. However it remained open under what conditions drug tests are conducted and what the consequences for positive testing students or those who refuse to be tested were. In addition there was no information as to who had access to the test results and how they could be further used or transferred.
Campaigns on the negative effects of drugs and demonstrations of law enforcement capacities continue to be seen as the principle method for general primary prevention. While an additional emphasis has been put into promoting healthy life-styles campaigns which focus only on illegal substances.
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Youth drug cultures, party drugs and club scenes 5th EXASS Net meeting, Budapest, Hungary, 4 -6 May 2009 at the invitation of the Hungarian Ministry of Social Affairs and Labour 2 Report of the 5th EXASS Net meeting, P-PG-Coop (2009) 9 2 Background document on safer nightlife, P-PG–Coop (2009) 4 |
Background
Illegal drug use is a relatively new phenomenon in Hungary. Under the communist regime drug problems constituted a taboo. Sociology, psychiatry and psychology had been prohibited disciplines since the 1970s and consequently no proper addiction or substance abuse treatment was available nor was research undertaken in this field for over 30 years. Public debate on issues related to illegal drugs was prohibited until 1985. The problem of illegal substance use was seen as being endemic of western societies.
Until the end 80’s drug use in Hungary was limited to smaller groups and was characterized by the use of inhalants, home made opioids (poppy-tea, poppy cutting) and codeine (both combined with glutethimide), antiparkinsonic medicine (Parkan), benzodiazepines (also combined with alcohol). Cannabis, LSD, amphetamines, ecstasy, cocaine, heroin were hardly available in the country. This was mainly attributed to the closed and tightly controlled borders. However there were widespread and long existing problems with alcohol abuse and addiction prescription drugs.
After the communist dictatorship the aim was to create a humane drugs policy.
Since the early 1990s the epidemiological indicators for Hungary show significant quantitative and qualitative changes in the use of drugs: all indicators – direct and indirect - show a growing prevalence of drug use. Cannabis, LSD, cocaine and heroin became available from the early 90s, amphetamines and especially ecstasy a since the mid 90s. An increasing number of new opiate users tend to start their career immediately with heroin.
The percentage of intravenous users among opiate users in treatment is above 90%. Despite the high rate of intravenous drug users the level of HIV/AIDS infections among this group remains unusually low with only 12 people in treatment having tested HIV positive between 1985 and 2003. As concerns Hepatitis C infections it is estimated that between 10 and 30% of IV drug users are infected, however no reliable data is available at the moment.
The comparison of the life time prevalence of drug use in Budapest at parties with the general population shows that it is much higher among the party-goers. On this phenomenon a mainly social/recreational pattern of use is observed.
The political response to drug related problems is built around an approach where the government takes the lead in a coordination and initiation role. This approach is trying to encompass all stakeholders, including users and groups critical of interdiction policies. Policy implementation is coordinated by local multi-sectoral and pluridisciplinary action teams. The main features of this policy approach include:
In developing strategies to deal with party drugs the Department for the National Co-ordination of Drug Affairs has taken the initiative to bring together the key stakeholders to develop future action on risk reduction and safer events.
Despite the existing services and programmes there is a broad consensus among professionals that the approaches and methodologies applied go in the right direction; however the level of services and availability is not seen as meeting the existing demand and requires further extension.
Services visited
During the meeting a number of services were visited by the participants.
Blue Point - Café Kontakt is a low-threshold drop-in centre that runs outreach work, provides for a needle exchange, counselling and referral. It is located in the 8th district of Budapest which is known to be a poor urban area with the ensuing social problems. Most of the drug users in this district making use of the service are of Roma origin (90%). Among them are 80% men and 20% women. In general their health status is poor since they are by large highly suspicious of any institutional service or care and consequently health problems remain often untreated. Recently amphetamine use is on the rise, particularly among sex workers, while opiate use is decreasing. Over the last year 2/3 of new clients were injecting amphetamines. Most clients stay mainly within their family contexts which is typical among Roma. For the strong family ties and suspicion of public services the number of those willing to undergo residential therapy is low. The users’ age ranges from 16 year to years 50.
The Café has 15 staff of which 10 are paid employees and 5 are volunteers. The staff is recruited mainly from among social workers. Volunteers are mainly sociology and social work students. No former users are in the team. It was so far not possible find a social worker with Roma background for the team. The annual budget of the Café is € 120.000 which is used half/half for staff costs and operations/materials. The staff has developed and uses an impressive mapping tool for the district incorporating the use of GOOGLE EARTH. In 2008 104.000 syringes were distributed of which 50% were returned.
The Hungarian Baptist Aid homeless shelter for drug users is another low-threshold service that offers accommodation. The concept of the shelter is developed around rights for users rather than rules. It is very much focusing on the needs and dignity of the clients. Drug and alcohol use are prohibited in the shelter, smoking is allowed outside. There is no fixed time limit for the stay of a client rather his/her personal needs determine the length of stay. The shelter also accepts people who have accommodation but cannot stay there for different reasons (abuse, violence in the family).
The shelter is in existence for over 8 years and is financed mainly by the Hungarian Baptist Aid, an accredited charity in Hungary. Besides the shelter a mobile needle exchange service is run by the organisation, a crisis car is provided to pick up people in the streets, in particular during cold nights and winter. The shelter is open to its clients all day. There is a policy of turning no one away who is seeking accommodation. So far there have been no problems with capacities in this respect.
The operations are based on an outreach concept that aims to establish initial contact and trust with homeless drug users. From there on clients can progress into detoxification, treatment and subsequently rehabilitation. The shelter provides initial counselling and is connected to treatment services, as well as to a therapeutic community outside Budapest where clients can be referred to who feel ready to go down this path.
The out patient centre at Nyírő Gyula Hospital provides substitution treatment and other medical services, including abstinence therapy, to drug users since 1987. The hospital is located in an urban area and firmly embedded in the local community, which is seen as essential by the staff in order to ensure accessibility and therapeutic success. Besides the treatment of drug users, the hospital facilitates a self help group for parents and family members of drug users. HIV and Hepatitis testing is voluntary among patients but encouraged.
Presently 252 patients are on the hospital’s substitution programme of whom 210 receive Methadone and 42 Suboxone. The medical staff considers Suboxone more effective than Methadone, however the cost being 10 times higher prohibits a more wide prescription of this medication. The effectiveness of the substitution programme has been scientifically researched and assessed between 2002 and 2005. The results show that the patients’ overall health status was significantly improved and many were able either to stay in their work or actually find new employment again.
There are 450 places available for substitution treatment in all of Budapest while the number of estimated IV drug users is 4.000 – 5.000 (for all of Hungary the estimate is 8.000 – 10.000). In many cases poly-drug use is observed. Substitution therapy is often supplemented by the patients through a use of alcohol and benzodiazepine products. Roma among drug users are the most difficult target group to channel into treatment while being by far the largest user group. This is seen by professionals in the hospital as one of the key challenges to be met in the future. Here also a trend change towards amphetamine use and away from opiate use is observed.
KEFs are local drug action coordination groups that are organised on the level of city districts and municipalities (outside Budapest). KEFs are the frontline level coordination groups that bring together all stakeholders relevant to implementing drugs policies and related programmes/services. Members can be all those who have a legitimate interest or work related to drugs and/or drug problems.
KEFS are not legal entities with formal authority but constitute rather the combined professional experience and expertise of all those involved which give the KEFs a standing of high authority. The role of the KEFs is primarily to translate national action to the local level, taking into account local needs and specificities. In this role the KEFs are the key advisors to local authorities on how to target services and deploy resources in effectively implementing national drug policies.
