P-PG/MinConf (2010) 2

11 October 2010

Summary of results and achievements of the Pompidou Group between 2007 and 2010

Chairman’s foreword

Meeting policy makers needs

We keep asking the questions: What are the outcomes of the Pompidou Group’s work? – What use is it for our governments? To help answer these questions, the Polish government’s ambition during its four-year Pompidou Group Presidency from 2007 to 2010, was to work towards better fulfilment of policy-makers’ needs.

Setting up inter-agency co-operation with European and International Organisations on a regular basis was a top priority for the Polish Presidency. To avoid overlap and in the hope to reach synergies, we managed to bring all important stakeholders together on a regular basis: 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 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.

Training Initiative 2010

Following discussions at the Mid-Term Conference leading to the observations that drugs policies tend to lack coherence, and that implementation often falls short of expectations, these became key concerns for the Polish Pompidou Group Presidency.  We are convinced that the Pompidou Group has the unique potential to contribute significantly to improving this situation.  The new ‘Pompidou Group Training Initiative’ by the Presidency aims at empowering member states to achieve more effective and verifiable results in designing and implementing drugs policy. In 2010 we started a pilot training course for drug policy managers hoping that this would create a new ongoing dimension in the Pompidou Group’s known field of competence, namely capacity building.

But besides this new initiative, we also had to take stock and see if the Pompidou Group still suited purpose, and if we were still meeting the expectations of our governments.

Revising structures and working methods

In order to assess the Pompidou Group’s ability to meet policy-makers needs and thus see that the results of our work impact in member states, an analysis of the strengths, weaknesses, opportunities and threats was initiated by and conducted under the guidance of our Presidency. This analysis led the Permanent Correspondents to conclude that the existing ‘Platform’ concept, its structure and working methods, had served their purpose but an adjustment was needed the better to serve the political decision making level in our capitals.

Consequently new revised working methods were adopted that will put the Permanent Correspondents, who are most closely linked to policy-makers, back into the driving seat when deciding on concrete activities and expected outputs. A more flexible work programme, attuned to the flexibility which is the recognised strength of the Group, together with lighter structures and a Bureau more close linked to the Permanent Correspondents, will ensure that work can be done in close correlation with real-time developments.

The future of the Pompidou Group

I am convinced that with the reformed structure and working methods we have suitably re-tooled the Pompidou Group to be more fit for meeting policy-makers’ needs and offering governments the forum to continue working towards common principles and visions.

Of course, all this requires resources and their wise use, nor is it a secret that the Pompidou Group is somewhat stretched as far as resources are concerned. But this situation indicates a clear way forward: focusing efforts and pooling resources. By following a red line in the work and by closer co-operation with key partners, the Pompidou Group will also increase its impact. What could be more obvious than to develop a coherent work programme under an overarching theme, unique to the Pompidou Group and Council of Europe, that is implemented in close co-operation with the EU and its institutions?

Bringing human rights to the forefront

Recently many eminent voices from the expert communities, as well as from international organisations, have called for mainstreaming of human rights in drug policies. I share this view and am convinced that human rights based drug policies can:

-          Save lives in helping to avert deaths by overdose and drug-related health problems through low-threshold interventions based on needs;

-          Provide more effective treatment and rehabilitation options by putting the needs of the individual first, thus reducing the number drug users;

-          More effectively facilitate the development of through-care options reducing the high risk of recidivism and relapsing after incarceration;

-          Afford wider scope for specific options that will be instrumental in enabling more drug users to find their way into care, treatment and rehabilitation and away from the streets and prison;

-          Enlighten law enforcement agencies and courts on human rights standards with clearer guidance as to permissible action, which will thus be swifter;

-          Make civil society and target groups, including drug users, active stakeholders in drug policies, thus fostering more societal cohesion in drug policies and containing risks of marginalisation of risk groups;

-          Serve as a starting point to overcome entrenched views on balancing repression and prevention and so enable governments to move forward again in curbing illicit drugs.

When speaking about human rights, it should be understood as referring to the legal rights enshrined in existing European Conventions of the Council of Europe. Only by this distinction can it be ensured that the discussions will lead to useful results for policy-makers and not to endless debates on prohibition and legalisation.

In embarking on this path, the Pompidou Group will make a major contribution to shaping the era that follows the present UNGASS process. But above all it will show that making human rights fully operational in the sphere of drugs policies can significantly contribute to reducing psychoactive substance use. The Pompidou Group is just the right place to undertake this work, since the Group has been the first organisation to look into human rights and ethical issues related to drug policies.

