OPINION OF THE ECONOMIC AND SOCIAL COMMITTEE on the Communication from the Commission - Community action in the field of drug dependence / Proposal for a European Parliament and Council Decision adopting a programme of Community action on the Prevention of drug dependence within the framework for action in the field of public health (1995-2000)
Date: 1995-02-22
Institutions: European Economic and Social Committee
Subjects: action programme, drug addiction, health policy, narcotic, social problem













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51995AC0186

OPINION OF THE ECONOMIC AND SOCIAL COMMITTEE on the Communication from the Commission - Community action in the field of drug dependence / Proposal for a European Parliament and Council Decision adopting a programme of Community action on the Prevention of drug dependence within the framework for action in the field of public health (1995-2000)  


Official Journal C 110 , 02/05/1995 P. 0008 





Opinion on the communication from the  Commission - Community action in the field of drug dependence - Proposal for a European Parliament  and Council Decision adopting a programme of Community action on the prevention of drug dependence  within the framework for action in the field of public health (1995-2000)(95/C 110/04)On  20  September 1994 the Council decided to consult the Economic and Social Committee, under Article   129 of the Treaty establishing the European Economic Community, on the abovementioned  communication. The Section for Protection of the Environment, Public Health and Consumer Affairs, which was  responsible for preparing the Committee's work on the subject, adopted its Opinion on 31  January  1995. The Rapporteur was Mrs Guillaume. At its 323rd Plenary Session (meeting of 22  February 1995), the Economic and Social Committee  adopted, by a majority vote, with seven abstentions, the following Opinion. 1. Introduction The Committee welcomes the Commission proposal for a Community strategy  for action in the field of drug dependency: an increasing and complex phenomenon with huge social  and economic costs to society. Competency for this lies within Article  129 of the Treaty. There is  need for coordinating action and rationalization of existing instruments. 2. General comments 2.1. Drug dependence within the framework of public health must be seen in  tandem with the EU Action Plan to combat drugs. Recognition is also given to the links with major  social problems: exclusion, unemployment, crime and that drug dependency knows no frontiers. 2.2. Under Article  129 of the Maastricht Treaty, the Community addresses the promotion of health  and prevention of disease. Drug addiction is the specific threat mentioned and identified as a  priority - a matter of common concern to be addressed in the context of cooperation in the fields  of Justice and Home Affairs. This priority also reflects the changing perceptions of how to fight  against drugs both at national and global level. 2.3. Since drug addiction was first discussed in 1985, the problem has been regularly aired,  analysis made from Member States' experiences in conjunction with the specialist institutions of  the UN and the WHO. With the opening-up of East-Central Europe, the international aspect of the  drug scourge becomes even more pertinent. 2.4. Despite the lack of reliable, and sometimes contradictory information, data does appear to  show serious increases in the following areas: - in drug-related mortality (from Schengen country figures); - in number of first-time use of drugs; - in the % of drug addicts among prisoners; - in the increase of AIDS cases; - in the concern of citizens and their families about the risks of HIV. Despite various statistics pointing to an escalation of drug misuse and greater public concern, the  increasing numbers requesting treatment may indicate that more drug users are wanting to overcome  their drug dependence. 2.5. According to one recent European survey (), results showed that while there is general  approval for the establishment of special centres of care, the reaction to the use of substitute  drugs was muted and the free distribution of syringes was approved of for instance by the young and  also by inhabitants of big cities. Surveys or polls are of dubious worth, but nevertheless reflect  the attitudes of society towards drugs, which now appear to be both changing and more sensitive. 2.6. This has led to the Commission being requested to support Member States and define basic  activities including exchanges of information, pilot projects and the establishment of a Community  network of NGOs, aiming to maximize cost effectiveness and impact. This reflects the changed  attitude of Europeans towards this problem in the emergence of prevention as a top priority.  Article  129 gives the Commission authority for research into causation, which is also emphasized  by the important role attached to the European Monitoring Centre on Drugs in providing data and  information hitherto not available. 2.7. As drug dependency is a complex phenomenon, the Committee accepts that its prevention needs  effort on local, national and global level involving multi-disciplinary and multi-dimensional  responses: i)activities to target high-risk groups and critical age groups; ii)education and training for all involved; iii)the setting-up of an advisory body on drug dependency with representation from each Member  State with national committees as the central point of reference for all the many agencies  involved, including non-governmental organizations. 2.8. There is a perception of success in today's society which is promulgated by the media and is  based on status, career progression and material possessions. This may cause individuals to feel a  sense of failure and despair if they do not achieve in these areas. Such despair may cause some to  seek solace in drug use and may inhibit the rehabilitation and reintegration into society of  reformed drug users. 