While the concept has proven to be feasible and viable there remains to be some uncertainty as to the specific role of the KEF, as well as what is expected of KEF members and what they can expect in return from the KEFs for their organisations.
Future projects: In a few months the first substitution programme will start in a Hungarian prison. A pilot project for the first consumption room in Hungary is being planned and expected to be implemented in 2010. Furthermore a first trial involving heroine prescription treatment is also planned to start next year.
Observations
The speed with which changes were implemented in Hungary since 1989 were seen as very impressive, given how long it took western European countries to bring about changes in their drugs policies. The aim to create a drugs policy with a humane approach was clearly visible in all presentations and projects visited.
Approaches, methodologies and actions all showed a sound intellectual rather than an ideological approach. Serious efforts are made in Hungary to verify the success of policies and intervention through research and development of an evidence base.
Participants were impressed with the capacity of stakeholders for networking and dialogue, as well as and their ability to resolve problems. A lot of good will across the board by all those involved in policy development and service delivery was observed including the ability to address issues from a pragmatic, professional level.
Active involvement of human rights advocacy organisations in the development and delivery of drugs policy are a unique approach that has not been observed to this extent anywhere else. This has demonstrated the capacity to have a high profile of human rights and civil liberties in drugs policy implementation.
Treatment programmes were seen as being particularly thoughtfully designed. Most services on all levels offer different treatment options that include harm reduction measures, substitution therapy, counselling as well as abstinence therapy, a combination that rarely exists to this extent in other countries.
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User involvement and dealing with cannabis consumption 6th EXASS Net meeting, Amsterdam, Netherlands,19 -21 October 2009 at the invitation of the De Regenboog Groep 2 Report of the 6th EXASS Net meeting, P-PG-coop (2010) 3 2 Background document on user involvement, P-PG-coop (2009) 8 |
Background
Problems of drug use in the Netherlands dramatically increased in the 1970s as large portions of the population began abusing opiates and other illegal substances. As the drug scene expanded areas of Amsterdam, concentrated around the now named Red Light district, became exclusive to the drug scene and were characterized by violence and crime. The large congregations of drug users, dealers and other criminals in the small streets of Amsterdam made it difficult for Dutch authorities to control and reduce drug use and crime. By the late 1970s, it was clear that a new approach was needed to deal with the escalating problems and amendments to the Dutch Narcotics Act were implemented in 1976.
The changes made to the Narcotics Act focused on a combination of demand reduction and harm reduction policies in hopes of solving the drug problem. The progressive approach of the Dutch policy has core features rooted in harm reduction and the minimization of the risks associated with using drugs rather than suppressing the usage of all drugs. On the demand side the Dutch policy emphasises compassion and treatment for those who use drugs. Yet it is strong on the supply side of the issue, making the trafficking of drugs a major priority for law enforcement and government officials.
What is unique about the Dutch policy is the role the government takes in preventing people from using drugs while at the same time providing treatment for those who develop drug problems. Prevention, out-patient care and residential care are all in the hands of experts who work within professional organisations aimed at reducing the health risks associated with drug use for the user and the general population.
Important aspects of the harm reduction strategy include programmes providing good medical care, methadone treatment, needle exchange systems and various kinds of day and night centres. The treatment given to drug users is not aimed exclusively at ensuring the abstinence of all drug users and the elimination of drug use, but rather it is intended to improve the medical condition of addicts and the way they function in society.
The harm reduction policy has been relatively successful and has helped limit the spread of the AIDS epidemic as well as reduced mortality rates among drug users. In recent years, the Netherlands has also seen significantly lower numbers of hard drug users than other Western European countries, notably France, Italy, Spain and the United Kingdom. These reduced numbers can be partially attributed to the harm reduction strategies and prevention policies enforced by Dutch authorities.
The objective in the Netherlands is to keep the use of dangerous drugs, as a health and social problem, under control by providing public information of the negative effects of drugs, including cannabis products. The toleration of soft drugs does not mean that the Netherlands has a more lenient attitude towards the use of soft drugs, but rather it is based on the consideration that tolerating the sale of soft drugs under clear conditions helps prevent the use of more dangerous drugs, and decreases the exposure of the criminal market associated with drug use.
In the Netherlands, just as elsewhere in the world, the purchase of hard drugs is illegal and the detection of criminal organisations involved in trafficking in any drugs is a top priority of Dutch authorities. The Dutch policy concerning soft drugs does not interfere with international obligations and the Netherlands continues to coincide with international efforts to prevent drug use and drug trafficking.
The Dutch drug policy has contributed to a reduction in the number of drug users within the Netherlands and while there are still areas of drug policy that need to be further developed, the current policy encompasses many areas of consideration that other national policies often exclude, including the social factors associated with drug use. The changes made to the Dutch drug scene and the reduced numbers of drug users in the Netherlands shows the success of harm reduction and prevention policies and provides a positive example for policy change.
Services visited
During the meeting a number of sites were visited by the participants.
De Regenboog Groep is a large organization, which provides care and aid to homeless people and drug users. The organization includes drop in centres, shelters, user rooms, needle exchanges and social care services in order to help facilitate harm reduction strategies and improve drug prevention methods.
De Regenboog Groep is well known among the using and non-using community of Amsterdam. This connection with the community is important for the work of and is a large contributor to the success of the organization. More than 600 volunteers work constantly in the different premises of the organisation. The inclusion of client and peer boards, which consist of users and ex-users, has helped De Regenboog Groep streamline policies making them more relevant and effective for its clientele.
The inclusion of peer boards is a good example of the open approach Dutch organizations and authorities have towards drug users. While many other organizations are concerned with curing drug addiction, De Regenboog Groep attempts to help drug users manage their addiction. This method of harm reduction and drug prevention is beneficial for the entire community.
The 420 Café is one of Amsterdam’s 150 coffee shops located in the centre of the city close to the main station. In order to operate as a coffee shop, and sell marijuana and hashish to customers, the 420 Café, like all other coffee shops in the Netherlands, must adhere to certain principals and regulations. For instance, the coffee shop must not have more than 500g of product on hand at any given time and cannot sell more than 5g per individual person. These regulations, along with other regulations such as maintaining a nuisance free area and ensuring no minors enter the cafe, allow for coffee shop owners to continue providing small amounts of soft drugs to the general public and allow authorities to maintain the market separation between hard and soft drugs.
The regulation of coffee shops is somewhat disturbed in the Netherlands. While the purchasing of cannabis products for individual use is not criminalized, purchasing large amounts for distribution is a violation of Dutch law. This would mean that a coffee shop owner purchasing 500g to stock his coffee shop would have to be prosecuted. However, the opportunity principle in Dutch law exempts certain violators and allows coffee shop owners to continue purchasing cannabis products in larger quantities (up to 500g).
The nature of Dutch policy allows for police discretion and permits officers and officials to focus on more serious offences such as the large-scale production, trafficking and dealing of drugs. Coffee shops provide a controlled area for citizens to consume small amounts of a controlled substance without the interference of the criminal market for hard drugs.
The Politiebureau Beursstraat is the police bureau responsible for the Amsterdam’s Red Light district. During the 1970s and the 1980s the area was characterized by crime and violence, however due to increased police presence over the past years, security features, particularly 25 security cameras, and policy changes, it is now one of Amsterdam’s popular nightlife areas.
The connection between the police and the community is also an important factor in the positive changes that have occurred in the Red Light district. The Keten Unit is a cooperation with community members and police officers where members come together to discuss issues relating to violence, drug use and youth criminals, in hopes of reducing the problems in the area. This cooperation has helped to clean up Amsterdam’s Red Light district and provide a certain level of safety on the streets.