                         

Dr. Piotr Jablonski

Chairman of the Permanent Correspondents                                           Warsaw, November 2010


Main achievements 2007-2010

Over the last 30 years the Pompidou Group has created tools that enabled decision makers and policy managers to implement policies to counteract trafficking and abuse of illicit drugs and associated problems. Since policy responses cannot only be based on scientific evidence but also need to take into account legal frameworks, public opinion and cultural specificities, the Pompidou Group provides the only forum in Europe where all these aspects are discussed in open debate. The ability of the Group to link policy, practice and research together with a high degree of flexibility is much valued by member States and has led to many important initiatives over time that continue to provide important added value in drug policy development.  The following constitutes a summary of the main achievements under the Work Programme 2007–2010.

Prevention

Two publications were produced to support policy-makers: a manual for local and regional authorities on organising drug prevention in recreational settings and a publication on evaluation of drug prevention. The Pompidou Group developed life skills training programmes as a means of reducing drug use, and implemented pilot projects in Lithuania, the Russian Federation and Ukraine. In these pilot projects, over 150 multipliers were trained and further replication was initiated. The life skills methodology remains one of the most effective interventions implemented across Europe.

The Pompidou Group showed that it is possible to make effective use of civil society involvement in prevention efforts. The European Youth Consultative Forum and the European Drug Prevention Prize engage young people, particularly those in risk groups, as successful actors in preventing drug use among youth and promoting healthy lifestyles The European Drug Prevention Prize was awarded in 2008 and during the Ministerial Conference in 2010 to six examples of good practice, following the nomination of a total of over 120 interesting and innovative grassroots projects from all over Europe.

Treatment

Thanks to the Pompidou Group’s work in the treatment field, improved knowledge is now available as to how treatment systems and rehabilitation services are organised across Europe. The work conducted by the Group shows the importance of taking into account national and cultural specificities in treatment systems to ensure that they can develop their full potential. The Pompidou Group identified the importance of involving service users in development of the guidelines on drug treatment. The analytical overview of treatment systems in different European countries serves as a valuable resource for further developing and re-tooling treatment systems.

By looking into procedures and players involved in establishing and implementing treatment guidelines in Europe, variations in the development and use of treatment guidelines could be analysed. In this way, information and knowhow can be provided as to how effective preparation and implementation of treatment guidelines is possible.

Criminal Justice

The Pompidou Group has extensively analysed experiences with diversion schemes and other alternatives to imprisonment, notably the existing schemes of quasi-coerced treatment, now providing member states with examples of best practice and an overview of prerogatives for successfully introducing such models into national policy.

Activities aimed at reducing the diversion of chemical precursor products used for producing synthetic drugs had the result of improving co-ordination among national agencies, as well as in the chemical industry. The Group for the first time provided a unique forum where national government agencies engaged with representatives of the private sector chemical industries.

Airports and general aviation

Controlling drug trafficking in civil aviation through co-operation between customs and law enforcement agencies throughout the member states is materialised in the Airports Group. It is the only multidisciplinary body in this field that brings together officials from police, border control agencies and customs agencies. On a confidential basis, this body regularly provides member states with the most recent knowledge on modus operandi used by drug traffickers in civil aviation as well the technical action required to counteract them. Between 2007 and 2010, work focused on improving direct transnational communication channels, and included organising a controlled delivery project with Central Asia.

Co-operation at frontline level

Since its creation in 2007, the EXASS network for multi-agency partnerships tackling drug problems at frontline level, bringing together stakeholders such as institutions, municipalities, service providers, NGOs and experts, has provided policy-makers with professional insights based on experience. At regular intervals, EXASS Net conveys ‘real time’ information and findings to policy-makers via specific on-line and printed products. The present work cycle provides examples of good practices for overcoming obstacles and for inter-agency co-operation on the following topics: dealing with cannabis consumption, effective user involvement in drugs policies, safer nightlife and party scenes, tackling drug-related health problems, and last but not least, making effective use of early intervention.

EXASS Net was commended as a successful innovative project in the 2008 INCB Report.

Research

Policies aimed at bringing more coherence to approaches to licit and illicit drugs were surveyed in 17 member states, giving governments a better understanding of the implications of divergent policy approaches in the field of drugs and psychoactive substances.

Recent developments in biomedicine, psychology and social sciences are regularly analysed having regard to the needs of policy-makers.  In the publication “Signals from drug research”, policy-makers are acquainted with the latest developments and expected implications for the policy level.

To improve the interaction and communication between the science research field on one side and policy-makers and governments on the other, a set of publications developed in conjunction with the ESSD (European Society for Social Drug Research) provides decision makers with insights into the links between policy development, theories, research methods and patterns of drug use.

Since 2007 the Pompidou Group, with the participation of EMCDDA, has kept an on-line Register of ‘who does what’ in drug research in Europe. After a pilot phase, a fully operational new version is now up and running with an inventory of 620 contacts including 443 researchers and 143 research projects in member states.