2.9. The Committee recommends that the broader approach is taken to encourage the promotion of  healthier life styles rather than the narrow, negative approach epitomized by the 'say no to drugs'  campaign in the USA. While positive role models e.g. sportsmen and women, are useful for the former  approach, they are only effective in primary prevention. Many who begin using hard drugs are for  the most part rebellious and anti-hero and do so as an expression of their anti-establishment  lifestyles. 2.10. The Committee is broadly in favour of the Commission's recommendation in all three areas of  activity: 1) improving public awareness in particular by means of coordinated transnational activities; 2) maximizing on the opportunities in other Community policies, programmes and instruments to  prevent and combat drug dependency; 3) initiatives and actions relating to young people of school-going age in relevant environments  and promote best practices in this regard. The Committee recommends that extra funding should be given to those border towns where the  prevalence of drug addiction is particularly high. 3. Specific comments 3.1. Classification and terminology3.1.1. 'Drug misuse' is defined as the non-medical use of drugs that  are only intended for use in medical treatment, and the use of drugs that have no accepted medical  purpose. 3.1.2. Drug misuse may be experimental, recreational or dependent. Experimental drug misuse,  however, refers to the first tentative use of drugs to discover their effects. Recreational drug  misuse is the continuation of drug misuse beyond experimentation but not amounting to dependent  misuse. Recreational misuse may vary from very occasional to very frequent use. Dependent drug  misuse (drug dependence) is characterised by a compulsion to take a drug on a continuous or  periodic basis in order to experience its psychic effects or to relieve discomfort caused by its  absence. 3.1.3. Because of the more restricted definition of drug dependence and the fact that most drug  misuse is recreational and non-dependent it is recommended that the term 'drug misuse' be adopted. 3.1.4. Drugs most commonly misused include: - opiates such as heroin; - stimulants such as cocaine, amphetamine and Ecstasy; - tranquillisers; - hallucinogens such as LSD; - cannabinoids such as cannabis; - steroids and stimulants to enhance performance in sport. 3.1.5. In some countries drugs are described as 'hard' drugs, e.g. heroin, and 'soft' drugs, e.g.  cannabis, in order to reflect how dangerous a drug is (in the US 'hard' drugs are referred to as  'narcotics' but this is especially confusing as in medical and pharmacological terminology a  narcotic is a drug which induces narcosis, i.e. sleep). The dangers of drug misuse are not  restricted to the drug itself but are, amongst other factors, influenced by the type of drug misuse  (experimental, recreational or dependent) and the manner in which the drug is used (e.g. smoked,  snorted, by mouth, or injected). Amphetamines may be viewed as a soft drug if taken orally,  occasionally, and in small doses but as a hard drug if injected on a regular or dependent basis.  Because of these difficulties in classification it is recommended that the term 'drug misuse'  should cover the misuse of any or all drugs and that, when necessary, specific and clearly  understandable terminology is employed, e.g. injecting drug misusers. 3.2. Difficulties may arise where Member States differ on whether care, counselling, treatment or  rehabilitation of drug misusers fall within the scope of Article  129. The Committee stresses the  importance of exchange of information between Member States in view of reducing differences of  approach. Greater exchange of information in these areas may ensure added value at Community  level. 3.3. Tests on body tissues3.3.1. Some (especially in the United States) have advocated the random  testing of body tissues to detect drug misuse/dependence. It has been argued that such testing will  deter individuals from using drugs and will identify those who have used drugs, thereby enabling  them to receive appropriate advice or treatment. With the exception of those individuals whose drug  use might significantly jeopardise the safety of others (e.g. bus drivers; air traffic  controllers), or in the case of competitors in sporting events, the Committee does not favour  random testing. For this reason, the Committee questions the necessity of the Communication  mentioned in point  56 on the reliability of tests currently undertaken. 3.3.2. The reasons are the following: - possible benefits of testing are outweighed by infringement of civil liberties; - practical difficulties in obtaining samples of blood, urine or hair; - hair testing may reveal drug use months or years earlier; - accurate results from testing necessitate the use of expensive procedures; - variations in the metabolism of different drugs mean that heroin and cocaine are only detectable  a day or two after the drug has been taken, whereas cannabis may remain detectable for weeks or  months; - testing may reveal the presence of drugs taken for medical treatment including methadone; - the drug most commonly detected is likely to be cannabis, a drug which generally causes less  problems and is unlikely to require treatment. 3.4. The Committee recommends that: 1) High priority must be given to enhance public awareness, in a positive and responsible manner.  The media must be encouraged to emphasize responsibility and partnership between parents, families,  teachers, police and the health and help agencies involved. 2) All awareness programmes need to be properly evaluated, but in the case of Drug Prevention  Weeks, maximizing on media focus and highlighting for example school programmes have seemed very  effective indeed. 