ABSTRACT: The information pertaining to the laws and provisions on drugs of the countries of the Pompidou Group, published as an appendix of the book ASPE DOSSIER - EUROPEAN CITIES AND DRUGS, published by the Gruppo Abele. This document was illustrated during the seminar on "Drugs in Europe: experiences and legislations compared", organized in Turin by Magistratura Democratic del Piemonte e Valle d'Aosta e by the Gruppo Abele on 1 and 2 December 1991.
Contents:
INTRODUCTION by Carla Rossi
NORMATIVE SOURCES AND OVERVIEW OF THE EUROPEAN LEGISLATIONS
Foreword
The laws on drugs in the countries of the "Pompidou Group"
AUSTRIA, BELGIUM, CYPRUS, DENMARK, FINLAND, FRANCE, FORMER FEDERAL REPUBLIC OF GERMANY, GREECE, IRELAND, ITALY, LUXEMBOURG, MALTA, THE NETHERLANDS, NORWAY, PORTUGAL, SPAIN, SWEDEN, SWITZERLAND, UNITED KINGDOM.
Traffic
AUSTRIA, BELGIUM, CYPRUS, DENMARK, FINLAND, FRANCE, FORMER FEDERAL REPUBLIC OF GERMANY, GREECE, IRELAND, ITALY, LUXEMBOURG, MALTA, NORWAY, THE NETHERLANDS, PORTUGAL, UNITED KINGDOM, SPAIN, SWEDEN, SWITZERLAND.
Special procedures of investigation
AUSTRIA, BELGIUM, CYPRUS, DENMARK, FINLAND, FRANCE, FORMER FEDERAL REPUBLIC OF GERMANY, IRELAND, ITALY, LUXEMBOURG, MALTA, NORWAY, THE NETHERLANDS, PORTUGAL, SCOTLAND, SPAIN.
Penalties for drug abuse
CYPRUS, FINLAND, FRANCE, FORMER FEDERAL REPUBLIC OF GERMANY, GREECE, IRELAND, ITALY, LUXEMBOURG, MALTA, NORWAY, THE NETHERLANDS, PORTUGAL, UNITED KINGDOM, SWEDEN, SPAIN.
The therapeutic approach
AUSTRIA, BELGIUM, CYPRUS, DENMARK, FINLAND, FRANCE, FORMER FEDERAL REPUBLIC OF GERMANY, GREECE, IRELAND, ITALY, LUXEMBOURG, MALTA, NORWAY, THE NETHERLANDS, PORTUGAL, UNITED KINGDOM, SPAIN, SWEDEN, SWITZERLAND.
EUROPEAN DRUG DEPENDENCY POLICIES
[Appendix of the report on the national programs for the reduction of drug consumption in the European Community (communication of 8 November 1990 to the Council). The countries mentioned are the ones the experiences of which are illustrated in the first chapter].
FRANCE
Actions on a national scale, Actions on a local scale, Size and origin of the subsidies, Trends and levels of drug depdendency, Prevention, Treatment and reintegration, Statistics and epidemiology, Personnel training, Research.
GERMANY
Actions on a national scale, Actions on a local scale, Size and origin of the subsidies, Trends and levels of drug dependency, Prevention, Treatment and reintegration, Statistics and epidemiology, Personnel training, Research.
ITALY
Actions on a national scale, Actions on a local scale, Size and origin of the subsidies, Trends and levels of drug dependency, Prevention, Treatment and reintegration, Statistics and epidemiology, Personnel training, Research.
THE NETHERLANDS
Actions on a national scale, Actions on a local scale, Size and origin of the subsidies, Trends and levels of drug dependency, Prevention, Treatment and reintegration, Statistics and epidemiology, Personnel training, Research.
PORTUGAL
Actions on a national scale, Actions on a local scale, Size and origin of the subsidies, Trends and levels of drug dependency, Prevention, Treatment and reintegration, Statistics and epidemiology, Personnel training, Research.
UNITED KINGDOM
Actions on a national scale, Actions on a local scale, Size and origin of the subsidies, Trends and levels of drug dependency, Prevention, Treatment and reintegration, Statistics and epidemiology, Personnel training, Research.
SPAIN
Actions on a national scale, Actions on a local scale, Size and origin of the subsidies, Trends and levels of drug dependency, Prevention, Treatment and reintegration, Statistics and epidemiology, Personnel training, Research.
(ASPE DOSSIER - EUROPEAN CITIES AND DRUGS, published by the Gruppo Abele, June 1992 - republished in CORA-STAMPA ALTERNATIVA "millelire", November 1992)
Introduction by Carla Rossi
In the present book of documents we wanted to republish the information regarding the laws and provisions on the subject of drugs of the countries of the Pompidou Group, published as an appendix of the book ASPE DOSSIER - EUROPEAN CITIES AND DRUGS, published by the Gruppo Abele.
As you will notice, there are considerable differences, both concerning the legislations and the various types of interventions. In any case, the material refers to the provisions contained in the various laws, but not all that which is established is necessarily applied.
One example of this: in the part relative to Italy, under the point Statistics and epidemiology, its says that
"The regional epidemiological observatories receive the notifications regarding the subjects in treatment, which are provided by the assistance centres and by the doctors. These data are processed at the central level by the Ministry of Health".
It is an ascertained fact that:
1) - the regional Observatories have been instituted only in certain regions;
2) - only certain regional Observatories - among these the one of Latium - have instituted the above mentioned informative system on drug dependency.
Foreword
The Pompidou Group (a cooperation group that struggles against drug abuse and the illegal traffic of narcotics) was established in 1971 at the initiative of the then President of France. As of 1988, it operates in cooperation with the Council of Europe. The Group promotes researches on all subjects related to the traffic and the use of narcotics, and coordinates the drug policies at the European level.
The following countries are currently members of the Pompidou Group:
Austria, Belgium, Cyprus, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Luxembourg, Malta, The Netherlands, Norway, Portugal, Spain, Sweden, Turkey, United Kingdom.
In April 1991, the Pompidou Group published a document which compared the legislations on the traffic and the use of narcotics in the Member States of the Group itself.
Following is a summary of the document. The legislative data it contains are update at June 1990. The part relative to the Italian legislation has been updated by Susanna Ronconi of the Gruppo Abele, who also took care of publishing the book.
The unabridged text of the document of the Pompidou Group - in French and English - as well as the text of three aforementioned International Conventions are available at the research and documentation centre of the Gruppo Abele, via Giolitti 21, 10123- Turin.
THE DRUG LAWS IN THE COUNTRIES OF THE POMPIDOU GROUP
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AUSTRIA
Federal law on narcotics, 18.9.1951, reformed in 1971, 1974, 1978, 1980 and 1985
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BELGIUM
Law of 24.2.1921 on narcotic, toxic, tranquillizing, disinfecting and antiseptic substances, amply reformed on 9.7.1925
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CYPRUS
Law on drugs and psychotropic substances N.29 of 1977, reformed in 1983
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DENMARK
Law on psychotropic substances of 24.5.1955, modified in 1965, 1969 and 1982. Moreover, sections 191 and 191a of the penal Code
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FINLAND
Law on narcotics of 21.1.1972, modified in 1987
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FRANCE
Law of 31.12.1970 on the prevention of the abuse and the traffic of narcotics, as well as of the use of toxic substances, reformed in a restrictive sense in 1986 and 1987
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EX FEDERAL REPUBLIC OF GERMANY
Law on the traffic of narcotics of 28.7.1981, modified in 1984, '86, '87.