Ethics and human rights

The Pompidou Group was at the forefront in addressing ethics and human rights issues related to drug control policies. As a result of the current Work Programme, member states are provided with guidance on drug screening at the workplace, and on consequences and ethical dilemmas of new ‘drug-proofing’ methods such as ‘vaccinations’ against cocaine use.

The expert opinions and recommendations emerging from the work of eminent national experts provide valuable information on ethical and human rights aspects in the fields addressed. This will help avoid infringements of individual rights when developing intervention tools such as screening programmes or considering ‘drug-proofing vaccinations’.

Training Initiative

Following an initiative by its Chairmanship, the Pompidou Group provided training and further education in support of drug policy management. The 2010 pilot training course delivered know-how on effective policy implementation and management to drug policy managers from 28 countries.

Bridging

The Pompidou Group’s capacity to facilitate dialogue between Europe and its neighbouring regions through co-operation, exchange and capacity building was again demonstrated in setting up and consolidating the Co-operation Network in the Mediterranean Region on drugs and drug addiction (MedNET) which has increased membership from originally 5 to 11 countries. In addition to the broad range of training and capacity building activities, a feasibility study in four countries on setting up monitoring centres was conducted, school surveys were organised in two countries with the expertise and support of the Pompidou Group and MedNET, and the first MedNET High Level Conference was held in Strasbourg in December 2009.


Conclusions and observations by Permanent Correspondents

It needs to be recalled that policy responses to drugs and drug-related problems cannot only be based on scientific evidence and vigour, but also need to take into account cultural influences, organisational structures and public opinion. It has to be noted that research results apparently seldom influence drug policy. Research results are frequently used, often in a selective and over-simplified way interpreted by political interest groups, in political debate in support of specific positions to which they correspond.

Chronic condition: Drug abuse is often a long-term problem for individuals, and addiction constitutes a chronic disease. In previous years, this has regularly been underestimated. As a result, in many cases intervention concepts and related resource planning are placed in a short and medium term perspective based on a vague hope of cure and social re-integration. In order to be effective, time scales for interventions and services rendered must be readjusted to such realities. Proceeding from this, policies and services must also take into account that there will be a growing number of older drug users for whom adequate medical and social responses will have to be developed.

Participation: Active youth participation and involvement in drugs prevention is a reality across Europe and should be at the heart of drug prevention policies. Youth participation brings added value to efforts of governments and civil society in tackling drugs-related issues, because it has the potential to reinforce protective factors whilst impacting on risk behaviour.

Drug user registration: Registration systems for drug users require urgent reform since systems of patient registration are an important source of information for developing target group oriented treatment options.  When setting up registration systems, due attention has to be paid to safeguarding clients’ data. If adequate data protection cannot be attained and demonstrated registration of drug users can constitute a barrier for people in need to seek treatment for fear of negative consequences.

Treatment systems: Drug treatment in European countries should be based on scientific evidence and good practice rather than on tradition, belief and unrealistic expectations. The perspectives of drug users, their relatives and others affected by the drug use and associated problems receive little attention. This can constitute a serious obstacle to the provision of adequate and successful treatment. Monitoring the application of treatment options and taking into account drug research results will provide information on what works and what impact is achieved.

Supply reduction: To stop the production of synthetic drugs, early intervention at the beginning of the drug production chain is crucial. Special attention is given to the potential risk of airport personnel involved in drug trafficking. This type of crime can only be kept in check by a harmonised, international, multi-agency approach. In addition, new forms of co-operation with authorised private companies present at the airports are necessary to stay in control of airport crime risks.

Co-operation: Partnerships between stakeholders at frontline level do not provide all the solutions to drug problems, but it can be more effective and resource-efficient than traditional approaches to implement such policies. An integrated approach combining law enforcement, treatment and prevention can improve the impact of drug policies. A prerequisite for implementing such integrated policies is the ability of the relevant stakeholders to co-operate in partnerships at first-line level.

Virtual tools: The use of information and communication technology provides added value to reduce drug abuse and addictions, if it becomes an interactive tool that links users with the professionals and agencies tasked to deal with drug-related problems. Whether information technology will play a positive role in diverting young people from substance use, or conversely be used as a means to promote it, will depend on support for young people in the development of their ability  to deal with this adequately. Recognition of their capacities, resources and energy will determine the positive role they can play in reducing or preventing drug use.

Informed choices: The issue of informed choices is crucial to all decisions in connection with adopting policies, implementing interventions and deciding on drugs research. Choices to be made constitute critical factors in legislative decisions, legal determinations as well as personal choices. Being based on the notion of individual free will, the concept of informed choice has to be constantly reviewed in the light of emerging results from neurosciences and genetics as to what conditions human behaviour.