Although there have been notable changes in the last years to the area, problems concerning nuisance and violence still exist. Currently a major concern is the selling of fake drugs in the area.
The selling of fake drugs exists all over the Netherlands however it is becoming an overwhelming problem in Amsterdam. The police are monitoring the problem and harsher punishments have improved the situation, yet work still needs to be done. It is clear that the police officers and law enforcement officials in Amsterdam’s Red Light district continue to work to improve the living conditions in the area and reduce the amount of crime.
The Makom: Drop In/Reintegration Centre is a project associated with De Regenboog Groep. As a drop in and reintegration centre, Makom offers a place to eat, shower and socialize for drug users and homeless people. The drop in centre caters for approximately 120 visitors each day and tries to provide the needed support and counselling for its clients. This support includes art classes that are available three days a week, hot meals three nights a week, and a clean and safe environment.
Another major component of the drop in centre is its High Five Project, which works to provide jobs for drug users and addicts. Each worker earns 5_euros per day and is assigned a job based on his skill and tolerance level. The High Five Project is supported by the social system and provides Makom with 50_euros per day for each client that is working. This money is used to support the centre and its various activities.
The centre is one of the many associated with the De Regenboog Groep and provides social assistance to homeless people, drug users and other community members that need help. The assistance that Makom provides helps to get homeless people and drug users off the street and into better living conditions, improving their quality of life.
The GGD Amsterdam/MGGZ Geïntegreerde Voorzieningen is similar to a one stop shop for social care. The centre provides social workers, treatment facilities, mental health services, and medical care for persons suffering from drug abuse, homelessness and mental/physical problems. On average, the centre’s clients are between 40-50 years of age and are often long-time drug users. Heroin and methadone treatments are available for clients that are unable to endure other treatment and detoxification services.
Social workers are also available in order to help reintegrate clients into the community and social system. Social workers are able to help find housing and employment, and cooperate with probation officers to keep offenders out of jail.
The centre offers a wide variety of care, however the different sectors are separated on the administrative side and making it difficult for some patients to get the full advantage of the centre. In order to avoid loosing clients in the system, the centre relies heavily on fieldwork done by the social workers to ensure that clients keep appointments and receive the proper treatment and care.
GGD Amsterdam/MGGZ Geïntegreerde Voorzieningen is part of the Dutch policy that helps to integrate drug users into the system through treatment and social aid, rather than attempting to cure or punish the addict. By receiving treatment and social care many clients of GGD Amsterdam/MGGZ Geïntegreerde Voorzieningen have been able to stay out of jail function in society.
Observations
The humanitarian and even compassionate approach of social workers, government agencies and law enforcement officials in tackling problems of drug abuse is very impressive in the Netherlands. The care the Dutch policy provides for drug users, through treatment methods, user rooms, and other social care services, is a positive example of harm reduction strategies that have helped to improve the standard of living for the entire community.
The participants of the EXASS Net group were impressed with the variety of social resources and programmes available for drug users in order to help integrate them back into society, especially the High Five Project of the Regenboog, in which the government helps to reintegrate drug users by providing proper funding.
The responsibility the Dutch government takes in helping rather than curing those using drugs is evident. The participants were especially impressed with the regard to human rights and the compassion that both policy makers and law enforcement officials show when dealing with issues of drug use.
The effort made in the Netherlands to help those dealing with drug issues is inspiring and a good example to bring back to other nations dealing with similar problems. It is a testament to the advancement of the Netherlands when dealing with harm reduction and drug prevention.
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Early intervention and outreach work 7th EXASS Net meeting, Oslo, Norway, 2 – 4 June 2010 at the invitation of the Oslo City Competence Centre on Drugs and Alcohol 2 Report of the 7th EXASS Net meeting, P-PG-coop (2010) 11 2 Background document on user involvement, P-PG-coop (2010) 12 |
Background
Early intervention aims to encourage drug or/and alcohol users to reflect on and possibly change their consumptive behaviour before facing problematic drug use. This can be achieved by building individual risk competencies and self-responsibility in order to stop people from, drifting into addiction and abuse. Early intervention could be defined as "Coming too late as soon as possible" by identifying and meeting the problem on an early stage.
Early detection of youth at risk is the first step of early intervention and requires qualified knowledge about risk assessment and the involvement at local level of various stakeholders such as outreach workers, school, police, justice system, child welfare, youth services, families, etc.
These stakeholders need to exchange information and cooperate through partnership-based approaches. The European municipalities have an important responsibility of initiating, coordinating and supporting such partnerships.
Early intervention
The definition of ‘early intervention’ differs across Europe. In principle it is about intervening early in life, but also at an early stage where problems are evolving. This means that not only children and young people are possible target groups, but also other groups might be targeted. Early intervention is about identifying and handling a problem at such an early stage that the problem disappears or is reduced with limited intervention.
According to the World Health Organisation, early intervention is a therapeutic strategy that combines early detection of hazardous or harmful substance use and treatment of those involved. Treatment is offered or provided before such time as patients might present of their own volition and in many cases before they are aware that their substance use might cause problems. It is directed particularly at individuals who have not developed physical dependence or major psychosocial complications. Early intervention is therefore a pro-active approach, which is initiated by the health worker rather than the patient. The first stage consists of a systematic procedure for early detection. There are several approaches: routine enquiry about use of alcohol, tobacco, and other drugs in the clinical history, and the use of screening tests, for example, in primary health care settings. Supplementary questions are then asked in order to confirm the diagnosis. The second component, treatment, is usually brief and takes place in the primary health care setting (lasting on average 5-30 minutes). Treatment may be more extensive in other settings
Early intervention is, as defined here, located in the overlap between indicated prevention and treatment, and therefore has a strong association with the medical field. The relative importance of early intervention may vary between countries depending on the capacities, roles and performance of their educational, health and justice systems. Early intervention may prevent teenagers from developing chronic addiction but there is a catch. There may be only a small "window of opportunity" for intervention, which means if you do not intervene before a certain point, the addiction becomes more entrenched and problematic.
Adolescence is the stage in life at which experimentation with substances usually takes place. Adolescents are highly vulnerable to social influences, have lower tolerance levels and become dependent at lower doses than adults. However, the majority of adolescents who experiment with substances do not become problem users.
Individual risks include early developmental problems such as sleep problems, externalising and internalising behaviour problems, several child psychiatric disorders (ADHD, conduct disorder and especially the association between these two, depression), post-traumatic stress disorder and events leading to it (e.g. childhood abuse, neglect), school failure, dissocial behaviour and delinquency. Personality traits such as sensation seeking may also contribute. Social learning variables including peer attitudes (prevalence of norms favourable to deviant behaviour), as well as personal approval (adoption of deviant norms), constitute separate risks. In addition, academic failure and problems related to school contribute to risk situations. Family factors such as familial substance use or abuse and lack of parental supervision constitute additional risks. Generally, boys are at a higher risk for substance use than girls.
Psychiatric disorders and substance abuse are linked. Psychiatric disorders in childhood and adolescence predispose the individual to addictive behaviour and addiction, and consumption of substances (alcohol, cannabis, cocaine) can lead to relapse to psychiatric disorders. The cerebral neurotransmitter systems are affected in psychiatric disorders; as a result, addictive behaviour emerges much more rapidly.