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GREECE
Law n.743 of 1.12.1970. New law on narcotics of 7.8.1987
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IRELAND
Law on the abuse of narcotics of 16.5.1977, modified in a restrictive sense in 1984
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ITALY
Law n.685 of 1975, reformed in 1990, law n.162, then included in the Single Text of 9 October 1990
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LUXEMBOURG
Law of 19.2.1973 on the sale of prescription drugs and the prevention of drug addiction, modified by the laws of 1987 and 1989
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MALTA
Law on dangerous substances of 1.9.1939, reformed in 1975 and further modified by law n.8 of 1986
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THE NETHERLANDS
Law of 23.6.1976 on opium and other substances, modified in 1985
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NORWAY
Paragraph 162 of the penal code punishes the production, traffic, import, distribution, sale of narcotics, as well as the illicit profits ensuing from the drug trade. Law n.5 of 20.6.1964 intervenes on prescription drugs and toxic substances, defining precise tables on the various substances
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PORTUGAL
Decree of 13.12.1983
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UNITE KINGDOM
Law on the abuse of narcotics, completed by the law on traffic of 1986, the Scottish law of 1987 and the law on international cooperation against the drug trade of 1990
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SPAIN
Law of 23.6.1983 (less repressive compared to previous legislation) modified by the reform of 1988, which has newly increased the penalization
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SWEDEN
Law on narcotics of 8.3.1968, radically modified by the law of 19.5.1988
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SWITZERLAND
Federal law of 3.10.1951, radically modified by the law of 20.3.1975
TRAFFIC
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AUSTRIA
The legislation considers the production, import, export and distribution of drugs as crimes, and punishes them with 5 years of imprisonment. 3 years is the penalty for the purchase or the possession of large quantities for distribution. No distinction is made between the types of substances, and penalties of 6 months are provided for instigation to consumption, and of 3 years for the same crime toward minors. Extenuating circumstances are granted for the possession of quantities for personal use and for the traffic of small quantities, while aggravating ones are provided for cases of participation in criminal associations.
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BELGIUM
Between 3 and 5 years of imprisonment and/or a fine for the import, export, transport, possession, manufacture, distribution, purchase and sale, without any distinction between the types of substances. Exemptions from the penalty are provided for in cases of cooperation with the judicial system as far as minor penalties are concerned, while aggravating circumstances which range from 10 to 15 years of compulsory labour are provided for the traffic addressed to minors of the 12-16 age level.
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CYPRUS
Like Spain, Ireland and the United Kingdom, this country makes a distinction between the various types of drugs. Penalties of 2 years or fines are provided for the import and export, 14 years or a fine for the production and for the supply, 7 years or a fine for the possession, 14 years or a fine for the cultivation of cannabis and for crimes relative to opium, 14 years or a fine for the possession and direction of plants where drugs are produced. As regards any aggravating or extenuating circumstances, these are calculated case by case, without being specifically provided for by the law. The crimes of drunk driving (1 year), disobedience on the part of the physicians of instructions received for the control of the use of drugs and of their users (2 years), for the issue of unjustified medical prescriptions (a maximum of 14 years).
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DENMARK
The import, export, manufacture, purchase, possession and production are punished with fines or imprisonment for a maximum of 1o years, while 6 years are provided for anyone who benefits from the profits of the international traffic. A peculiarity of the legislation of this country is that for recidivists, the penalty is increased by half, while other types of aggravating circumstances are provided for in cases of large quantities, large profits, large quantities of drugs considered to be extremely dangerous, an in cases in which the health of a great number of people is endangered (a maximum of 15 years). The measures are extenuated, with simple warnings, for the detention of cannabis for personal use or small distribution, only in the event in which there are no precedents of the same kind.
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FINLAND
A maximum penalty of 2 years or an adequate fine punish the important, export, manufacture, transport, offer, sale, purchase, distribution and possession of drugs. Two years of imprisonment are provided for persons who benefit from the profits of the traffic, while the possession of large quantities, the large-scale trade and the particular dangerousness of the substances are considered aggravating circumstances (a maximum of 10 years).
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FRANCE
Penalties from 2 to 10 years of imprisonment without any distinction between the various types of drugs punish the cultivation, transport, possession, supply, purchase and recycling of money generated by the profits of the traffic. The instigation to consumption is punished with penalties between 1 to 5 years and a fine, while professionals (doctors, chemists) who issue false prescriptions or prescribe the use of a substance without ant real therapeutic need are punished with penalties ranging from 2-10 years. Aggravating circumstances are association (10-20 years), the fact of being a recidivist (double the penalty), and the fact of making personal use of drugs when working in educational institutes or in the services. The penalties are milder in the cases of doses for personal use or cooperation after the arrest. Until 1987, France provided for the possibility of seizing all the properties of the defendants.
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EX FEDERAL REPUBLIC OF GERMANY
The production, transport, import, export, circulation, transit, purchase and possession of drugs are considered crimes, and can be punished with a maximum penalty of four years or an adequate fine, with no distinction between the various drugs. Four years are provided also for crimes of instigation to consumption through advertisement of any kind, for the prescription of the use of drugs on the part of professionals (doctors, psychiatrists, dentists), without the specification of the reasons and of the methods of application, while penalties ranging from 1 to 5 years are inflicted on persons found driving under the effect of narcotic substances. The traffic that occurs through criminal organizations is punished with aggravating circumstances from 2 to 15 years, just as aggravating circumstances are the sale to minors, the death of the buyer, the import of large quantities. Milder penalties in the case of small quantities for personal use and of cooperation with the police.
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GREECE
A minimum of 10 years and a maximum of 20 are provided for the export, import, offer, sale, possession, production, preparation and cultivation of drugs, 15 years for the traffic in schools and military centres, 10 years for unjustified medical prescriptions. 3 years of imprisonment for driving under the effect of drugs, while aggravating circumstances are: criminal association, the fact of being recidivists, the instigation toward minors, and are are punished with life imprisonment. Minor diminutions of the penalty are provided for in the case of small-scale trade on the part of drug addicts.
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IRELAND
This country makes a distinction between hard drugs and soft drugs. For the latter, the legislation provides for 7 years or a fine for the traffic of cannabis, whereas the traffic, production, manufacture, preparation, supply, distribution, transport, import, export and possession for sale of hard drugs are punished with life imprisonment. The cultivation of opium and cannabis is punished with 14 years and/or a fine, like all the possible infractions committed by professionals (doctors, chemists, etc). The possession and the use of false medical prescriptions are punished with 3 years and/or a fine.
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ITALY
The Italian legislation makes a distinction between the various psychotropic substances, which are classified into six tables passed by the Minister of Health.
The cultivation, production, refinement and sale, and even the simple possession of quantities exceeding the so-called "daily average dose" of cocaine, opium derivatives and other so-called "hard" drugs, is punished with 8-20 years of imprisonment and with a fine of 50-500 million lire. For cannabis and hashish, the penalty is between 2 and 6 years of imprisonment, and a fine of 10-150 million lire. If the crime is defined as a "minor" one - in terms of means, conditions and circumstances - a penalty of 1-6 years and a fine of 5-50 million is applied for so-called "hard" drugs, and between 6 months and 4 years and a fine of 2-20 million lire for the so-called "soft" drugs. The same penalties are diminished, between one half and 2/3, for persons who commit a crime and cooperate with the judicial authority. When the trade of psychotropic substances is connected to three or more people, with the specific characteristic of an association aiming to the illegal traffic of narcotics, the penalty provided for is imp
risonment for no less than 20 years, for persons who promote and run the association, and no less than 10 years for those who participate; such penalties are further increased if the association disposes of weapons and if the members of the association are more than nine.