Assessment: Evaluation requires further expansion and application in Europe. It should be understood that it is first of all an instrument for measuring impact and making practical improvements. When reduced to a tool for convincing funders or lobbying for resources, the scope and purpose of intervention will be distorted and consequently the usefulness of the assessment results will diminish.

Capacity building: The Pompidou Group has demonstrated in a wide range of activities, including MedNET co-operation and the Life Skills Training Programmes, its ability to contribute to the shaping and implementation of different interventions, as well as to the preparation of strategies and actions. In this way the Group’s work can have demonstrable impact on drug policies. This can be a unique complementary contribution to EU action under its Neighbourhood Policy and related programmes, as potential to be borne in mind and utilised by decision makers wherever appropriate to support non-EU States in developing drug strategies and policies. 

Human Rights: Including a human rights dimension in drug policies will help to underline the multidimensional nature of psychoactive substance use and addictions in terms of a range of inter-related and mutually reinforcing societal factors. Furthermore, the human rights dimension would allow this aspect to be brought back to centre stage. Adding a human rights dimension to the evidence based approaches can help to refocus drugs policies on demand reduction and thus bring public health, as the first principle of drug control policies, back to the forefront.


Summary of signals from experts and practitioners of Pompidou Group Platforms

Conclusions and proposals on…

…. Prevention

The Prevention Platform identifies new approaches and methodologies to achieve more effective and widespread impact with prevention efforts.

Involving target groups

Effective prevention programmes cannot be developed and implemented without taking the following factors into account:

Ü  Involvement of school, family and community and clear definition of their responsibilities,

Ü  Recognition of cultural differences,

Ü  Drug prevention activities work well when combined with activities that also tackle other social problems.

The Pompidou Group’s European Youth Consultative Forum and the European Drug Prevention Prize have become model activities for successfully engaging young people and demonstrating the value of their contributions in developing and implementing responses to drug problems.

Youth participation

Active youth participation and involvement in drugs prevention is a reality across Europe and should be at the heart of drug prevention policies. Youth participation brings added value to efforts of governments and civil society in tackling drug-related issues because:

Ü  young people are experts on youth and youth cultures,

Ü  it helps to make interventions more relevant, timely, resourceful and attractive,

Ü  it is the most promising way to engage with hard-to-reach target groups.

Young people need to have access to leisure time structures which offer them a wide range of activities and possibilities for personal development. Young people appreciate opportunities to engage in sports, culture, education and other areas where they can utilise their creative potential by developing and determining activities themselves.

To reach young people more effectively, more use should be made of the new technologies (IT) 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 using them innovatively.

 

Whether IT will play a positive role in diverting young people from substance use or be means to promote it depends on the level of interest taken by governments and civil society in supporting young people in the development of their creative potential. Recognition of their capacities, resourcefulness and energy will determine their positive role in reducing or preventing drug use.

Evaluation

Innovation and experimentation are still needed in drug prevention since there is insufficient knowledge of how and under what circumstances prevention can produce the anticipated results. In particular, project monitoring and evaluation are still weak and need to be improved to find out more about what works among the prevention approaches employed.

Evaluation should be primarily applied as a tool for practical improvement to interventions; if reduced to convincing funders or lobbying for resources, its scope and purpose will be distorted and the usefulness of the results reduced.


… Treatment

The Treatment Platform provides guidance and information about systems and approaches that will help deliver more targeted and effective treatment options. Treatment systems and guidelines were the main focus of the Platform’s work.

Drug treatment in European countries should be based on scientific evidence and good practice rather than on tradition, belief and unrealistic expectations. The perspectives of drug users, their relatives and others affected by the drug use and associated problems receive little attention. This is a serious obstacle to delivery of adequate and successful treatment.

Principles of knowledge-based medicine are instrumental in drug treatment as in any other branch of medicine, and at the same time the basis for developing treatment guidelines.

In order to develop adequate knowledge, information from registration systems and drug treatment results should be correlated for an insight into the requirements for guidelines.

While patients with drug addiction problems often suffer from a multitude of medical, psychological and social conditions, requiring a range of long-term interventions, most of the present research on the effectiveness of treatment is conducted on relatively short-term interventions that address mainly the substance-related addiction.

Most of the available evidence on substitution treatment concerns the pharmacological part of the treatment. However, most substitution treatment options provide for psychosocial interventions as part the individual treatment plan. The effects of this treatment aspect in combination with substitution treatment remains to be further explored.

Developing treatment guidelines requires profound preparation pooling available knowledge from research, professional practice and science on all relevant aspects of the states of the art and practice.

