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Drug Control Policy: The European Perspective

International symposium aimed at assessing alternatives for the drug control regime in the light of international drug policy

David Timis

on 13 November 2013

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Transcript of Drug Control Policy: The European Perspective

What do we do?
contribute to the

multidisciplinary, innovative, effective and
“evidence-based” drug policies
in 35 member states.
seek to
link policy, practice and science
play a
bridging role
between EU countries and non-EU countries.
cooperate with other Council of Europe initiatives, placing special
emphasis on

ethical issues and respect of human rights
How do we do it?
Currently, the Pompidou Group carries out activities in the following areas:

Airports - Reducing drug supply and drug trafficking
EXASS Net - Drug policy co-operation in South-East Europe and the Balkans
MedNET - Activities within the Mediterranean network
Fight against Chemical Precursor Diversion
Prevention at work
Prevention in prisons
When you can stop you don't want to, and when you want to stop you can't...

Addiction is a complex disease, and quitting takes more than good intentions or a strong will.

In other words,
addiction is here to stay
The current
economic crisis
has precipitated an onset of
new addiction challenges
and there is a sense of concern that treatment and prevention programs will continue to be cut as countries look for ways to balance their budgets.
Recent Developments Concerning the Spread of IDU's and HIV
• an increased prevalence of HIV among Injected Drug Users (IDU’s) since the beginning of the economic crisis;

• increased waiting periods to have access to opioid substitution treatment due to the cuts made under austerity measures;

• reduced volume of injection equipment exchange due to the budget cuts made in several countries in Europe;

• an increasing concern amongst policy makers about the stigmatization of drug addiction and subsequent discrimination (“addict-o-phobia”).

An intergovernmental body formed in 1971 at the suggestion of the French President Georges Pompidou.
Began as an informal co-operation forum of 7 European countries (France, Belgium, Germany, Italy, Luxembourg, Netherlands, United Kingdom) looking to share their experience with combating drug abuse and drug trafficking.
Incorporated into the Council of Europe in 1980.
At present, the Pompidou Group comprises 35 member states.
Who are we?
financial crisis
that has engulfed Europe since 2008 has caused:
increases in national debt levels;
rising interest rates;
decreased GDP;
worsening unemployment rates.

The most

vulnerable groups
of people hit by the crisis are:
old people;
people with disabilities;
migrants and refugees;
ethnic minorities;
low income people;
unemployed people.
Financial Crisis in Europe
Evidence suggests that the economic downturn, and particularly
, has also a dramatic effect on
mental health

• The prevalence of psychological problems in unemployed people (34%) is more than twice than in employed people (16%);

• The negative effects of unemployment on mental health were less in countries with strong employment protection systems (Sweden, Finland) than in those with poor employment protection (Spain, Greece).
However, despite more than 100 years of research about the
effects of economic turbulence


, the relation between the two is
not yet fully understood

This is due to several factors:
the absence of up-to-date morbidity and mortality data;
the lack of funding for health research;
the largely silent public health voices and health ministries.
Consequences on Public Health
economic crisis leads to
among others:

• widespread malnutrition;

• stunted growth in children;

• substance abuse, which in turn leads to:
HIV infections;
alcohol-related deaths;

• increased susceptibility to disease.
HIV Outbreak in Greece
An HIV outbreak in injecting drug users that started in 2011, worsened in 2012 as a result of the economic crisis:
• Beginning with 2007 and up until 2010, between 10 and 15 HIV infections were reported yearly in injecting drug users in Greece.