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LUXEMBOURG
Between 1 and 5 years for the import, export, manufacture, transport, purchase, sale, possession and supply. The same type of penalty is applied for crimes of instigation and advertisement to consumption, for issue of a medical prescription without an actual therapeutic reason, and for driving under the effect of narcotic substances. Aggravated penalties are provided for instigating minors to the use of drugs (10 years) for having caused permanent psychic damage (20 years) or death (life imprisonment). Extenuating circumstance are provided for only if the defendant cooperates with the police.
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MALTA
The legislation provides for penalties between 4 and 20 years for cases considered serious with respect to the import, export, cultivation, sale, manufacture, distribution and possession. For crimes of instigation to the use, or the sale in another state, penalties of 1-10 years are applied and/or a fine, while the use and the issue of false medical prescriptions is punished with penalties that vary between 6 months and 5 years. The possession of small quantities for personal use is punished with a fine, and reductions by one third or half the penalty are applied in cases of cooperation with the police.
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NORWAY
The Norwegian law establishes a minimum penalty of 14 days without providing for a maximum one for cases of traffic, production, import, export, distribution, infractions of the regulation on narcotics. The laundering of money generated by the profits of the trade is punished with 2 years, 10 years for serious cases, and 21 years for extremely serious cases. Driving under the effect of drugs is punished with 1 year and a fine, while the distribution of false medical prescriptions is punished with penalties between 2 and 5 years, or a fine. The traffic of large quantities is considered an aggravating circumstance which is punished with penalties of up to 21 years.
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THE NETHERLANDS
The Dutch legislation makes a distinction between international and national traffic, and between hard drugs (opiates, cocaine, heroin) and soft drugs (cannabis). As a result of this diversification, penalties of 2 years are provided for the national traffic of soft drugs, 8 years for the national traffic of hard drugs, 4 years for the international traffic of soft drugs and 12 years for the international traffic of hard drugs. The possession and sale of cannabis is not considered a crime up to the quantity of 30 grams; exceeding quantities are punished with 1 month and/or a fine. The cases of recidivity represent an aggravating circumstance up to a maximum of 16 years, while the instigation to the use is punished with penalties between 1 and 12 years.
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PORTUGAL
The distinction between the various types of drugs and traffic is different with respect to the Dutch one, because it does not make a distinction between the international traffic and the national one, but between the traffic of large quantities and the traffic of small quantities. The distinction between the types of substances is based on the tables contained in the international Conventions of 1961 and 1971, which take into account the dangerousness of the substance, the intensity of the symptoms, and the degree of addiction it causes. The penalties range between 6 and 12 years for the large-scale traffic of narcotics and psychotropic substances included in tables I, II and III, between 2 and 4 years for the large-scale traffic of substances included in table IV, while the traffic in small quantities is punished with penalties of 1 year for the substances included in table IV and between 1 and 4 years for narcotics and substances included in tables I, II and III. The criminal association (penalty increase
d by 1/4), the fact of heading such organizations (between 12 and 18 years), the use of false documents (increase by 1/4). The instigation to the use is punished with penalties from 1 to 3 years, while the penalty is reduced in the cases of traffic of small quantities for personal use.
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UNITED KINGDOM
This legislation provides for a classification in three parts, which divides the substances according to their noxiousness, basing itself on the tables of the international Conventions of 1961 and 1971: class A includes the most harmful substances (table I), class B includes the less harmful ones (tables II and III), class C analyses substances which are only mildly harmful (table IV). Life imprisonment as well as very high fines are provided for the production, possession and supply for traffic for substances of A class, 14 years in addition to fines for class B, and 7 years plus fines for class C. The United Kingdom is the only country where the supply of solvents to minors of 18 years can be punished with 6 months of prison and/or fines, while the instigation to consumption is punished with penalties between 6 months and 6 years. Infractions of the rules committed by professionals (physicians, chemists, dentists) are punished with 14 years or a fine for classes A and B, and with 5 years or a fine for clas
s C. Compared to the laundering of money ensuing from the drug traffic the penalty is 14 years (maximum value) or a fine. Great Britain, like Ireland and Malta, does not provide for aggravating circumstances, as it already has a very strict legislation, with life imprisonment as maximum penalty. The law of '86 provides for the seizure of all goods for which there is an ascertained link with the drug traffic and, as regards this problem, the United Kingdom participates in a series of bilateral agreements for which it is possible to seize goods in other countries.
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SPAIN
The Spanish legislation makes a distinction between hard drugs and soft drugs (cannabis and derivatives). As far as the cultivation, manufacture, traffic and possession of soft drugs is concerned, the penalty is between 4 months and 4 years, and between 2 and 8 years for hard drugs. Recidivism, supply to minors, participation in criminal organizations, large-scale traffic, sophistication and manipulation of substances, the fact of being a professional (physician, chemist) are considered aggravating circumstances, and are punished with penalties between 6 months and 6 years for soft drugs and between 6 to 14 years for hard drugs. Crimes which are considered very serious and the fact of heading a criminal organization are punished with penalties between 10 and 17 years for soft drugs and between 14 and 23 years for hard drugs.
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SWEDEN
The production, manufacture, supply, sale and possession are punished with a maximum of 3 years, while the smuggling, import and export are punished with a 3-year penalty for crimes considered ordinary and between 2 and 10 years for crimes that are considered serious. Driving under the effect of narcotic substances is punished with a maximum of 1 year, while transferring the revenues of the traffic is punished with a penalty between 3 and 10 years. Criminal association, large quantities, harmfulness of the substance and recidivism are considered aggravating circumstances (with an increase of the penalty up to a maximum of 14 years).
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SWITZERLAND
Three years of prison and a fine are provided in cases of cultivation, manufacture, import, export, supply, distribution, sale, purchase, illegal prescriptions, possession. The Swiss legislation makes a distinction between public instigation (3 years and a fine) and private instigation (3 months and a fine). Criminal association and large profits are considered aggravating circumstances.
SPECIAL INVESTIGATIVE PROCEDURES
A certain number of countries have felt the need to adopt additional legislative measures to support the investigation on the traffic.
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AUSTRIA
Searching people and baggage at the borders is permitted.
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BELGIUM
The King may give powers of criminal police to designated officials who may then take irrefutable measures such as searches or controls of various kinds.
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CYPRUS
The investigative police may search individuals or premises and carry out preventive temporary arrests.
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FRANCE
This country has extended the possibility of carrying out searches also during the night, and has doubled the maximum length of the police arrest, bringing it to 4 days. There is the possibility of carrying out bodily searches at the borders. The time limit for the judicial proceeding is extended from 3 to 10 years, so that the crime for drugs is the same as the criminal one.
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FORMER FEDERAL GERMANY
The special measures provided are the following: seizure of goods, inspections, searches, examinations, temporary arrests and preventive custody.
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IRELAND
The police may carry out searches without having orders from the court, and arrests without supplying justifications.
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ITALY
In addition to the possibility of considerably diminishing the penalty for offenders who cooperate in a concrete and decisive way in the investigations, the Italian legislation provides for the possibility for the police of carrying out simulated purchases of drugs in order to acquire elements of evidence and, for the same purposes, of delaying or omitting measures of capture, arrest or seizure. Moreover, it has the possibility of inspecting ships and airplanes that are suspected of being used to transport drugs also in extra-territorial waters and air zones, and against ships or airplanes belonging to other countries. Every type of search and inspection carried out by the judiciary police may be carried out also in the absence of a prior authorization from the judicial authority.
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LUXEMBOURG
The Minister of Health may appoint special officials who acquire the status of criminal police officers and therefore the power to order inspections of any kind.