Systems of patient registration are the primary source of information for developing target group oriented treatment systems. Monitoring the application of treatment options and taking into account drug research results will provide information on what works and what impact is achieved. Together, these two aspects constitute the knowledge base that is required to develop treatment guidelines.

The implementation of treatment guidelines requires long-term provisions to allow for ongoing monitoring arrangements, which are indispensable to the application and impact of the guidelines.

Connecting funding rules and treatment regulations to the requirements of guidelines has proved effective in increasing the rate of acceptance of guidelines and their level of application.

Legislation plays an important role in available drug treatment. It is therefore important that existing legislation be consistent with evidence-based treatment modalities, otherwise anticipated treatment will not be fully realised.

… Criminal Justice

The Criminal Justice Platform analysed existing alternatives to the imprisonment of drug offenders, in particular quasi-coerced treatment, explored ways to deal with recidivism in drug-related crimes, and ways to prevent the diversion of chemical precursor products.

High quality of treatment is a precondition for the success of diversionary arrangements for drug dependent offenders, including the option of quasi-coerced treatment. Further improvement of treatment as an alternative to imprisonment can be achieved by:

Ü  putting more emphasis on rehabilitation, monitoring and evaluation,

Ü  refining the referral and assessment procedures,

Ü  assessing the appropriateness of treatment options,

Ü  verifying consistency of procedures and reviews,

Ü  facilitating effective aftercare arrangements. 

Recidivism in drug-related crimes needs to tackled on different levels.

Law enforcement should increasingly pay attention to chemical precursor product diversion in order to prevent production of synthetic and non-synthetic drugs. Backtracking investigations require further extension and improvement. In this respect, information exchange between law enforcement and regulatory authorities needs to be extended and co-operation improved by means including direct contact between staff.

… Airports and general aviation

The Airports Platform facilitates technical and practical co-operation in drug supply reduction at European airports and in general aviation, as well as linking customs and law enforcement agencies working in this sphere.

Airport employees play a central role as facilitators to drug trafficking. This specific type of crime can only be kept in check by a harmonised, international, multi-agency approach.

New forms of co-operation with authorised private companies represented at the airports are necessary to stay in control of airport crime risks.

There is a need for a systematic application of profiling to passengers on regular and low-cost flights and to air cargo.  This can be most effectively facilitated by providing:

Ü  legal access to data from air companies;

Ü  collection of representative data;

Ü  rapid exchange of data between different services responsible for drug trafficking.

The Airports Group has demonstrated that it can play an important instrumental role in facilitating trans-national controlled deliveries with regard to their legal framework and operational implementation.

Comparing the respective modus operandi of trafficking in human beings, money laundering and trafficking in drugs and drug precursors from a multidisciplinary perspective (police, customs, border guards) can lead to identification of the responsible criminal organisations.

  

To stop the production of synthetic drugs, intervention at the beginning of the drug production chain (“No narcotic drugs without chemicals”) is crucial. A prerequisite for successfully preventing drug precursor diversion is the ability of relevant agencies on a national and international level to co-operate with each other.

…. Co-operation at frontline level

EXASS Net is the transversal network of the Pompidou Group connecting partnerships between stakeholders at frontline level responding to drug problems. EXASS Net provides experience and assistance for inter-sectoral co-operation.

Reports from practitioners, corroborated by statistical indicators on drug use and crime, suggest that the inter-sectoral co-operation of stakeholders at frontline level in applying low-threshold services over the past 15 years continues to yield results.

Approaches that force drug users into services and treatment yield scant sustainable results. It is more effective to use approaches and structures that provide an infrastructure of services and interventions allowing drug users to manage themselves within the system. This type of infrastructure provides various routes into stabilisation, maintenance, treatment and eventually abstinence.

A high degree of discipline among drug users in complying with programme rules can be achieved when:

Ü  rules are clear and simple,  

Ü  not too many rules are in place,

Ü  sanctions are not unreasonable,

Ü  in the event of failure there is a path to return.

Above all, the concept of voluntary participation and the fact that the services offer genuine improvement for the life situation of the drug users are what lead to generally more disciplined behaviour.

Growth of different ethnic target groups, due to greater mobility within Europe and with neighbouring regions, requires more qualified personnel with intercultural and language competences. Recruiting professionals from respective ethnic backgrounds has proved to be a very limited option. Consequently there is a need for more professional exchanges between countries and direct working contacts between frontline professionals in Europe. This is particularly crucial for any attempt to repatriate drug users to their home countries.

The general recruitment of staff to work in this field is becoming more challenging. Among the areas of employment in the social field, the drugs services find it increasingly difficult to recruit young professionals. However, employment in services organised in partnerships based on inter-sectoral co-operation appears to offer work with high motivation levels and lasting job satisfaction. 

Active involvement of human rights advocacy organisations in the development and delivery of drugs policy can help win greater acceptance of drug policies among drug users and reach difficult target groups. In addition, an approach based on human rights and compassion leads to greater acceptance of drug policies and services in the community and generates more understanding towards necessary measures.

Policies tend to be more sustainable and to yield better results when approaches, methodologies and actions are based on sound experience and available evidence, and take care not to raise unrealistic expectations. Such approaches, however, require serious efforts to verify the success of policies and interventions through accompanying research and development of an evidence base.

The capacities for networking and dialogue, as well as the ability to resolve problems and the goodwill to engage with all concerned stakeholders in the community, are keys to effective policy implementation and programme delivery.

… Research 

The Research Platform highlights new findings in neurosciences, psychology and biomedicine, as well as proposing ways to connect research, policy and practice more closely to meet challenges ahead,thus facilitating the development of evidence-based policy.

Interaction between research and policy: how does research influence policy?

Science and research have only a few hard, undisputed facts on drug use to contribute to the policy making process:

Ü  the earlier one takes drugs, the higher the risk of becoming dependent,

Ü  the longer one takes drugs, the more difficult it is, to stop,

Ü  some stop using drugs with some medical care,

Ü  some do not stop drugs despite medical care,

Ü  some stop using drugs without any medical care.

Linking policy and research continues to be a challenge. It appears that research evidence is rarely used in drug policy. Research evidence is mainly invoked in reports presented to parliamentarians or in arguments directed at the public. In these cases, research findings are translated by “research brokers” into the language of public opinion.

A review among 17 countries shows that policy is influenced by various factors. Among these, science in general plays a minor role in the political decision making process, whereas public opinion, cultural values and ideologies constitute far more significant determinants.

Findings from psychology, sociology and biomedicine

In psychology the concept of addictive personality is by now largely rejected, and a number of personality traits commonly observed in drug abusers are not seen as expressing inevitably pathological processes.

Behavioural disinhibition has been validated today as the most important personality dimension related to drug abuse. In addition, disinhibitive personality traits are also related to an earlier age of onset, polydrug use, chronic/heavy use, behavioural and antisocial personality disorders, substance dependence severity, HIV risk behaviours and psychiatric symptoms.

Sensation-seeking and impulsiveness are personality traits which permit better prediction of drug use patterns. Impulsivity seeks to accomplish rapid behavioural changes regardless of negative consequences. Sensation-seeking strives for novel sensations and experiences.  It is advisable to incorporate findings from both, educational sciences and psychological research, in interventions or educational models that are aimed at reducing drug use driven by sensation-seeking and impulsiveness.

Recent findings from the biomedical field show that psychiatric disorders are inextricably linked with substance abuse, with the psychiatric disorder occurring first. Consequently, substance abuse in such cases is to be mainly attributed to the presence of anxiety and to a lesser extent depression, rather than to lifestyle-related reasons.

… on Ethics and professional standards

The Ethics Platform assessed ethical problems of drug testing in different environments, as well as exploring ethical dimensions related to research findings.

Drug screening

The recurrence of the debate on screening in numerous European countries illustrates the importance of this question in terms of available choices, freedom and safety.

To date there is no research evidence that indicates a preventive function of drug screening in schools. While it cannot be assumed that drug screening in schools will prevent a young person from using psychoactive substances, it does increase the risk of stigmatisation and exclusion.

Drug screening at the workplace can be classed as an intrusion in the private life of employees, so it is advisable that basic rules be defined as to the categories of risk situations and professions where drug screening would be permissible, the use of the results of the screening, as well as how and by whom, e.g. an occupational physician, it would be carried out.

When determining the use of the results of drug screening at the workplace, the existing international instruments that ban discrimination at the workplace must be taken into account. It should also be borne in mind that unemployment can lead to increased and problematic consumption of psychoactive substances.

Most available rapid screening methods and tests are still limited and the results obtained difficult for non-experts to interpret.

Drug screening by insurance companies is applied to various degrees across Europe. In analysing existing practices, it has become apparent that the standards for the protection of the fundamental rights of individuals are not appropriately balanced with the interests of insurance companies.

Ethics and research 

The issue of making informed choices is crucial for all decisions in connection with adopting policies, implementing interventions and deciding on drugs research. Choices to be made constitute critical factors in legislative decisions, legal determinations as well as personal choices. Being based on the notion of personal free will, the concept of informed choice has to be constantly reviewed in the light of emerging results from neurosciences and genetics as to what conditions human behaviour.

It must be properly appreciated by legal and medical practitioners, but also by policy developers, that the degree of consciousness of persons who suffer from addictions, particularly in cases of multi-substance dependencies, is strongly influenced by the addictions and affects their capacity to make free choices.

So-called ‘vaccines’ against drug addiction are intended to modify temporarily the susceptibility of human beings to certain substances. At present, most practical experiments are conducted on cocaine and nicotine. The prospect of their marketing raises problems particularly because they will be apt to influence the preferences of individuals as well as their physical and mental integrity. Some recent high-profile media coverage has inferred expectations across societies which, however, are not validated by the existing indications from scientific research.


Retooling the Pompidou Group

The Mid-Term Conference of the Pompidou Group and the subsequent assessment of its strengths and weaknesses, as well as existing threats and emerging opportunities, reaffirmed as one of the Group’s strengths its ability to adjust to rapidly evolving changes in the area of drugs and related problems requiring policy responses.

It also became evident that, by providing a forum of open dialogue, the Group continues to occupy a unique niche.  However, many delegations feel that this virtue does not suffice in itself to secure the future of the Group. In addition, it is widely perceived that the results of the Group’s work are not sufficiently transmitted to the national policy machinery, so that sometimes there is little visible impact. As a consequence, output and products, which are more likely to be instrumental to policy-makers’ needs and thus will eventually be reflected in national drugs policies, should be pursued.

Highlighting ethics and human rights dimensions, as well as anticipating the impact of emerging results from neuroscience and biomedicine, remain further hallmarks of the Group that set it apart from other organisations. Regrettably, this specific expertise is not always fully recognised. It is seen as imperative to validate and optimise this work further. An important first step in doing so will be to change the Research and Ethics Platforms into proper Expert Committees. 

Another area where the Pompidou Group has proved its capacity beyond doubt is its ability to engage and co-operate with neighbouring countries not members of the EU in Europe and beyond. The co-operation activities with Eastern Europe and North Africa show that the Group is not only effective in capacity building but also very competitive because of its highly cost-effective way of working.

Linking policy, practice and research remains another of the Pompidou Group’s unique strengths. Recently the Platforms, in existence since 2003, have not always proved the most effective instrument for reaching practitioners. Professional networks such as the Airports Group and the EXASS Net have shown themselves to be more promising in bringing messages from practitioners to the attention of policy-makers. As a consequence, the existing Platforms in the fields of prevention, treatment and criminal justice will not be continued beyond 2010; rather,  the Group will be provided with the means to set up ad hoc expert groups to fulfil specific tasks defined by the Permanent Correspondents.

In sum, the expert committees and ad hoc expert groups serve the information needs of the PCs. They will deliver knowledge, experience and evidence from research and practice as requested.

The Pompidou Group’s Work Programme 2011–2014 reflects the changes in structure and working methods. In aiming at more cohesion and highlighting the core values of the Council of Europe, the  Work Programme 2011-2014 should be built around human rights dimensions in drugs policies as the overarching theme. This dimension would also guide the Permanent Correspondents in their task of developing annual programmes of activities, another novelty aimed at ensuring the necessary flexibility to meet decision makers’ needs in a timely manner and to ensuring that the Group is on top of emerging issues.

To increase synergies and avoid overlaps, but also in recognition of the dangers of limited resources, increased co-operation and co-ordination are sought with the institutions and agencies of the European Union, in particular the European Commission and the EMCDDA. Pompidou Group seeks, in order to avoid unnecessary overlaps and to create synergies wherever possible.

The revised structure and revised working methods of the Pompidou Group were adopted by the PCs at their 64th meeting following a proposal by the Group’s Presidency (P-PG/BUR (2009) 15). The revised concept builds on the ‘diagnosis’ and conclusions from the SWOT analysis conducted (doc. P-PG/BUR (2009) 9 rev), the conclusions from the Mid-Term Conference in 2008 and the discussions held during the 63rd and 64th PC meeting. It is expected that with agreed revisions, coming into effect with the new Work Programme 2011–2014, the future work of the Group will be sufficiently retooled to meet policy-makers’ needs even more effectively in the future.


Overview of the results 2007-2010

Prevention Platform:

activities/topics

Results & products

Conference on families, lifestyles and drug prevention, Porto, 2007

2  Conference report

2  3 proposals for pilot projects in prevention

: Selected conference presentations available on Pompidou Group website

        

Expert group developing pilot projects to reach vulnerable families in drug prevention and good prevention practices in resort areas (follow-up to 2007 Conference)

2 Handbook for municipalities and regional

    authorities on prevention in leisure time settings

European Drug Prevention Prize 2008

Ü  Active engagement of target groups in drug prevention activities for young people

Ü  34 candidatures from 15 countries received

Ü  3 Awards presented at the 2008 PG Mid-term Conference

 

Conference on concepts and methods to evaluate impact and success of prevention programmes, Prague, 2010

Ü  Proposals for future Pompidou Group work programme on evaluations methods and transferability of good practice

2  Conference report

European Drug Prevention Prize 2010

Ü  Active engagement of target groups in drug prevention activities for young people

Ü  80 candidatures from 26 countries received

Ü  3 Awards presented at the 2010 Ministerial Conference and shortlist of innovative drug prevention projects involving young people

Treatment Platform:

activities/topics

Results & products

Providing knowledge of how treatment systems and rehabilitation services are organised across Europe

2 Publication on treatment systems in Europe

Conference on procedures and players establishing and implementing treatment guidelines in Europe, Nicosia, 2009

: Conference materials

      (available on Pompidou Group website)

Conference on targeted treatment for stimulants users, Strasbourg, 2010

 

2  Conference report


Airports Platform:

activities/topics

Results & products

2007 Airports Group annual meeting

2 Updated General Aviation Directory of National     Contact Office

2 Updated Inventory of Drug Control Officials at     European Airports

2008 Airports Group annual meeting

 

2009 Airports Group annual meeting

2010 Airports Group annual meeting

Criminal Justice Platform: activities/topics

Results & products

Conference on quasi-coerced treatment,

Bucharest, 2007

Ü  best practices in diversion schemes and preconditions for the implementation on national levels

2  Conference report

Conference on trafficking in precursors and medical products, Bucharest, 2009

Ü  Involvement of the private manufacturing sector in enhancing co-operation on precursor control

Ü  Proposal for Pompidou Group activity on precursor control in airports and aviation

2  Conference report

Research Platform:

activities/topics

Results & products

Coherence or different approaches between licit and illicit substances in prevention, law enforcement and treatment

2  Publication on the situation in 17 European countries  

Monitoring developments in biomedicine, psychology and social sciences

 2  Publication “Signals from drug research”

Interaction and communication between science and policy-making

(in co-operation with ESSD)

2 Publication on Drugs and Society, 2007

2 Publication on Cannabis, 2008

2 Publication on old and new policies, theories, research methods and drug users, 2009

On-line Register of who does what in drug research

: www.pgregister.coe.int/pompidou

     620 professionals and 144 projects


Ethics Platform:

activities/topics

Results & products

Ethics aspects in drug screening at work and at school

: web page with reports and expert

       recommendations 

2 Publication with expert recommendations

Ethical aspects of research

2  Conclusions from round table discussions 

Consequences and ethical dilemma of new ‘drug-proofing’ methods such as ‘vaccinations’ against cocaine use

2  Pompidou Group document with expert opinion on ethical aspects of ‘drug-proofing vaccinations’

Ethical aspects of quasi coerced treatment

2  Contribution to Criminal Justice Publication

Other activities

Results & products

Inter-agency group (PG, EU COM, EU Troika, EMCDDA, UNODC, WHO)

Ü  PC thematic debate on ‘legal highs’

Ü  Review of Memorandum of Understanding

between PG and EMCDDA

Mediterranean Network MedNET

2 Feasibility study Mediterranean drugs observatory

2 MedSPAD school survey in Lebanon

2 Proceedings of 4 treatment seminars in Algeria

2 Proceedings of a conference on the role of

       research in policy in Algeria

Ü  3 annual training programmes, study visits and surveys in prevention, treatment, research and implementation of the law

Ü  8 annual meetings

Ü  Lebanon, Egypt, Jordan committed

Ü  4 fact finding missions for feasibility study

Ü  2 Addictology courses set up in Morocco

Ü  2009 High-level conference and drug addiction

EXASS Network

222 7 thematic reports on EXASS Net meetings and visits to Amsterdam, Budapest, Helsinki, Frankfurt, Lancashire, Moscow, Oslo

: internet website set up at:

       www.exass.net

: internet resource and download on safer night life

: internet resource and download on user involvement


Other activities

Results & products

Health in prisons programme (HIPP)

Ü  Contributions to 3 annual WHO meetings

European school surveys (ESPAD) (support for non-EU countries for project co-ordination)

2 Acknowledgement in the ESPAD 2007 report

2 Press communiqué for the international report

Technical co-operation school-based prevention Programmes (Ukraine and Lithuania)

2 training materials

Ü  trainings and study visits conducted

Ü  150 multipliers trained

Ü  agreement with local authorities to implement LS trainings

Ü  replication programme with Ministry of the Interior started

Technical co-operation on drugs and road safety

: PG video clip in co-operation with Pompidou

      Group Presidency produced

Training young researchers on qualitative drug research and on communicating findings to policy-makers

Ü  24 researchers trained and certified in 2008 and 2009