Genetic and environmental factors shape synaptic structure and function. This is the part of the network that can be pathologically modified in psychiatric disorders, which may increase its vulnerability to the changes necessary for the development of addiction. Influences from the environment can also lead to changes in the morphology of the brain; a better understanding of neurobiology cannot lead to mere biological determinism, as it must take into account the role that external factors might play. The challenge for neurobiology, in this area, is to explain how certain factors affect the development of the brain in such a way as to lead to a greater risk of the development of substance use disorders.
It is thus important to target early intervention measures and concentrate efforts on youngsters who are:
It is also important to focus on transitional periods:
As early intervention requires cooperation between various local stakeholders, there is a need of city involvement in initiating, coordinating and supporting local partnerships;
In order to improve the citizens' health and safety, the municipalities have also the responsibility of supporting concerned services and NGOs by improving access and quality of the services. This can be made by organising training sessions, methodological support, providing financial resources, etc.
The Oslo experience
In Oslo, early intervention regarding drugs and alcohol misuse is part of a wilder model called SaLTo which aims at preventing crime among children and young people (12-23 years old with the focus on children and young persons who grow up in vulnerable environments with drink, drugs and crime).
The main objectives of the SaLTo model are:
Overall strategies:
The SaLTo model's structure:
* * *
In accordance with its terms of reference the EXASS Net activities were evaluated in order to provide a basis for deciding a future continuation under the 2011 – 2014 Work Programme. One of the strongest points of EXASS Net remains the direct and continued exchange of experiences. Indeed, it appears that EXASS Net has been very successful in its goal of facilitating personal contact, networking and know-how transfer between stakeholders at frontline level. Participants are able to cooperate on specific and key issues on a bilateral basis. Participants also appreciate the educational value of both the field visits and discussions. The overall conclusions of the evaluation are:
After four years of EXASS Net, the main conclusion that can be drawn is that practical cooperation between stakeholders and its consequent actions, coupled with political commitment, can increase policy impact significantly. The main added value of EXASS NET for the policy-making level is that EXASS Net was capable of effectively linking policy management and practice, as the above examples show. This increases the effectiveness of policy implementation.
Ü Pompidou Group Training Initiative
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Pilot Training Course for Drug Policy Managers at the invitation of the National Bureau for Drug Prevention of Poland 1st Module: Needs Assessment Seminar, Warsaw, Poland, 13 – 15 May 2010 2 Compiled Training Material of the Needs Assessment Seminar, P-PG-Train (2010) 25 2nd Module: Qualifying Seminar, Clewiska, Poland, 23 – 27 June 2010 2 Compiled Training Material of the Qualifying Seminar, P-PG-Train (2010) 26 |
Executive summary
The PG Training Initiative 2010 seeks to link policy, research and practice by offering training and further education in support of drug policy management. The main objective is to facilitate know-how and build capacities for more effective policy implementation, management and evaluation of drug control policies and related programmes. In 2010, the PG organised a pilot Training Course for Policy Managers for which participants from 28 PG member States registered.
Objectives
The Training Initiative has a twofold objective that will be reflected in 2 training modules:
Consequently the 2 foreseen modules took the form of a needs assessment seminar and a qualifying seminar, both together constituting the 2010 pilot training activity. Based on the result of the pilot project training activities for the PG 2011-2014 Work Programme were developed.
Profile of participants
Under the PG Training Initiative 2010 a pilot training course was offered to managers from governmental institutions that are responsible for developing and/or implementing drug policies and/or coordinating related programme implementation, service delivery and cooperation with stakeholders.
Results
During the seminar under the 1st module participants identified the needs in their work of implementing drug policies. They explored the obstacles and opportunities that they come across with during their work. They identified factors and competences that are needed to help them overcome obstacles and barriers and thus do their work even more effectively. A list of needs as well as a list of suggestions for supportive action was elaborated so that they could be discussed during the 2nd module in the course of the qualifying seminar.
During the second seminar, the qualifying module, participants received training units on the following topics:
1. Conceptualisation and updating of drug policies
Ü The constitutive elements of a drug policy
Ü Evidence-based/informed approaches and political challenges and limitations
Ü Concepts of and experiences with integrating policies on licit and illicit drugs
Ü Building consensus around a drug policy between political and administrative structures
Ü Implementation of a drug policy on different levels in centralised and de-centralised systems
Ü Taking into account international policy instruments and priorities in drug policy development
2. Drug policy research
Ü How to guarantee the knowledge transfer between research, policy and practice
Ü How to incorporate research results into drug policy
Ü Addressing and formulating needs for specific research efforts in drug policies
Ü Identifying and defining research needs and objectives in supply reduction
Ü Monitoring and evaluation of drug policies
3. Promising approaches in prevention
Ü Meaning and aims of drug prevention
Ü Appropriateness and feasibility of universal, selective and indicated prevention
Ü What are promising and evidence-informed approaches in prevention and harm reduction policies
4. Effective supply reduction
Ü Overview of different supply reduction systems and practices
Ü Mechanisms of international cooperation in supply reduction (PG Airports Group, Europol, Interpol, WCO)
Ü Indicators and criteria used in supply reduction to define objectives and success
Ü Implementation at frontline level
Ü Ways to better integrate and coordinate supply and demand reduction approaches
5. Treatment and rehabilitation
Ü How to assess and improve coverage, accessibility and continuity of care
Ü Applying treatment guidelines and making good use of recommendations
6. Qualifying staff and quality of work
Ü Developing a policy for continuing education for professionals
Ü How to make use of guidelines, research findings and practical proposals from the field
Ü How to define research needs in the context of a drug policy and how to integrate the results in it.
7. Cooperation across sectors and between stakeholders
Ü Reasons for networking among services/stakeholders and how to overcome obstacles and resolve problems
Ü Building up coordination and collaboration between the actors (horizontally and vertically)
Ü Conflict management between supply and demand reduction policies
Ü Promoting societal learning around drug policies between involving all stakeholders and civil society
Ü Good practice in cooperation between state institutions and NGOs
8. Good governance in drug policies
Ü Financing, resources and opportunities for funding
Ü Making use of and applying results from evaluation and quality control
Ü Initiating and managing changes
Ü Raising public awareness and working with and through media and information technology platforms
* * *
Evaluation
Results of an initial evaluation of the training seminars showed that overall this new format based on developing training inputs on the basis of the needs identified by the beneficiaries has proven to function very successfully and has serious potential to better match the needs of policy managers for expertise.
Taking into account all contributions and the total costs, this activity has also shown to have a highly effective cost benefit ratio and thus has been by means a very good investment.
The evaluating experts recommend that such training should be offered on an annual basis as part of the PG’s next work programme.
Follow-up proposal
In retaining the positive momentum generated by the pilot training course and in following the encouraging responses by participants of such trainings, which are increasingly referred to as executive trainings, such training should be a regular offer to member states under the next PG work programme, preferably on an annual basis. The training course should follow the tried and tested model of 2 modules: a first seminar conducting specific needs assessment on a topic area, followed by a second seminar providing knowledge and qualification.
By seizing the opportunity of existing contacts between the Council of Europe/Pompidou Group and the University of Syracuse, USA, and its interest in cooperating with the PG in a training activity in 2011 with the aim to contribute to Europe-USA contacts in the field of drug policy and research, it is proposed to hold a joint European-US training course on benefits and draw backs of more coherent policy approaches to licit and illicit drugs. The objective would be to explore the benefits of coherent and integrated policies on different substances with a view to better risk management and creating more cost-effective and coordinated responses to tackle the effects of drug use in times of increasing poly-drug use.
Ü MedNET
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Mediterranean Network for co-operation on drugs and addictions MedNET fosters co-operation, exchange and transfer two-way knowledge between North African and European countries which are members of the Pompidou Group and donors (North-South and South-North) as well as within the countries of the Mediterranean Basin (South-South) All information about MedNET: : http://www.coe.int/t/dg3/pompidou/Activities/medNet_en.asp |
Executive summary
If cooperation in the Mediterranean region already started 10 years ago with the first conference on cooperation in the Mediterranean Region held in Malta in November 1999, the MedNET network was officially set up in 2006 at the initiative of France and the Netherlands.
The first activities of the network were based on the work carried out just after the Malta conference that is in the research field with the MedSPAD survey, the Mediterranean adaptation of the ESPAD school survey which looked at the scope of the drug problem among youths in Algeria, Morocco and Lebanon.
The objective of the MedNET network is to promote cooperation, two-way exchange of knowledge between North African and European countries of the Mediterranean Basin, .
The ultimate aim is to improve the quality of implementation of drugs policy in all the participating countries in both North Africa and Europe, with the emphasis on greater awareness of cultural factors influencing intervention policies.
Signals and results 2007-2010
· Morocco and Lebanon carried out a school survey on drug and alcohol abuse amongst secondary school students (MedSPAD) to identify the scope of the drug problem amongst young people.
· The work of the Pompidou Group has raised awareness about the necessity to consider drug addicts as human beings, and not only as criminals, thus favouring prevention and treatment.
· Approaching the use of drugs as a disease was part of a series of training workshops on treatment in Algeria which serve to train the medical staff who will work in the new treatment to be set up in this country.
· Building capacity in the field of prevention was done through a series of training workshops in Algeria
· The Pompidou Group supported the introduction of a ‘risk reduction strategy’ through its “Opiate Substitution Training”. This contributed to the training of medical staff and the introduction of Opiate Substitution Treatment in Morocco, for the first time in any Arab country. This was further enhanced through a study visit of medical doctors and psychiatrists to methadone treatment centres in France and in Switzerland. Four methadone treatment centres will subsequently be opened in Morocco and opiate therapy will be in introduced in Lebanon.
· The Pompidou Group co-funded university courses and certificates in ‘Addictology’ in the Universities of Casablanca and Rabat.
· The Pompidou Group promoted the interaction between civil society (NGOs), policy makers and researchers and the setting up of an experience sharing network amongst them. This will contribute to the development of an evidence-based drug policy.
· Algeria, Egypt, Lebanon and Morocco showed their interest to set up first a system of systematic data collection at national level to provide the data needed for the development of a national drug strategy.
· The growing two-way exchange of knowledge between North African and European countries as well as within the countries of the Mediterranean Basin is demonstrated by more trainers from the South involved in training seminars and exchanges that cater for sharing of experiences by all counterparts in the Mediterranean Region.
· The number of countries has increased since twelve countries are now part of the network
Ü ESPAD & MEDSPAD
Executive summary
The Pompidou Group has continued supporting the fourth data collection of the European School Survey Project on Alcohol and Other Drugs (ESPAD). It has supported the project from the first project meeting in 1994. In particular the support of the Pompidou Group has enabled researchers from eastern and central Europe to participate in project meetings.
Results 2007-2010
Survey report on 35 European countries based on a methodology developed by Pompidou Group.
Ü ESSD Training Course
Executive summary
During the summer, August 2008 and 2009, the European Society for Social Drug research (ESSD), in close collaboration with the Pompidou Group of the Council of Europe, organised an intensive training course on qualitative research on drugs for 12 young researchers in Amsterdam.
The aim of these summer courses was to enable PhD students to expand their knowledge and abilities concerning qualitative drug research and provide them with some proficiency in communicating research findings to agencies and policy makers. This issue of communication, public opinion and development of policy appears to be a recurring subject in the Research Platform discussions. A lack of communication or misunderstandings in communication seems to become an obstacle in policy development (see the latest platform publication “From a policy on illegal drugs to a policy on psychoactive substances”).
PG’s financial support went towards the costs for the accommodation for all, the programme coordination, the trainers, the facilities and the material for the course. The Pompidou Group also financed the travel and subsistence expenses of the trainees from Eastern Europe. Without this funding, the course would not have taken place.
The idea of launching such a course was presented by the Chair of the ESSD (Prof. Dr. Dirk Korf) to the Pompidou Group in 2006 when the Group was drafting its 2006-2010 work programme which was adopted at the 14th Ministerial PG Conference in November 2006. PG supported the holding of the course for several reasons:
- Communication between researchers and policy makers need to be improved. Researchers should not accept projects that they cannot realistically conduct with the limited funds and short time periods. Policy makers must clarify their expectations.
- Communication of research findings should also be directed to the public arena which includes the media. Findings should be disseminated by researchers with communication skills participating in TV and radio debates.
- Lastly, the work of the PG towards Central and Eastern Europe had been a priority for a long time and PG felt it was important to continue to exchange knowledge between EU and non-EU Central and Eastern European countries and continuing thus to play a bridging role.
Results 2007-2010
24 PhD students aged 23-31 from Belgium (2), Croatia (4), Czech Republic (3), Georgia (3), Hungary (2), Netherlands (1), Poland (1), Portugal (1), Spain (1), Russian Federation (4) were successfully trained on the following subjects:
A substantial part of the course was dedicated to practical fieldwork and exercises.
The PG Secretariat was present during the last two days of the course which were dedicated to the presentation by the students of the results of their fieldwork. The students were given suggestions and warnings on how to proceed when presenting their results to funding agencies, senior officials, policy makers and to the media. It was stressed how important communication between researchers and policy makers can be to develop evidence-based policy.
The summer course appears to adequately fit the needs of researchers who have to present the results of their research. The courses addressed the latest signals of the Research platform, that is the interaction between research, policy and practice where communication plays a vital role in order that findings on drugs do not get “lost in translation” between policy makers, practitioners and researchers.
Taking into consideration that the needs of the students are met, that their awareness in communication with agencies, funders and policy makers has risen and that the course is successful, it is hoped that the Pompidou Group will be able to further support this initiative.
Ü European Union
Setting up inter-agency cooperation with European and International Organisations on a regular basis was a top priority for the Polish Presidency. To avoid overlap and in the hope of reaching synergies we managed to bring all important stakeholders together: the EU Commission, EU Presidencies and Troikas, EMCDDA, UNODC, WHO. This Inter-agency group initiated the Pompidou Group’s debate on Spice and Legal Highs, helped to improve the European Research Register, contributed to the feasibility study on a possible framework convention on public health, and was the forum where a dialogue on human rights in drugs policy started.
European Commission
Thanks to the secondment of a Polish Official from the Ministry of Foreign Affairs, the Secretariat made an in-depth study of the possibilities for the co-financing of activities in the Mediterranean Region and Eastern Europe between the European Commission and the Council of Europe.
The study concludes that the Union for the Mediterranean and the Eastern Partnership are not feasible frameworks for possible cooperation since drug issues are not among the listed priorities.
However the study shows that direct cooperation with the EU delegations in individual countries is a potential way forward. Consequently the PG has initiated direct contacts with EU Delegations in countries interested in cooperation. Agreements would have to be based on EU strategic documents for each respective country. In 2010 consultations commenced with the EU Delegations in Moldova, Ukraine, Algeria, Egypt, Jordan, Lebanon and Morocco.
Horizontal Drugs Group (HDG)
It was determined that improving knowledge transfer mechanisms in Europe, particularly towards Eastern Europe and the Mediterranean region would continue to be an important goal for the Pompidou Group. The Executive Secretary presented the cooperation of the Pompidou Group with the Mediterranean Region to the HDG during their meeting in November 2009.