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MALTA
Arrest without justification and police custody to a maximum of 20 days are permitted.
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NORWAY
The law provides for the possibility for the police to carry out telephone controls during the investigations on the traffic. Moreover, as of 1988 the police may check mail sent to Norway to inspect against the traffic, and may seize goods.
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THE NETHERLANDS
The special investigation measures essentially concern the major international traffic of hard drugs, while the investigations on the traffic and the use of soft drugs are considered less important.
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PORTUGAL
The criminal police has the faculty to carry out bodily searches, to inspect private homes, premises and any public place considered suspect. Banks and other financial activities cannot refuse to give the police all the necessary information, nor can they avoid to accept controls.
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SCOTLAND
In Scotland, where a special criminal judiciary system is in force, the police custody may be extended to 8 days, with the possibility of carrying out bodily inspections, inspections of private homes, premises of all kinds and controls on the activities, as in the entire United Kingdom.
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SPAIN
In 1988 a special Office for the prevention and repression of the traffic of narcotic substances with special powers has been created.
PENALIZATIONS FOR DRUGS ABUSE
The consumption and traffic of drugs is punished with penalties that differ from one country to another, with different hypotheses of aggravating and extenuating circumstances.
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CYPRUS
The possession of drugs classified in tables A and B is punished with maximum penalties of 7 years of with fines, the possession of drugs which are classified in class C is punished with a maximum of 5 years or a fine, the crimes relative to opium are punished with a maximum penalty of 14 years of a fine.
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FINLAND
The use of drugs is punished with a maximum penalty of 2 years or a fine.
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FRANCE
The use of drugs is punished with penalties varying between 2 months and 1 years or fines.
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FORMER FEDERAL GERMANY
The court does not punish the cases of possession (or production, cultivation, import, export, etc) of drugs for personal use only in cases of very small quantities.
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GREECE
A distinction is made between consumer and addict, so that the latter is exempted from the penalties provided for the consumption.
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IRELAND
The possession of drugs for personal use is punished with 7 years of prison in the case of hard drugs, and with 3 years and a fine for soft drugs.
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ITALY
The Italian law prohibits the personal use of narcotic or psychotropic substances. The penalties provided are of two kinds: an administrative one and a penal one. Any person in possession, for personal use, of a quantity of substances not exceeding the quantity of active principle called "average daily dose" (if the quantity exceeds this limit the penalties provided for the traffic are applied) and established with special tables by the minister of health, is subjected to the suspension of the driver's licence, of the passport, of the gun permit and of the residence permit for a period between 2 and 4 months in the case of so-called "hard" drugs, and between 1 and 3 months in the case of so-called "soft" drugs. If the Authority which issued the administrative sanctions - the Prefect - deems that the person at hand will abstain in the future from consuming drugs, for the first time he does not apply the penalty. The sanctionary proceeding is suspended also in the case in which the person asks to be submitted
to a therapeutic program and if the Prefect deems this appropriate. If the person interrupts the therapeutic program twice, or does not appear before the Prefect, he is deferred to the judicial Authority, which establishes new obligations (e.g. prohibition of leaving home in certain hours, prohibition of leaving the municipality of residence, etc.). If the person infringes such obligations or if he is deferred for a third time to the administrative authority the offender is punished with the arrest until 3 months or with a fine of up to 5 million.
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LUXEMBOURG
The possession is punished with penalties between 3 months and 3 years, in cases in which there are no precedents the penalty is changed into a simple written or oral reprimand.
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MALTA
The possession is punished only with fines.
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NORWAY
The possession of drugs in small quantities considered strictly for personal use implies fines or penalties to a maximum of 6 months.
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THE NETHERLANDS
The possession of hard drugs is punished with fines or with 1 year of imprisonment.
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PORTUGAL
The legislation is mild with occasional consumers and does not punish the use under 21 years of age in cases without precedents of the same kind.
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UNITED KINGDOM
The possession of substances that are classified in class A is punished with 7 years or fines, in the case of substances of the B class 5 years or a fine, while for the substances of class C the penalties are of 2 years or a fine. Smoking opium is punished with 14 years of imprisonment.
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SWEDEN
The possession of drugs for personal use is punished only with a fine if it is ascertained that there is no concourse in activities of traffic. Exemptions from the penalties are provided for drug abuse in cases in which the subject has already been submitted to treatment.
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SWITZERLAND
The personal use and possession of drugs are punished with 3 months of imprisonment and a fine, but only in cases in which the situation is not considered as traffic.
THE THERAPEUTIC APPROACH
The therapeutic treatment may be imposed or voluntarily chosen by the subjects punished for the various crimes relative to the narcotic substances and may replace or integrate the penalty.
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AUSTRIA
As far as this kind of intervention is concerned, the legislation considers the therapeutic treatment as a measure alternative to the penalty which may also interrupt its execution, provided the drug user submits himself to medical treatment. The physical must report the motivations, the methods of application and the progress of the treatment to the ministerial office, so that the office itself can make every type of decision. The therapeutic treatment may be adopted in cases of possession of small quantities of drugs for personal use.
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BELGIUM
The suspension of the sentence or its change are possible in cases of drug consumption which exclude every type of trade. In these cases, the therapeutic treatment is adopted.
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CYPRUS
The voluntary therapeutic treatment may be carried out both in private and in public facilities.
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DENMARK
It is the Ministry of Justice which decides when a temporary (or of the length of the sentence) therapeutic treatment is possible.
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FINLAND
This country does not provide for a therapeutic treatment as there are no specific legislative measures which criminalize the drug user.
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FORMER FEDERAL GERMANY
The voluntary treatment is possible medical facilities. The court may suspend the sentence for a period between 2 and 5 years when the penalty is less than 1 year and, in particular circumstances, when it is less than 2 years. If the treatment takes place in particularly rigid facilities, the period may be reduced by 2/3 of the necessary time, and in these cases it is the court that decides.
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GREECE
The drug user who is punished for an offence may be submitted to compulsory treatment in "therapeutic corrective institutes". If the subject is not considered responsible for his actions, he is sent to adequate hospital facilities. The length of the period of treatment is decided according to the cases.
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IRELAND
This country provides for the preventive detention in institutes of compulsory treatment.
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ITALY
According to the Italian legislation, the detentive penalties for crimes related to the state of drug addiction are to be served in prison institutes that are adequate to the carrying out of therapeutic programs. For the drug user found in possession of a quantity not exceeding the so-called "average daily dose", who accepts to be submitted to a therapeutic program, there is the suspension of the penal or administrative sanction; the drug addict who is sentenced for crimes related to his state to a penalty not exceeding 3 years, the execution of the penalty may be suspended for 5 years, if the person is undergoing a therapeutic and socio-rehabilitative program. If the offender completes the program and does not commit any crime, the penalty is canceled.
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LUXEMBOURG
Persons suspected of using drugs are subjected to medical controls. If the result is positive, and they refuse to submit voluntarily to the treatment, they are sent to structures specialized in compulsory treatment for a period of time decided by the court.
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MALTA
The court may impose the compulsory treatment in replacement of the penalty if the defendant is not involved in the drug traffic.
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NORWAY
According to the law, at the request of the direction of the Ministry of Health, the medical authorities and the police must provide information on drug abuse. If there is the suspicion of a crime committed, it is the direction of the Ministry that must provide the information to the police. Compared to crimes relative to drugs, there is the possibility of choosing a medical treatment.
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THE NETHERLANDS
Because the consumption of drugs in small quantities is not penalized, and because the drug user is not criminalized, the Dutch legislation does not provide for medical measures, though there are many preventive measures, and the medical treatment is voluntary, especially with the assistance of private associations.