• The number of infections increased to 256 in 2011, and to 314 in the first 8 months of 2012.
Low provision of preventive services has been an important contributor to increased HIV transmission in Greece, and non-governmental organizations reported disruptions of needle exchange programmes and other preventive initiatives since 2008.
Way Forward
After the fall of GDP and tax revenues, and the increase in unemployment and spending, European countries had responded to the financial crisis in various ways:
European countries' response
On one hand,
some countries were better prepared to face the crisis and they:
protected their health budgets by making cuts in other sectors;
increased taxes on alcohol and tobacco in order to raise revenue and promote health.
On the other hand
, other countries were not prepared for the crisis and they:
cut costs, particularly in the hospital and pharmaceutical sectors;
reduced or froze the salaries of their health professionals.
Several European countries have requested the Pompidou Group to take urgent actions to address the issue of reduced budgetary resources for drug policy programmes and the public health consequences resulted from the crisis.
Pompidou Group's Response
Austerity Measures
The austerity policies have been
very controversial
, because recent evidence has shown that they have affected economic growth much more adversely than previously believed.

Moreover, austerity
affects all sectors of government spending
, including public health and drug policies. One of the consequences is a decreased extent of coverage for health and prevention services, including harm reduction and substitution treatment programmes.
Aims and Objectives
• to analyze the possible consequences resulting from the economic crisis in Europe for drug use patterns and resulting adverse social and public health effects;

• to identify drug policy responses to contain adverse social and public health consequences related to drug use and risk taking behavior in times of economic crisis;

• to provide guidance to governments when setting drug policy priorities under conditions of austerity budgets;

• to propose a mechanism for on-going consultation, sharing of experiences and mutual support for drug policy decision makers from concerned and interested countries.
Recent Projects
An "International Conference on Mental Health and Addiction in Prisons" was organized in Bucharest Romania, in February, 2013;

A workshop on "Pharmacotherapy with Methadone" was organized in Chisinau, Moldavia, in April 2013;

In Morocco, addictology courses are currently on-going in two universities (Rabat and Casablanca);

In Egypt, the project concerning the "Gender Oriented Care of Substance Dependent Women" is preparing a workshop for the 15 of May, in Cairo.
Future Recovery
The uncertainty created by the crisis and the consequences of austerity measures are not reassuring and they are not prefiguring any significant economic improvements in the near future.
An absence of economic growth means loss of income and employment, and reductions in social assistance for ordinary people, which have long-lasting consequences for the most vulnerable members of society.
However, a small source of optimism is that European civil society organizations, including professional bodies, have spoken out about the adverse health effects of cuts to health and social spending.
Recently, Nils Muiznieks, the Commissioner for Human Rights of the Council of Europe, said that in order to recover from the economic shock:

“We need to rethink our approach to the crisis, putting human rights at the center of our efforts to bring order and sustainability to our public finances”.

The question is whether anyone will listen…
patrick.penninckx@coe.int http://www.coe.int/pompidou
Heroin Use in Decline
is still responsible for the largest share of drug-related diseases and deaths in the EU, but while these problems continue, they do so at lower levels:

• new recruitment into heroin use has fallen;
• the availability of the drug has declined;
• some countries have experienced acute shortages of heroin.

Patterns of Drug Use Are Shifting
Opioids other than heroin
are now cited as the main problem drugs by a high proportion of those entering treatment:

synthetic opioid fentanyl (Estonia);
buprenorphine (France);
increased use of amphetamines (Hungary).

Responding to Drug Use in Europe's Prisons
635 000 people are held in penal institutions in the EU
, and most of them initiate drug use or begin to engage in more harmful practices while incarcerated; this is due to:

•poor hygiene;
•lack of healthcare provision.

The Web Revolution
New drugs are invented every year
to circumvent current bans, and freely sold on the internet; as consequences:

people are taking more drugs than the authorities even know exist;
new designer drugs are created by slightly altering the formula for known molecules such as MDMA or LSD;
when the new drugs are banned, users simply start experimenting with other dangerous chemicals.

People Who Inject Drugs
16 million people inject drugs globally, 3 million of whom are living with HIV.

Eastern Europe and Central Asia are the two regions vital to the success of reducing these figures by 2015.

Here, the number of people newly affected is rising, and the domestic public sector only provides 15% of spending on prevention programmes for people who inject drugs.

Drug Control Policy: The European Perspective
International Symposium
European University Institute
17-18 June 2013, Florence, Italy

Patrick Penninckx
Executive Secretary of the Pompidou Group
Full transcript