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Drug policies and grass root involvement in Europe ; historical context, current perspectives and future challenges Finnish Harm Reduction Seminar Helsinki,

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Presentation on theme: "Drug policies and grass root involvement in Europe ; historical context, current perspectives and future challenges Finnish Harm Reduction Seminar Helsinki,"— Presentation transcript:

1 Drug policies and grass root involvement in Europe ; historical context, current perspectives and future challenges Finnish Harm Reduction Seminar Helsinki, November 2011 John-Peter Cools Tribes Institute, The Netherlands

2 Content 1.Drug use and policy, 2.International perspective 3.State of affairs in Europe 4.Challenges for the future

3 Substance use people use psychoactive substances since time immemorial used for medical, spiritual or recreational purposes examples: herbs, nuts, leaves, derivates of plants and synthetics Opium laws:classification in useful (e.g. medicaments, consumer goods) and illicit substances

4 Drug use in Europe; 60s, 70s 60s: ‘ Swinging 60s ’ wide range of substances (cannabis, LSD etc) part of alternative youth culture 70s: ‘ Me Decade ’ + start economic crisis increased use of amphetamine, heroin injecting

5 Drug use in Europe; 80s Economic social crises ‘ Heroin/amphetamine epidemics ’ among vulnerable populations: unemployed youth, migrants, people with mental health issues, youth trauma increased marginalisation of drug users introduction of HIV in IDU populations

6 Drug use in Europe; 90s Post-Cold War optimism new generation of synthetic drugs (e.g XTC) part of youth (rave and nightlife) culture increased use of (crack) cocaine Central and Eastern Europe: ‘ Heroin/amphetamine epidemics ’

7 Drug use in Europe; 2000 onward Globalisation and internet ‘ stable ’ rates of heroin and cocaine use increased rates of amphetamines wide range of synthetic drugs (e.g. Examine, GHB, Mephedrone) and ‘ legal highs ’ internet crucial in supply and consumer info

8 Global markets changed geo-political climate increased travel and migration shift in drug supply & trafficking routes uneven economic development

9 Global markets II new developing drug markets (heroin and ATS) in transitional and developing countries in Asia, Latin America and Africa rich & middle class: ‘Taste new liberties and modernity’ poor: ‘Forget sorrow and hardships.’

10 Drug policy; traditional approach Ideological inspired, a drug-free world: 1.Prevention, ‘ Just say No ’ 2.Treatment, ‘ Just stop ’ 3.current drug users: criminalised, marginalised coercive treatment: years of imprisonment or inpatient drug-free psychosocial treatment

11 Drug policy; modern approach Banning is not realistic Abstinence not the only goal Range of alternatives to be developed In line with other substances: –tobacco: regulate advertising, taxation, environmental policies, filters, lower tar& nicotine, chewing gum, patches –alcohol: restricted sales, taxation, bottle labeling minimum drinking age, drunk- driving laws, server training

12 The Netherlands The Netherlands starts different new approach shift in paradigm: public health next to public order driven by public debate & new insights started 1976

13 Harm reduction “Harm Reduction refers to policies, programmes and practices that aim primarily to reduce the adverse health, social and economic consequences of the use of legal and illegal psychoactive drugs without necessarily reducing drug consumption. Harm reduction benefits people who use drugs, their families and the community.” (Source: Harm Reduction International aka IHRA) “Temporary acceptance of second best goals on short term.” (Source: A. Wodak)

14 Part of comprehensive policy Harm reduction is: –no ‘One-size fits all’; but offers different strategies –no ‘End point”, but offers an entry point to generic services and referral Harm reduction is a set of practical strategies to reduce negative consequences of drug use and drug policies It incorporates a spectrum of strategies varying from safer drug use to abstinence


16 “Habit is habit and not to be flung out of the window by any man, but coaxed downstairs a step at a time.” Mark Twain, 1894

17 European countries, 80s Netherlands, UK and Switzerland adapt pragmatic approach strong grass roots influence based on commitment, solidarity and advocacy for fair and effective policies initially: bottom-up later: top-down endorsed, strengthened and mainstreamed by authorities strong opposition from other countries

18 European countries, 90s in 90s more countries (eg Germany, Spain, Portugal) shift towards health- centered approach decriminalise cannabis focus services at problem drug use develop full range of tailored health and social services

19 European response, 2000 - various networks of HR and public health projects commissioned by the European Commission European drug strategy 2000-2004; importance of balanced approach European drug strategy 2005-2009 mentions HR European Action plans focus on evidence-base, effectiveness, coverage and quality of health services

20 State of Affairs; HR in Europe Harm Reduction integral part of most countries drug and HIV responses: –Needle Exchange Programmes –Opiate Substitution Therapy –explicit Information and Education materials –community based outreach –drug consumption rooms –services in custodial settings (arrest houses and prisons) –involvement of users –.... also in countries with traditional approach (e.g. Italy, Sweden) HR is supported by collected evidence by EMCDDA EU increasingly speaking with one voice

21 ‘ Unintended consequences of drug policies ’ prohibition and law enforcement generate violence and corruption pressure on health (and other) harms for users, e.g.: –effects of black market on quality of substances –marginalised existence of users

22 Challenges ahead coverage of HR in all countries drug user involvement in services and policy development 3.eroding quality of HR services 4.swing towards issues on security, safety and public order political (and funding) agenda ’ s

23 1. Limited coverage of HR on country and local level in prison settings access to HIV/HepC treatment responses for stimulant users new generations of drugs and users

24 2. Under-developed user participation recent inventory: limited number of peer support groups. Also in ‘ old HR countries ’ existing peer initiatives on local level, national level are under pressure international recognition (e.g. UN system) of importance of user involvement

25 3. Eroding of HR services mainstreaming and roll out of HR may lead to medicalisation and technocracy of service delivery leading to decreased quality of services

26 4. More Public order increased role of public order and nuisance control. coercive treatments, compulsory treatment enlarged range of law enforcement tools: CCTV cameras and general municipal ordinance (specific areas, crowds, alcohol/drug drug free zones)

27 5. New political agenda ’ s decreasing sense of urgency economic crises, severe pressure on funding new administrations: –‘ small government ’, reduce ‘ welfare state ’, deregulate & cut costs –push for Security and Safety agenda –in drug policy: ‘ Recovery ’

28 Conclusions drug use has become inevitable part of our societies and peoples lives European drug policies are relatively well developed: –they promote comprehensive policies (no single solutions) –they encompass Harm Reduction –but are based on the unrealistic and counterproductive principles of illegality of drugs

29 Ways forward for Harm Reduction ‘ Get organised ’. National and international networks and parterships ‘ Build your case ’ on comprehensive system linking prevention, treatment and harm reduction invest in linkages with ‘ recovery-agenda ’ invest in partnerships between academics, politicians, services and drug user communities need for MEANINGFUL involvement of community and user initiatives

30 Ways forward II AND: need to address contradictory drug policies develop policies based on regulation instead of prohibition

31 Thank you for your attention! John-Peter Kools Expert on drug use, HIV and harm reduction Research, training and publication +31 61504839

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