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PORTUGAL
In this country, the drug users who refuse the voluntary treatment are submitted to compulsory medical treatment in adequate structures of a maximum of 1 year. The medical staff must report to the court every three months on the progress of the treatment, so that the court can decide whether to continue it or not.
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UNITED KINGDOM
The legislation of the United Kingdom provides for the possibility for the defendant to be submitted to medical treatment to diminish his dependency from the substance; the defendant must accept to undergo the treatment.
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SPAIN
The legislation provides for a suspension of the sentence in cases involving subjects with no precedents and sentenced to a penalty of less than 2 years, who can decide to submit to medical treatment.
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SWEDEN
A system of compulsory treatment of a maximum of 6 months has been introduced, which, on the order of the court, is applied in serious cases, i.e. when the subject is considered to be dangerous for himself and for other people.
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SWITZERLAND
There is the possibility of suspending the penalty for a period of 2 years, during which the subject is submitted to medical treatment.
EUROPEAN DRUG DEPENDENCY POLICIES
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FRANCE
Actions on a national scale
The national authorities are fully competent as regards the definition of the actions of prevention, treatment and reintegration, as well as of the financing of the structures specialized in assisting the drugs addicts. A general delegation for the struggle against drug dependency is charged with the general coordination of the actions of the sector.
Actions on a local scale
The departments are in charge of the prevention of the problems of juvenile problems. They administer and finance clubs and groups charged with prevention, which deal with the problem of drug dependency. In the context of the prevention of delinquency, which is taken care of by the unions for their responsibility in keeping the public order, and in the context of the urban social development policies, the municipalities increasingly deal with problems pertaining to drug dependency, especially as far as the prevention and reintegration are concerned (before and after a crime is committed). The task of the general Delegation is enhancing the actions that associate the various levels of competence of financing and the State.
Size and origin of the subsidies
Over the last years, the State has considerably increased its financial participation. For the ministry of solidarity , of health and of social protection alone, the expense allotted for the prevention and assistance of drug users in specialized centres and hospitals has increased from 235 francs in 1984 to 428 francs in 1990. Moreover, the general delegation has recently started dividing among the various ministries a yearly income of 250 million francs, of which about 150 million are destined to finance the interventions on the supply at the levels of the ministries of education, of solidarity and health, of justice, of youth and of sport.
Trends and levels of drug dependency
The number of drug users is estimated to be 100,000; this figure has not been updated since 1980.
Prevention
In 1990 France has applied a prevention program based on three fundamental points: massive information and appeals to the media, involving the families and the schools, the privileged places for the young's formation, and promotion of local initiatives, with the cooperation of various personalities.
Treatment and reintegration
As of the '70s there is a network of services available to drug addicts. Special attention is devoted to their specific needs, and various therapeutical models are offered: welcome centres (with outpatient service, psychotherapy, prevention and reintegration), special hospital unites, centres for subsequent assistance and communities. The variety of the interventions is intended to meet the varying individual needs in the best of ways, creating the necessary spaces for various therapeutical models. The importance of the medical system increases: as of 1988, generic physicians receive a specific professional formation. Specific services have been instituted in most prisons, with the purpose of receiving, accompanying and preparing the inmates for their release, instructing them on how to receive help. Moreover, various measures have been adopted to limit the risks of the spread of infective diseases, especially of HIV, liberalizing the sale of syringes and carrying out programs for their replacement. The latt
er seem to be an important factor of prevention, thanks to the information provided on HIV contagion and to the contacts thus established with the drug users who do not rely on any centre of assistance. Improving the drug users' access to jobs is part of the global program for the reintegration of the young.
Statistics and epidemiology
A yearly statistic survey on a national scale (made by the ministry of Solidarity and of Health) and an epidemiological survey on the drug users in prison are carried out in the specialized information and treatment centres (National Institute for sanitary and medical research: INSERM). There is a network of surveillance on a regional scale, which takes in and analyses the indicators on the consumption of drugs. The population surveys mostly refer to the consumption of illegal drugs, but as from 1978 surveys are made also in schools (INSERM) on the consumption of illegal drugs. Various sociological and anthropological studies have been conducted. The general Delegation and all the ministries involved plan to establish a permanent observatory on drugs and drug dependency.
Personnel training
Permanent formation in drug dependency on a national scale offered to generic physicians by the ministry of Solidarity, Health and social protection, under the supervision of the regions. Moreover, a national cycle of formation has been established for those in charge of the centres of assistance for HIV patients, and a program for chemists similar to the one reserved for the physicians. Other courses are open to the public, especially to parents. A pamphlet has been published containing information for the chemists, and a second pamphlet for the local authorities has been planned.
Research
The researches on drug dependency in France have always played an important role. Main areas of research are: neuroscience, epidemiological research, ethnographic research, psychosocial research and, to a lesser extent, historical and juridical research.
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GERMANY
Actions on a local scale
Public health, including the treatment of drug users, pertains to the single Laenders.
Size and origin of the subsidies
The authorities have increased the subsidies by 11 million Deutschmarks, which have been increased from 1,800,000 to 12,8 million Deutschmarks.
Trends and levels of drug dependency
The number of drug addicts who use hard drugs on a regular basis amounts to approximately 60/80,000, with a progression toward groups of more advanced age.
Prevention
Particular importance is given to the concept of vulnerability and on the need to protect people at risk and to develop the secondary prevention. The objective is the carry out specific information campaigns to illustrate the dangers and the legal implications of drug consumption, and encouraging total abstinence. The program includes a vast series of interventions aimed to specific groups of people; advertisement campaigns that use the media with the cooperation of representatives of personalities, school personnel, young in their natural environment and in institutionalized groups (military and civil service), young and parents.
Treatment and reintegration
A few essential requirements have been determined for the treatment centres: possibility of access, availability and diversification to meet the various needs. Special initiatives have been developed in favour of the group of habitual consumers. The program underlines the need to integrate the treatment with a well-balanced series of assistance services and of planning various stages of treatment (despite the danger of protracting the dependency). Controversies have arisen regarding the use of drug surrogates, and there is no uniformity among the Laenders. The federal position is that of administering them only in special cases, under medical and psycho-social supervision. There is a network of services, nonetheless, which must be extended in terms of quality and quantity, especially in the rural areas; external work; measures aimed to improve the relation of confidence (in order to get in touch with a greater number of drug users); possibility of offering special structures; drug-addicted women with childre
n; easy access to detoxication therapies in clinics; in certain Laenders, distribution of surrogates.
Statistics and epidemiology
An "informative system based on the centres" (EBIS) is operating, which collects information on drug users in 300 outpatient centres. The federal Centre for the education of the young carries out a survey every three years on the young's tendency to consume drugs. The Ministry of Youth, of family and women and of health has long been carrying out representative surveys on the nature and extension of the drug consumption in particular age groups. The survey currently under way uses a sample of 19,000 people, of ages between 12 and 39, and for the first time also includes the territory of the former East Germany.
Personnel training
The need is felt to improve the training of the personnel at all scales. The improvement implies a greater number of interdisciplinary courses of secondary formation (for judges, procurators and social workers who cooperate with the courts and the police).
Research
There are problems of research, as the drug dependency experts have generally not received a sufficient research formation, and the university researchers have not devoted enough attention to the problem. The basic biological research, the medical formation and the interconnection of the available data system all need to be improved. Particular attention should be devoted to the family environment and to the various aspects of prevention. Need for a better coordination between federal government and other bodies, and greater efforts in the research institutes in cooperating with the treatment centres. A national-scale survey of the research needs and potentials is under way.
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ITALY
Actions on a national scale
The new drug dependency law, which came into effect on 26 June 1990, has redefined the institutional means for the development of the policies and programs of intervention in the struggle against drug dependency. The President of the Council of Ministers presides the "National Coordination Committee for the struggle against drug dependency", formed by the competent ministers of the Ministries of Health, Defence, Interior, Education, Social Affairs, Justice and Foreign Affairs, assisted by a committee of experts and by the permanent observatory on the drug phenomenon. The permanent Conference for the relations between the State, the regions and the autonomous provinces ensures the coordination between the central government and the regional governments.
Actions on a local level
The law gives the regions and autonomous provinces the faculty to plan and carry out the plans of intervention on the subject of prevention and sanitary and socio-rehabilitative treatment. The municipalities and the mountain communities must carry out activities for the prevention, reintegration in school and at work of the drug users.
Size and origin of the subsidies
The new drugs law provides for the following funds for 1990, 1991 and 1992:
a) Lit. 360 yearly for the institution and operation of the central Service for drug and alcohol dependency in the Ministry of Health;
b) Lit. 6,050 yearly starting from 1991 for the institution in the roles of the Ministry of the Interior of a special unit of 200 social workers;
c) Lit. 4 billion yearly for the operation of the committees established in the Ministry of Education for the primary prevention of drug dependency in schools;
d) Lit. 176 yearly for 1990, of which 30,000 to enhance the public services for drug dependency; and Lit. 180 yearly starting from 1991 to finance projects to fight against drug dependency introduced by the ministries, the regions and the municipalities;
e) Lit. 150 billion yearly to finance interventions aimed for drug users and AIDS patients;
f) Lit. 10 billion to market disposable selflocking syringes;
g) Lit. 20 billion for 1990 and 38 as of 1991 to hire personnel for the prevention of AIDS among drug users in the public services.
Trends and levels of drug dependency
It is currently impossible, on the basis of the available data, to express an estimate of the total number of consumers of illegal substances, while the data relative to the number of subjects who use the public assistance services and socio-rehabilitative structures (C.T.) are available. According to estimates of the Ministry of Health, the number of drug users who have accepted to be treated in the public structures throughout 1989 amounts to 60,000, with an increase of almost 18% compared to the previous year. At 30 June 1990, about 38,000 subjects were being treated in the public structures, and 11,000 were being treated in residential communities. The average age of the new users has increased. 30-40% of the subjects on treatment has tested HIV-positive: almost 90% of the people who have started a treatment over the last two years was using heroin, 5-6% were using hashish derivatives.
Prevention
An advertisement campaign for prevention is under way, in parallel with the one for AIDS through the media, prevalently aimed at young people aged 12-16. The Ministry of Education has long been promoting initiatives pertaining to prevention and sanitary education, with refresher courses for teachers and parents. Similar initiatives are being taken by the Ministry of Defence in favour of draftees.
Treatment and reintegration
517 public drug dependency units operate in the various regions of Italy in the context of the national health system, in addition to the possibility of being hospitalized for detoxication. About 11,000 drug users reside in the 433 residential communities, which are almost entirely operated by non-governmental organizations, financed with national and regional public funds. The interdisciplinary teams of the drug dependency units use both treatment programs that rely on substitutive drugs, and counseling and psychotherapy. Moreover, in cooperation with the AIDS units, they also treat HIV-positive patients.
Statistics and epidemiology
The regional epidemiological observatories receive the notifications relative to the subjects in therapy, which are provided by the units and the physicians. These data are processed by the Ministry of Health. The drug dependency units and the physicians send information on the subjects in therapy to the regional sanitary observatories. The data are processed on a central basis bu the Ministry of Health. The Permanent Observatory on the drug phenomenon, an instrument of the national co-ordinating committee against drug dependency, which operates at the Ministry of the Interior, periodically and statistically collects the epidemiological data relative to the social and sanitary aspects, to prevention and the repression of the illegal traffic in cooperation with the central administrations of the State and of the local boards.
Personnel training
At the moment there is no post-graduate formation for the physicians and psychologists who operate in the drug dependency units. Occasional initiatives are organized by some univerities, but for brief courses only. The training of the operators has been done so far by the regional governments. Non-governmental agencies organize training course for the personnel of the communities. The new law provides for an organic national training plan, specifically aimed at the operators of the units and for those of the community, as well as structures for permanent training.
Research
Several researches are being carried out in the field of drug dependency, financed both by the various ministries (Health, Interior, University, etc) and by the regional governments. However, such researches often are not integrated and coordinated. The need is felt to increase the funds allotted for research in order to better investigate and monitor the phenomenon.
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THE NETHERLANDS
Actions on a national scale
The actions on drugs are established at the national scale, in a close cooperation between the ministries of Justice, Health and cultural Affairs.
Actions on a local scale
The 23 main municipalities are in charge of prevention and outpatient assistance. The 12 provinces are in charge of therapy unites (detoxication centres).
Size and origin of the subsidies
All the centres of assistance and therapy - except the methadone programs of certain local sanitary services - are non-governmental independent institutions. The medical counseling problems for alcohol and drug problems (CAD) with a multidisciplinary approach dispose of a total budget of FL 79 million for 1990; the budget of the social assistance services for drug addicts for 1990 amounted to FL 55 million, while the budget of the methadone distribution programs operated by the local health services amounts to about FL 7 million. 95% of the funds is issued by the Ministry for social assistance, Health and cultural affairs, which distributes it among the main municipalities. The treatment centres are financed with the funds of the health insurance. The global cost of the measures of prevention and therapy amounts to about FL 250 million. The cost includes the therapeutic measures against alcohol addiction.
Trends and levels of drug dependency
According to accurate estimates, in 1989 there were about 20,000 heroin addicts; there has been a stabilization of the general problems, but an increase of the cases in the less advantaged categories from a social and economic point of view. The average age of the heroin addicts is on the increase, and so is the age of the first use of drugs. Heroin addicts tend to consume various types of drugs. There is no evidence that the consumption of cocaine has risen over the last years, and that it has caused problems comparable to those ensuing from the consumption of heroin. According to local reports, the share of benzodiazepine and MDMA (Ecstasy) drug dependency is rapidly changing.
Prevention
The anti-drug prevention forms part of the health education in schools and in programs for the young that mean to promote mental sanity and psychophysical wellbeing. Specific information campaigns are know to be effective only if they are aimed at specific risk groups; therefore, the campaigns that involve all the mass media are not considered effective. Considering the local risks (in a community, school, youth centre, etc), the accent is placed on drug dependency generally speaking, on the legality or illegality of specific drugs, on primary or secondary prevention. On a national scale, special funds are mobilized for the coordinators of the prevention and the development of the technical structures. However, priority is given to the problems relative to alcohol, smoking and prevention of AIDS among drug users.
Treatment and reintegration
The following principles apply to the treatment and reintegration of drug users: a diversified network of medical and social services organized on a local or regional scale; easily available assistance; maximum use of non-specific services and promotion of the social reintegration of the current and former drug users. The regional networks include outpatient services (on-the-spot activity, social counseling, therapy, distribution of methadone and reintegration), semi-residential services (day/night centres, outpatient treatment, work and recreational activities) and residential services (emergency and detoxication units and communities). The system includes forms of assistance which do not aim chiefly to end the detoxication, but to reduce the possible damage: on-the-spot activity, welcome, distribution of surrogates, material help and possibilities of social reintegration. The anti-AIDS measures supply information on safe sex and on drug consumption, and offer programs for the replacement of dirty needles a
nd the distribution of condoms. The networks are based on the various types of centres: medical counseling offices for problems relative to alcohol and drugs, municipal programs for the distribution of methadone; sanitary services and welcome structures. The counseling offices are also in charge of following prisoners on probation.