3) Telephone lines are invaluable and used by families and friends for often practical and simple  advice. It is well proven that ignorance of how to get help is far higher than ignorance of how to  get drugs. 3.5. The Committee feels that emphasis should be given to schools in at-risk areas. Vocational  guidance should include education for teachers and youth leaders and any professionals likely to be  in contact with drug users - i.e. prison officers. 3.6. The Committee should endorse the need for: - staff-student exchanges; - establishment of pilot schemes between local authorities; - establishment of multi-disciplinary drug-prevention networks; - support systems to aid risk reductions. 3.7. Drug substitution, early detection, syringe exchanges3.7.1. The advent of HIV brought about a  practical response by most EU countries in schemes to distribute clean injecting equipment to  injecting drug misusers and an expansion in the prescribing of the heroin substitute methadone to  those dependent on opiates. There is good evidence that needle exchange schemes have led to drug  misusers presenting themselves to services earlier, have limited the spread of HIV infection and  have encouraged many to embark upon treatment programmes. Methadone maintenance treatment is now  available in all EU countries except Greece and Greece is about to begin. Methadone treatment  varies enormously throughout the EU both in the extent to which it is available and the nature of  the way treatment is delivered. In the UK and Denmark methadone is usually dispensed from community  pharmacists for addicts to take home but all other EU countries favour the consumption of methadone  on-site at specialist clinics. Whilst there is good international evidence that methadone  maintenance treatment improves physical and psychological health and reduces mortality rates,  criminality and HIV transmission, there is a pressing need for research into what types of  methadone treatment programmes are most effective. The varied approach to methadone maintenance  amongst Member States offers the opportunity for cross-national research into service  effectiveness. Although methadone is the most widely accepted treatment for opiate dependence, the  results of currently ongoing research involving other opiates such as buprenorphine (and heroine)  should be monitored. 3.7.2. The widespread availability of drugs in most prisons, the high prevalence of injecting drug  misusers amongst the prison population and the present reluctance of authorities to provide clean  injecting equipment or methadone treatment for prisoners combine to provide an ideal environment  for the spread of HIV infection. Some innovative schemes have attempted to address this problem.  Drug misuse in prisons is an area which requires urgent action and would benefit from cooperation  and collaboration between Member States. 3.8. Environment3.8.1. There is no doubt about the importance of environmental factors in influencing  drug misuse at various levels. Environmental factors may affect the vulnerability of an individual  to first using drugs, to progressing from initial drug use to the use of more dangerous drugs, from  first experimental use to more regular recreational use and then to dependent use. Environmental  factors are also important in determining whether an individual continues to use drugs or stops,  and whether cessation of drug use is temporary or permanent. 3.8.2. The current epidemic of drug misuse which started in the 1980s and has continuously worsened  is markedly dissimilar to the earlier and smaller escalation of drug misuse which occurred in the  1960s. Whilst the latter largely affected the middle classes and often was the result of a search  for 'personal growth' or 'inner meaning', the more recent epidemic predominantly (but not  exclusively) affects socially deprived urban areas with high unemployment. When there is little  prospect of a job and a salary to spend on recreational activities a life of drug dependence has an  appeal to many. Addicts lead a busy life raising money - usually illicitly - to pay for their drugs  and visiting their dealer each day. Many cite 'boredom' as a reason for a relapse into drug  dependence once they have become drug-free. For others the prospect of vast financial rewards and  little opportunity for legitimate employment make drug dealing an attractive career option. 3.9. Women and ethnic minorities3.9.1. While there is no apparent discrepancy in treatment, there is  evidence that access to advice and treatment for drug dependence is less readily available to women  and to members of ethnic minorities. Women drug misusers are subject to greater stigmatisation than  men and may fear intrusion by social services if they are pregnant or have children. Both those  with the responsibilities of child-care and those for example employed as 'prostitutes' may find  accessing services especially difficult. Those from ethnic minorities need access to information  and treatment that takes into account their language and culture. 4. Conclusions The magnitude of the drug problem is immense. The consequences of drug dependence  have enormous financial, health and social costs. Each Member State is already committing resources  to address the problem, but robust evidence of effective action is scarce. The Committee endorses the Commission's initiative in this area recognizing the urgent need to  support: 1) the evaluation of current research and practices; 2) the promotion and evaluation of innovative programmes, particularly in education; 3) the exchange of information and experience. The Committee acknowledges that money alone will not cure the drug problem: it believes that  greater resources should be targeted towards information exchange through networking at all levels.  It urges that maximum and imaginative use be made of modern technology. