One of the fruits of Ireland's EU Presidency was the increased coordination of Europe's war against drugs. Still very much a national prerogative, it was felt that by pooling best practice we could learn from each other - hence the European Monitoring Centre for Drugs and Drug Addiction whose important annual report has just landed on my desk.
The report admits that international statistical comparisons of abuse are made difficult by the use of different polling techniques and because of the general unwillingness of users to admit to the use of the harder drugs. Ireland, in particular, has surveyed the problem less systematically and is thus not included in comparative tables of serious drug abuse.
But a comparison of data on one-time use of cannabis puts Ireland at the top of the league. In an anonymous survey in 1995, 37 per cent of 16-year-olds said they had taken cannabis. In the UK the figure for teenagers generally was 36 per cent, while in the Netherlands it was 30 per cent.
The UK is at the high end of the scale for harder drugs with 4 per cent of 15/16-year-olds admitting to having taken ecstasy, 10 per cent amphetamines, 12 per cent LSD, and 1 per cent cocaine or heroin. The lowest incidences appear in Finland, Greece, Sweden and Portugal.
The main global trend seems to be an increase in the use of cannabis, amphetamines and ecstasy.
As is well known in Dublin, Ireland's AIDS problem is closely related to drug abuse - some 43 per cent of the cases of AIDS to date - with only Spain and Italy higher (at 66 and 64 per cent).
The rate of arrests for drugrelated crime - a measure of police effort as much as the drugs problem - reflects a general increase throughout the 1980s and first half of the 1990s, with the trend falling only in the Netherlands. Seizures of heroin and cocaine rose in the late 1980s to level off this decade. The seizures of the "dance drugs', amphetamines and ecstasy, are still rising sharply while those for LSD have fallen significantly.
Although cutting off the source of supply is still a priority, discussion and implementation of demand reduction strategies are assuming a far more important role than in the past. The emphasis now is on education and empowerment by offering alternatives to drug abuse rather than on coercion. Prevention, by common consent, is most effective when organised locally and close to its target in families and communities. School programmes involving specially prepared teaching materials, training for teachers and drug experts and direct contact with former drug abusers are at the heart of many EU memberstates' efforts. In Spain and Sweden, specific education programmes target the parents of young children. And in Italy a 1994-95 campaign involved some 850,000 parents. Many are also developing youth activities outside schools to feature strong anti-drugs messages.
In Bavaria considerable experience has now been developed in encouraging the use of toy-free nurseries where the temporary ban on toys encourages children to invent new forms of activity and avoid early reliance on objects. While abstinence is still the central theme of education, since the mid-1980s harm reduction approaches, such as needle exchanges to prevent HIV infection, are now more widely used though still controversial in some countries. The report acknowledges that a more addict-centred approach aimed at re-integrating users into the community is less popular with the public than a repressive one and that this ambivalence is reflected in often contradictory approaches between ministries of the same government.
"Nowhere is this seen more sharply than in the treatment responses to imprisoned addicts, where the ambivalence is patent in the juxtaposition of punishment based on a view of the addict as criminal, and treatment based on a view of addiction as illness," the report argues.
Mass media campaigns, popular in some countries, are severely criticised in others as an expensive waste of effort - far better, they say, to engage in a dialogue with potential abusers. Run in conjunction with communitybased activities, they can be successful, however.
The problem, as always, is money. Community-based and individual attention programmes, particularly outreach programmes which use workers on the streets and going to the homes of those who cannot visit offices, are expensive. Such projects tend to be focused on metropolitan areas - such as Lisbon, Amsterdam and, indeed, Dublin - the work of whose Inner City Organisations Network is cited by the report. "Low-threshold services", like those in Barcelona, Madrid and Valencia, are seen as crucial to making harm-reduction services easily accessible to addicts. In the Netherlands informal centres allow those unwilling to abandon their addictions to have at least a measure of comfort or safety.
Projects in Belgium, the Netherlands and Germany target opinion- formers within the drugtaking community with information on infection to get around the problem of the rejection of official information by most users.
Substitution treatments, usually involving methadone, are used in all countries but to widely differing degrees. Residential treatment varies, with the southern countries preferring therapeutic community care to traditional hospital care.
The report also deals with police action, trends in drug manufacture, action by the memberstates and by the EU, and the international environment.
Further information on the EMCDDA is available from its website: http://www.emcdda.org.