European Monitoring Centre for Drugs and Drug Addiction(EMCDDA)
In 2010 PG and EMCDDA reviewed their cooperation and explored potential areas of joint activity and cooperation, in the future, searching particularly for proactive methods and non-competitive paths. Following this process the text for a new Memorandum of Understanding was agreed, which will be formally signed during the 2010 Ministerial Conference of the Pompidou Group.
A cooperation was launched with the EMCDDA to set up an online register of current drug research projects carried out by Pompidou Group member states and funded by governments or other institutions. The Pompidou Group is leading this pilot project and holds regular meetings with EMCDDA to keep them informed of the development phase of this project and to take into account their expertise. The register, launched in 2007, takes into account the comments made by its users (more than 600 people) and the regular improvements have been made in consultation with the EMCDDA
As for the activities in the Mediterranean Region, EMCDDA was invited to participate in the high level MedNET Conference on 1 December 2009. EMCDDA work on treatment demand was also presented during a regional seminar in Cairo in March 2010. A joint article entitled “sharing information on drug treatment demand in the Mediterranean” was then issued by both organisations in drug net Europe.
Cooperation between both organisations is going further with the active participation of EMCDDA in the seminar on laying the basis for setting up national drug observatories to be held in Rabat from 30 November to 2nd December. The programme was agreed and designed by both organisations.
Ü United Nations
United Nations Office on Drugs and Crime (UNODC)
A letter of agreement was signed on 12 November 2008 between PG Executive Secretary and UNODC Regional Representative for Middle East and North Africa with the aim of formalizing the working relationship between PG and the Regional Strategic Framework of operation Programmes of UNODC Regional Office for the Middle East and North Africa (ROMENA) to increase the impact of their activities and further strengthen their coordination in the region. Since then, both organisations participate in the regular steering committees and a regional seminar was organised in collaboration in Cairo in March 2010.
World Health Organisation (WHO)
In partnership with the International Harm Reduction Association (IHRA), WHO has launched the Menahra project which has established knowledge hubs in the Mediterranean Region (Iran, Lebanon and Morocco). Since 2008, the MedNET network has contributed to the funding of some 15 regional seminars for North Africa aiming at the prevention of drug-related risks.
WHO-HIPP
The Pompidou Group is a member of the Steering Group of the WHO Health in Prisons Project (WHO-HIPP). With its 40 Member States it is one of the largest and it is the longest running project of the WHO in Europe.
In 2010 the WHO Health in Prisons Project (WHO-HIPP) celebrates its 15th anniversary. With its 40 Member States it is one of the largest and it is the longest running project of the WHO in Europe. Throughout the period concerned the PG Secretariat participated regularly in the annual WHO HIPP network meetings as well as in the bi-annual WHO HIPP Steering Group meetings and in conferences organised with the WHO HIPP framework.
The Norwegian expert from the Treatment Platform Dr Gabrielle Katrine Welle-Strand served as an observer in preparation of the WHO "Guidelines for Psychosocially Assisted Pharmacotherapy of Opioid Dependence" and took part in the meeting of the technical development group (TDG) for the WHO on 17-21 September 2007 in Geneva which finalised this WHO Guidelines. The Guidelines were published in 2009.
The Pompidou Group was presented at the conference on Prisons and Mental Health in Trencin on 18 October 2007 underlined importance of drug and other addictions treatment.
The Pompidou Group took part in the conference on prisons and women's health in Kiev on 13 November 2008. The declaration of the conference points out the shortcomings in implementation of the recognized standards of evidence-based treatment in prisons such as substitution therapy, psychotherapy, counselling, training, peer support and harm reduction measures.
The Pompidou Group was presented at the WHO consultations with representatives of intergovernmental organizations on ways they could contribute to reducing harmful use of alcohol on 8 September 2009 in Geneva. The PG recommendations to develop a common approach to psychoactive substances were presented (based on PG publication “From a policy on illegal drugs to a policy on psychoactive substances”).
In October 2009 the Pompidou Group’s experts (Dr Andrej Kastelic of Slovenia and Dr Dragan Milkov of Serbia) have organised and chaired a workshop on continuous drug treatment during the Madrid Conference on Health in Prisons (October 2009) which was attended by over 300 participants from around the world. The issue of drugs in prisons has a prominent place in the final declaration of the Madrid Conference. The continuous treatment, including treatment of drug using offenders, is identified as a main priority of the WHO HIPP work in the upcoming years.
WHO HIPP presented its findings on prevention of drugs-related deaths after release from prison at the PG Strasbourg conference on stimulants drug use treatment (May 2010). The findings will be edited and published including a number of comments from the conference participants.
In 2010 the Pompidou Group specifically contribute to the discussion of the WHO framework to assess prison health as well as to the discussions of updating the WHO Prison Health guide through participation in the meetings in May and October 2010.
Ü Contacts with non-member States
The contacts with Council of Europe member States, not member of the Pompidou Group have been pursued. Regular contacts were established with the Permanent Representations of: Georgia, Ukraine, Moldova, Montenegro, Serbia, Former Yugoslav Republic of Macedonia and Bosnia Herzegovina. No final results have been obtained (requests for accession), but some Permanent Representatives to the Council of Europe made positive comments about their countries’ possible future involvement in the PG’s work (Moldova, Montenegro, FYROM, Serbia) .
The Secretariat promoted the participation of Council of Europe member States and Belarus in the Training Initiative for Drug Policy Advisers (participants from Armenia, Belarus, Georgia, Serbia and Ukraine).
Ukraine
Draft State Anti-Drug Policy
The First Deputy Minister of Justice of Ukraine, Ms Inna Emelianova, by letter of 12 August 2010, requested an expert opinion on the Draft State Anti-Drug Policy of Ukraine for the Period 2011-2015. The Secretariat contacted several National Correspondents and experts in order to give a comprehensive and complementary analysis within a very short timeframe. The expert opinion only engages the experts concerned and not the Pompidou Group as a whole.
Prevention Programmes
In 2007-2008 the Pompidou Group trained 130 multipliers (teachers, educators, social workers) in the Zaporozhye Region of Ukraine in the ‘life skills’ - drug prevention methodology. This project was funded from a voluntary contribution of Norway and Switzerland (total cost of the project was 80,000 €).
As a spin off of this project and at the request of Ukrainian experts and authorities, the Pompidou Group prepared two new pilot projects in the same region of Ukraine. One project will assist in developing school-based prevention programmes. The second project will focus on the issue of drugs in prisons.
The aims of the project are:
- facilitate accession of Ukraine to the Pompidou Group through establishing working contacts with the authorities in charge at national and regional level;
- revise the PG training materials on drug prevention in schools, adopting the European experience in school-based prevention and in continuous drug treatment systems for offenders to the local prevention and treatment context in Ukraine;
- organise capacity building activities for local experts with special emphasis on facilitating inter-agency cooperation in dealing with drug issues involving educational, social, law enforcement and medical authorities as well as judiciary and prosecution institutions;
- a feasibility study on implementation of good European practices in prevention and treatment of drug use;
- further dissemination of good practices to all regions of Ukraine and possibly to neighbouring countries;
- assistance to Ukraine in the development of a coherent approach to drug problems.
The project received support from the Ukrainian Monitoring and Medical Centre on Drugs and Alcohol, as well as from the State Department for the Execution of Punishment of Ukraine, both of which would become official partners in the project implementation and evaluation.