Statistics and epidemiology
Disposes of an informative system based on the treatment services which include an outpatient counseling service for alcohol and drugs and specialized clinics. The central institute of public statistics published reports on drug-related deaths and collects data on the spread of AIDS. A survey was carried out in 1990 in Amsterdam on sudden deaths caused by drug abuse. After the positive experiences made with anthropological techniques in various local researches on drug addiction, a permanent program for the study of drug addiction is being planned on a national scale.
Personnel training
Various projects to promote the training in universities, post-graduate training and the continuous training of the personnel that deal with drug users, sanitary personnel or social workers generally, have been financed. The Dutch institute for alcohol and drug problems offers various training programs which cover all the conditions of treatment and prevention.
Research
There are various lines of research: epidemiological studies (including the research for surveys and information systems within the Pompidou group), studies for the study of therapies, qualitative and descriptive sociological studies. The research activity is promoted through funds given by the ministry of Health, of cultural affairs, of justice, of public education and of scientific research, and through funds from non-governmental agencies.
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PORTUGAL
Actions on a national scale
In March 1987 an interdepartment and interinstitutional integrated anti-drug plan was launched, called "Project Life", coordinated in the various sectors by the following ministries: Interior, Justice, Education, Health, Labour, Social security, Youth and the cabinet of adjunct ministries. The program's purpose is to decentralize the anti-drug campaign and to encourage the common initiatives. The main aspects of the plan are: information, therapy, professional and social reintegration and the reduction of the consumption.
Actions on a local scale
The regional and local initiatives have recently been encouraged in order to better develop and coordinate the specific interventions.
Trends and levels of drug dependency
The global number of drug users in Portugal is estimated to amount to 40 or 50,000, a third of which are supposedly concentrated in the conurbation of Lisbon. Each year, 3,000 new therapeutic hospitalizations are registered, most of which for intravenous use of heroin. According to the most recent estimates, 4,000 drug users are in therapy and 350 participate in programs which provide for the distribution of methadone. The number of users who seek treatment is increasing, and there are elements pointing to the growing diffusion in the streets of heroin selling. The consumption of cocaine is rather limited, but is on the rise, and is frequently combined with the use of heroin. Dependency from more than one drug is also rising.
Prevention
In its efforts to prevent, it uses a whose series of specific initiatives: information and awareness-raising campaigns to encourage various social groups and to promote the prevention of drug abuse; production and distribution of informative material to specific groups, campaigns carried out by the media and cooperation with the latter; a telephone help line; informative and training programs for specific groups (schools, parents, young, professionals); recreational activities with the cooperation of nongovernmental organizations.
Treatment and reintegration
The therapeutic facilities (day hospitals, methadone distribution, communities) are insufficient, and the few existing ones are concentrated along the coast. The need for a better cooperation with the social services is evident. The government coordinates 8 outpatient centres and two communities. Methadone is distributed in a single centre, in Porto. A centre connected to Project Life (Taipas) is a specialized unit which offers a whole series of services (outpatient service, detoxication in clinics, emergency service and day service). The nongovernmental organizations carry out an important role in the realization of therapeutic programs and of reintegration. There are plans for the creation of units inside the prisons. An agreement has been reached, albeit insufficient, with a maternity unit to assist pregnant drug users. Assisting drug addicts with AIDS is the task of the anti-drug therapy units.
Statistics and epidemiology
It has been decided to develop a network for the systematic collection of data on drug dependency. The network will be integrated in the European network proposed by resolution 89/C/185/01 of the council of ministers of health (EEC).
Personnel training
Generic physicians are starting to receive some specific information on drug dependency. It is considered important to complete physicians', psychologists' and nurses' formation in toxicology.
Research
The researches conducted so far are insufficient and are not receiving specific funds, despite the existence of a scientific potential to be developed. In cooperation with the Pompidou Group, epidemiological studies have been carried out in the schools.
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UNITED KINGDOM
Actions on a national scale
The responsibility for the realization of the governmental strategy is the task of a certain number of ministries. Their activities are coordinated by the ministers themselves. Moreover, a consultive committee on the abuse of narcotic substances has been formed. The main components of the United Kingdom's strategy to contain the consumption of drugs are two: the first relies on an informative and educational program which has the purpose of discouraging the use of drugs, especially among the young; the second means to create a contact between the drug users and a series of services that will make it easier for them to adopt less dangerous consumption habits and ultimately to discontinue the use of drugs completely.
Actions on a local scale
The regional sanitary authorities, with the help of the respective counseling committees and regional groups for drug problems must:
- develop regional plans to assist the drug users, verify their application and control their effectiveness;
- urge the district sanitary authorities to make an effort to quantify and verify the problem, promptly establishing services apt to satisfy the local requirements;
- guarantee the development and coordination of adequate inter-district services.
The local assistance to the drug users is guaranties by a series of facilities, which include groups of volunteers, generic physicians and the sanitary authorities themselves. The actual coordination of the assistance services is the task of the district committees for counseling on drug dependency problems, whose members are formed by representatives of the sanitary services, of the social services, of the police, of the centre for assistance to prisoners on probation, of the school authorities and of the groups of volunteers (including the parents and the groups of personal initiative). Their task is to check the type of drugs that are most widely consumed, estimate the effectiveness of the local services, make proposals to improve them and to coordinate the efforts of the various groups active in the fields of prevention and assistence.
Size and origin of the subsidies
As from 1986/87, the government has allotted funds for all regional sanitary authorities so that they can extend the services for drug users; further funds have been allotted as from 1987/88 to prevent the spread of AIDS among drug users. The funds are distributed on a regional scale, according to the proportion of population between 15 and 34 years of age.
Trends and levels of drug dependency
Measuring the size of an illegal activity such as drug consumption is a difficult task. One indicator is represented by the number of drug users formally registered at the central office by the physicians. According to this number, there is a yearly 30% increase of the notifications between 1980 and 1985, a regression between 1985 and 1987 and a new surge as from 1987. However there is no complete survey of the drug consumption: the physicians must notify only the consumption of the most dangerous drugs, in particular opiates, cocaine, certain hallucinogens and injectable amphetamines. The changes registered partly reflect the changes in the physicians' compulsory notification. Moreover, a certain number of users are not registered in that they have not sought for medical help. It is estimated that the register of drug addicts contains no more than one fifth of the users of illegal drugs, even though the proportion may change as a result of the constant efforts directed to draw the highest possible number of
users toward the services. Moreover, there are possibly as many users of legal drugs, with the exception of those who smoke hashish. Other indicators of the changeable size of the drug dependency problem are the statistics relative to the seizures of drugs and to the authors of drug-related crimes. The number and size of the seizures of drugs have rapidly increased from the end of the '70s until the mid-'80s. There follows a significant decrease of the seizures of heroin, but not of cocaine and amphetamines. It is a further demonstration of a suspension in the number of drug users in the second half of the '80s, even though the changes occurred in the statistics relative to the seizures may obviously be affected by a series of other factors. The data relative to the drug-related crimes confirm the general trend.
Prevention
The twofold strategy aimed to discourage the consumption of drugs and to draw the drug addicts toward the various services reflects the priority given by the government to the complete elimination of drug dependency. Nevertheless, the minimization of the risks among drug users is given equal importance. This is largely due to the acknowledgment of the role carried out by drug dependency as a channel for the spread of the HIV virus. In 1985, the government launched a vast education and sanitary information campaign to discourage the consumption of drugs. The campaign was started in the wider context of the actions of the government started in 1983 and aimed to improve the infrastructures, encourage the operators of the field and improve the training level. It was the first step toward the development of further preventive measures, currently being applied, such as counseling services for parents and children and informative material for the schools. An extension of the government's preventive strategy was the
introduction, in 1987, of programs for the replacement of dirty syringees.
Treatment and reintegration
The regional and local sanitary authorities are charged with estimating the drug users' needs in their area of competence
and guaranteeing a series of services in the light of these needs and of the national addresses. The government's addresses lay down that all sanitary authorities guarantee the access to the services.
The sanitary authorities take the responsibility of:
- developing a regional policy based on the supply of services to the drug users, verify their realization and estimate their effectiveness;
- together with other bodies, try to quantify and estimate the problems and take the necessary measures;
- guarantee the adequacy and coordination of the interdistrict services;
Every sanitary authority is requested to institute at least one regional team of experts in drug problems, formed by physicians, nurses and social workers. In Scotland the single initiatives may vary in order to take into account the different organizational and administrative structure of the local government, but the overall system of the services offered to the drug users is equivalent to the one used in England and in Wales. Central coordination committees have been established in all main sanitary districts; they are meant to control the local interventions. In addition to the general allotments, over 2,2 million pounds yearly have been placed at the disposal of the sanitary authorities in Scotland to support and develop the drug dependency services. Over the last six years, a vast series of services have been created almost out of nowhere, concentrated in the areas in which the problem of drug dependency is particularly serious. The offer of services, however, is still not widespread; there are no emer
gency structures, disposable syringes, outpatient services and residential reintegration centres.
Statistics and epidemiology
All regional sanitary authorities have been asked to create a database in which to collect anonymous data on the drug addicts who resort to the private or state-run services. This archive will enable the regions to estimate the trends in drug consumption, and in the use of the anti-drug services in their region, and to plan further interventions. The information will be subjected every six months to the Ministry of Health, and will be used to estimate and monitor the expenses of the sanitary authority, as well as to plan further interventions. The database will moreover provide the information requested by the Ministry of the Interior in order to compile the registers of the drug users.
Personnel training
The council for drug dependency counseling has introduced a whole series of guidelines on the training of the personnel that has to deal with drug users, as well as of the sanitary personnel, the teachers, the juvenile assistants, the heads of the sanitary service and the personnel of the residential centres. The teachers carry out a fundamental awareness-raising role with the young, illustrating the risks which the consumption of drug involves. The government has allotted funds for training courses offered by the national nurses' association and by the national association for the assistance to previous offenders and their reintegration. In Scotland, the government is financing a project for training in drug dependency at the university of Stirling, and the formation of the sanitary personnel at the centre of studies on alcohol (Palsley College of Technology).
Research
The English and Scottish ministers of Health have financed and commissioned a series of research projects and other studies in the field of prevention, treatment and reintegration. The projects which have already been carried out include an estimation of the services offered made in the context of two volunteer sectorial projects and of three mobile units in London, a research carried out as part of the "Project of drug indicators", which has lead to the publication of a small handbook to estimate the drug problems on a local scale and a project to devise any heroin problems in the neighbourhoods. The projects that are currently being carried out include researches on the role which the chemists should occupy in the prevention of AIDS, and an estimation of the request for services and on their use. A vast research program on the syring exchange schemes and on their effects on the drug users' behaviour is still under way.
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SPAIN
Actions on a national scale
In 1985, the national anti-drug plan was launched. It coordinates all governmental and nongovernmental bodies, and the organizations of citizens as far as the anti-drug actions are concerned. The plan is the competence of two organs: an interministerial group which coordinates the central administration (health and social protection, justice; interior; public education; scientific research and social affairs), and a sectorial conference which includes representatives of the autonomous communities (regions).
Decisions are taken and actions are launched relative to the reduction of the supply and of the demand. The national assembly of nongovernmental bodies acts as a consultive organ. The struggle against the consumption of drugs is viewed as a global and collective task, based on a specific and non-specific prevention, on therapy, reintegration and formation of the competent personnel. The chief objective is that of uniforming the perception of the problem and the necessary reply, providing the adequate asssistance through the existing sanitary and social structures and minimizing the use of specific resources.
Actions on a local scale
Autonomous plans for the struggle against drugs are progressively developed in the 17 autonomous communities. The plans provide for interventions of prevention, therapy and reintegration in each community.
Trends and levels of drug dependency
Over the last three years, the indicators point to an increase in the supply of drugs, in drug-related deaths and in therapeutic hospitalizations - therefore there seems to be an increase in the consumption and in the relative problems. The average age of the drug users subjected to therapy, urgently hospitalized or deceased is also rising. The problems are mostly caused by heroin consumption, even though the use of cocaine is spreading.
Prevention
Over the last few years there has been a progressive increase in the resources destined to prevention in the autonomous communities, in relation to the global budget allotted for the anti-drug programs (from 14% in 1986 to 28,6% in 1989). The three main fields of preventive intervention are schools, meeting places and working places. A program for prevention in the schools was launched in 1987-1988 by the Ministry of Public Education. Particular support is given to the programs in favour of young people at risk, to improve the social image of the drug users, to support the social and sanitary services and the network of technical information on the prevention programs "IDEA-prevention", to apply the laws on the availability of legal and illegal drugs, their adjustment to the local circumstances and the formation of the local delegates. The programs are based on an accurate knowledge of the situation that prevails in the various geographic areas in which they are applied and developed with the cooperation of
representatives of various levels of power and social sectors.
Treatment and reintegration
Most of the outpatient services and half of the therapeutic communities are publicly financed. Despite the fact that the resources have been consistently increased over the last years, there are still waiting lists. There is a special program to assist the drug users who are in prison. Special anti-risk activities have been developed to oppose the spread of the HIV virus (including educational programs for risk groups and programs for the distribution of methadone). Priority is given to a better financial coverage, to the diversification of the therapeutic services, the improvement of the programs for the assistance of drug users with legal problems and the estimation of the programs. The rehabilitative efforts mean to favour especially the reintegration in the social and working environment. The plan is to enhance the participation in this process of the general social services. Occupation is favoured through the training, the promotion of the juvenile cooperatives and the encouragement given to the alterna
tive working activities.
Statistics and epidemiology
A permanent system for the collection of data based on three indicators is under way: number of patients on outpatient treatment, mortality and emergency hospitalizations not resulting in death (State information system on drug dependencies: SEIT). The system provides information on the consumption of opiates and cocaine at the national and regional scale. A retrospective study has been carried out in six cities on the deaths connected to the consumption of drugs (1983/89). Between 1984 and 1989, various surveys have been carried out, mostly on a regional scale, but it is impossible to make an estimation in the absence of standardized surveys carried out at various times. Indirect indicators concerning the supply of drugs are also available.
Personnel training
As from 1987, the national plan provides for post-graduate university courses on drug dependency in five universities of Spain. Three universities currently offer the possibility of graduating in drug dependency. Other institutes of higher education have included drug dependency in their programs. The public health schools in the autonomous communities offer a specialized formation. Specific material has been developed to favour the professional formation of the personnel. The minister of public education promotes the formation of teachers and parents.
Research
The resources for the research on various aspects of drug dependency have been increased. The project is to create a special line of funds for researches on drug dependency in the context of the most important Spanish body for sanitary research. On a national and regional scale, a number of epidemiological and sociological studies and other research initiatives have been financed. It seems necessary to establish priorities of research in the field of drug dependency. On a national scale, a computerized documentation and information centre has been created (ELEUSIS).