The total cost of the project is 415,000 € for a period of 2 years with over 200 local multipliers to be trained. The PG contacted several Foundations and Institutions to sponsor the project (European Human Rights Trust Fund, the Mentor Foundation, and the Delegation of the European Union to Ukraine). The PG will appeal to member States for voluntary contributions towards these projects.
Moldova
Project on Treatment and Harm Reduction in Prisons
Following the Secretariat mission to Chisinau, Moldova in March 2010, during which the future cooperation and possible projects in the drugs field with Moldova was discussed, inter alia, with four Ministers (Justice, Interior, Health, and Education) and the EU Delegation in Moldova. As a result the Secretariat received a letter of interest of the Moldovan government (21 May) with the request to assist the Department of Penitentiary Institution of the Moldovan Ministry of Justice with a project in the field of treatment and harm reduction in prisons.
Based on its assessment of the Moldovan drugs situation in prisons, the PG designed a project, entitled “Treatment and Harm Reduction in Prisons (THRP)”, with the objective to contribute to reforms in Moldova through the training of harm reduction and treatment professionals in prisons, material support (harm reduction and treatment materials), and improvement of national and regional drugs policies. The PG presented the project to several donors. The EU delegation put the topic “drugs in prisons” on its indicative list (to be endorsed by the European Commission in early autumn). The ‘Fonds Lutte contre le trafic de drogue’ from Luxembourg agreed to finance the first phase of the project (50.000 €).
The first phase of the project includes activities (round tables and training) that aim at promoting the benefits of treatment and harm reduction measures in prisons and improve national drugs policies. The activities intend to lead to sustainable outcomes (through the training of knowledge multipliers and production of training materials), and produce ownership. Moreover, the project part is designed in a way that it can be a self-contained project producing tangible outcomes already this year and/or function as the starting point for extended cooperation in the field of anti-drugs in Moldova. The project planning is currently underway and contacts with partner institutions (Department of Penitentiary Institutions and WHO-HIPP) have been established.
For further contacts see also above ‘Contacts with the European Union’ and ‘World Health Organisation’.
Ü Mediterranean Region
Morocco
Following many years of participation in MedNet the Kingdom of Morocco has formally requested the accession to the PG …..
Israel
The Pompidou has been invited by the Israel Anti Drug Authority (IADA) to undertake a field visit to Israel in the late autumn of 2010 and to share information on developments in research, prevention, treatment and law enforcement issues in Europe and in Israel.
Ü Non-governmental sector
European Society for Social Drug Research (ESSD)
In order to take into account the complexity of the research field and to cooperate with other research disciplines, the PG continued the cooperation with the European Society for Social Drug Research (ESSD). Therefore the PG supported three ESSD annual conferences and the publication of their proceedings in 2007, 2008 and 2009.
The PG published together with the ESSD a book signalling the latest developments in social drug research.
Correlation Network 2
The PG has been invited to participate in Correlation II, an EU funded networking project, which aims to improve prevention, care and treatment services, targeting blood-borne infectious diseases (BBID), in particular Hepatitis C and HIV/AIDS, among vulnerable and high risk populations (e.g. drug users and young people at risk) by:
The project will:
· Review models of good practice
· Implement field testings
· Develop guidance documents
· Develop and implement training modules
· Support and strengthen capacities of health service providers
· Formulate practice and evidence-based policy recommendations
The project cooperates with different stakeholders on different levels, including EMCDDA and WHO. The Pompidou Group joined the project as a collaborating partner to ensure policy impact on a European level. The Correlation project in return has contributed significantly to the work of the Prevention Platform on issues concerning outreach work as well as to EXASS Net by providing regular expert input and hosting meetings.
Ü Capacity building for school-based prevention
In 2007 and 2008, the Pompidou Group ran a “Life Skills” – training programme in Ukraine and Lithuania. The “Life Skills” is a methodology to teach children skills of resistance to the negative influence of their environment (peers, mass media, and family). The project started in Zaporozhye in spring 2007 and lasted till autumn 2008. In Vilnius the training seminar took place in May 2007. The idea was to introduce the life skills programme in the school curriculum within the context of the education on healthy life styles.
The Pompidou Group conducted several training seminars for local teachers and educators. As a result, a training manual on life skills is translated in Ukrainian and Lithuanian; a group of 20 local trainers in Ukraine and 20 local trainers in Lithuania are trained; around 100 local teachers went through five-day training seminars in Ukraine. The Institute of the Ministry of Internal Affairs (analogue to the Police Academy) has introduced some elements of the programme in their curriculum.
Lithuaniacontinues to utilise the Pompidou Group manual and methodology in training of its school psychologists to date without direct involvement of the Pompidou Group. In Ukraine, the project to further disseminate the methodology to other regions of the country has being developed by the Pompidou Group and local experts and the Pompidou Group is currently seeking funding for this project from the EU and international NGOs.
Ü Communication strategy for the Pompidou Group
2 Communication strategy for the Pompidou Group P-PG (2006) 18
Following the assessments of the PG undertaken during the 2004-2006 Work Programme the Secretariat implemented a comprehensive communication strategy was developed and implemented by the Secretariat during 2007 and 2010.The aims were:
· Enhancing visibility and impact of the PG
· Increasing dissemination of information & publications
· Improving the communication inside the PG (between PCs, BU, Platforms, Secretariat, experts)
· The communication strategy sets out short-, medium and long-term goals to achieve the set objectives.
As a result of the implementation of the communication strategy the following has been achieved:
· the corporate identity and image of the PG has been mainstreamed into all documents, products and appearances
· a newly created website with restricted sections for PCs, Bureau and Platforms;
· only activity-logframes as a reporting and progress monitoring tool for PCs and the Secretariat
· download capacity of all PG documents from the website, including all meeting documents for PCs
· briefing and information materials more suitable for different target groups and stakeholders
· budget savings resulting from significantly reduced document production through electronic dissemination
Ü Evaluation of Pompidou Group activities
2 Strengths, weaknesses, opportunities and threats of the Pompidou Group (SWOT analysis)
An assessment of the PG’s work during the period 2007 – 2009, doc. P-PG BUR (2009) 9 rev 2
The Permanent Correspondents requested the Secretariat to prepare an analysis of the strengths, weaknesses, opportunities and threats (SWOT analysis) for each sector of activity (Platforms, networks, assistance activities etc.) of the Pompidou Group for the period 2007 to 2009. The SWOT analysis was conducted in cooperation with the Presidency and the Platform Coordinators. It also takes into account the conclusions from the PG’s Mid-term Conference in 2008.
Conclusions
The analysis showed that the PG continues to be highly recognized, on national as well as international levels, for its ‘think tank’ function, more precisely: linking policy, research and practice, monitoring new developments in research and highlighting ethic and human rights dimensions, target group involvement (European Prevention Prize), multi-sectoral and multi-disciplinary cooperation (EXASS Net), and bridging with neighbouring regions (MedNET). In addition the Group’s ability to adjust to evolving changes in the area of drugs and related problems, which require policy responses, continues to be seen by all stakeholders as a key strength. The change of working methods in 2003 and the results of the audit process in 2005/2006, as well as the feedback during the 2008 Mid-term Conference underline this.
The challenge for the PG will be to demonstrate its ability to be adaptable to the needs of policy makers. The mission, work programme and working methods will have to reflect that an adjustment has taken place in this respect. The different assessments undertaken show that some Platforms do not meet policy makers’ needs as effectively as it was anticipated. It is therefore necessary for the PG to revise and re-tool its structures and methods in linking policy, research and practice.
In more detail the SWOT analysis as well as the conclusions from the Mid-term Conference highlight the specific competences of the PG:
The key barriers and obstacles the PG faces include:
New activities developed by the PG should seek to tackle the following challenges:
In developing its future work programme the PG should take into account the following issues:
The conclusions from the feasibility study formed the basis for the document on Mission, organisation, governance and working methods (doc. P-PG (2010) 4 rev 4) and the 2011 – 2014 Draft Work Programme.
Ü Feasibility study for a framework convention
2 Feasibility study on a possible European convention on promoting public health policy in the fight against drugs, doc. P-PG (2009) 2 rev
Following the decision of Permanent Correspondents of the Pompidou Group during their 61st meeting and the decision of the Committee of Ministers of the Council of Europe as of 14 May 2008 (Appendix 2) based on the PACE Recommendation 1813 (2007) (Appendix 3) and Resolution 1576 (Appendix 4), the Secretariat has prepared a feasibility study on a possible European convention on promoting public health policy in the fight against drugs.
The feasibility study proposes a European framework convention that would be complementary to the existing UN Conventions setting out principles and measures for effective public health policies in the fight against drugs. The proposed approach of the convention would underline the respect for human rights on the one hand, while acknowledging existing national and international obligations on the other.
The concept of a framework convention is feasible as a regulatory response to the widely perceived needs for action identified, which the study sets out in detail. These needs for action mainly require an instrument on the governance of relationships and management of processes, rather than creating new legally enforceable rights for individuals. A new instrument should therefore set out principles and measures that can become operational in existing contexts and legal frameworks. The importance of human rights is underlined by basing the convention on principles enshrined in existing conventions, which would be reflected in the individual provisions of the new instrument.
The study proposes a framework convention with an additional protocol mechanism that would create a framework with the capacity to swiftly adopt regulatory responses to emerging future challenges. To monitor the new instrument, a follow-up mechanism is proposed that is built on and around existing capacities on the national and international level thus creating no significant new burden for governments.
The elaboration of such a legal instrument could increase the capacity of member States to render public health policies in the fight against drugs more effectively.
The convergence of identified needs by the key governmental bodies on European and international levels, coupled with a widely expressed political will to bring public health policies back to the forefront in drugs policies, is a constellation that would favour starting work on the project of such a convention at this moment in time.
The feasibility study concludes with a proposal for terms of reference for a drafting group under the supervision of the PCs and a draft timeline for elaborating a European convention for submission to the Committee of Ministers of the Council of Europe by the end of 2011.
The feasibility study contains an overview of relevant international legal instruments and highlights the UN Single Convention on Narcotic Drugs as the only instrument in the area making reference to public health policies (Art. 38). It recognizes the UN convention system as the common platform for combating illicit drugs. Hence it is proposed that a framework convention would be designed as a complimentary instrument in scope and content that presents added value to the existing instruments.
The study describes different international and European instruments in order to illustrate the functionality of the instrument termed ‘framework convention’.
It is important that any new instrument shows the potential to create added value beyond what exists today and thus attain a level of commitment among member states that justifies the process of its preparation. The feasibility study identifies the added value of a Pompidou Group/Council of Europe Convention as follows:
Human rights based approach
A new convention would make human rights its foundation and primary reference point, not only by generally setting out human rights principles in the preamble but in particular by introducing principles concerning treatment, access to services, client service-provider relationship, non-discrimination and equivalency in the operative part.
Setting standards
Common principles and measures set out in a legal instrument give member states clarity and guidance when making decisions on improving public health policies with relation to drugs.
Improving policy impact
The adoption of a framework convention, being a binding instrument, has the capacity to elevate the importance and generate more clarity and commitment of stakeholders, leading to an increase of impact of the principles and measure enshrined therein.
Creating a framework for the future
To address possible consequences resulting from future evolutions, it is proposed that a new framework convention includes a protocol mechanism through which subsequent regulatory actions can be taken more speedily and at a lower cost than through standard processes of treaty negotiation or amendment.
Complementing existing instruments
As the system of UN Conventions does not comprehensively address public health issues and since at the time of their adoption there was little knowledge and practical experience in the drug-related problems that emerged in the subsequent years, there is clearly room for a new instrument. The need for a new instrument is further driven by the variety of measures, insights and methods that emerged over the last decades to treat drug addiction, reduce HIV-Aids spread by IV drug use, that require formal validation to ensure more effective and wider application.
Following in-depth discussions during their 63rd and 64th meeting, the Permanent Correspondents decided that there was no consensus as to the necessity for a new Convention. However, they remained open to assess the issue again following the implementation of the new work-programme, from a Human Rights perspective.
Ü TV spot on drugs and road traffic
: http://www.youtube.com/user/CouncilofEurope#g/c/AF76336C877BD227
: http://www.coe.int/T/dg3/pompidou/default_en.asp
The spot, provided to the Pompidou Group as a courtesy from the Polish PG Presidency, was revised to fit a European target group and broadcast limits, and has then been produced in 8 languages: French, English, German, Italian, Russian, Polish, Slovenian and Serbian. It was published on partner web sites and national websites.
TV broadcasting
French-German TV Channel ARTE 134 times between 29 March and 18 May at different hours and will still be broadcasted during the remainder of the year (specially around 26 June the World drugs Day and the November ministerial conference).
- Music channel MCM between 26 May and 6 June.
- Regional channel TV Voivodine (Serbia) during the summer 2010.
- National channel TV RTS (Serbia) on 18 July during a show on disease of addiction
Broadcasting during Festivals
Projection on large screens and distribution of postcards with the spot’s visual in 4 languages.
List of summer festivals which aired the spot and/or distributed the postcards:
France
Les Eurockéennes in Belfort (2 - 4 July) 100000 visitors (questionnaire on spot impact) ;
Slovenia
Rock Otocec in Novo Mesto (2 - 4 July) (questionnaire on spot impact);
Germany
Kiss my rock Festival in Berlin-Brandenburg (2 - 4 July) 50.000 visitors
Klangfarben Festival in Regensburg (23 - 25. July)
KitKet (2 - 4 July)
Rock im Stadtpark UG (6.- 8 August) 6.000 visitors
Resist to Exist in Berlin (6 -8 August) 3.000 visitors
Switzerland
St Gallen Open Air Festival (24 – 27 June) 30.000 visitors
Serbia
Exit festival in Novi Sad (July): Aired on regional channel TV Vojvodina every day during the festival
Publication of information and/or postcards:
Bootboohook Hannover (20 – 21 August): Publication of the postcard picture of the campaign in their festival magazine (circulation 15.000)
Festivalhopper (German Website to get information, dates about festivals and buy tickets) (400.000 visitors per month): Published the press release in German with a link to the Pompidou website.
PART VI – Budgetary report
In line with other Council of Europe Budgets, the ordinary budget of the Pompidou Group has remained broadly stable over the period 2007-2010.
The 2007-2010 Work Programme was set up so that core activities (mainly the platforms but also a very limited number of projects) could be financed out of the ordinary budget. Possible additional projects were foreseen but subject to their funding being forthcoming from voluntary contributions from member States or other sources. The Group is very grateful to the countries and organisations who have responded to this appeal thus enabling a significant number of additional activities to be undertaken. These contributions are listed below (table 2).
At the end of the period the overall staffing of the secretariat is composed of:
Executive Secretary
Principal Administrator, Secretary to the Permanent Correspondents and the Ministerial Conference
4 Administrators, responsible for various platforms
1 Programme Manager (secondment as from 2010)
1 Administrative Assistant
4 Secretarial Assistants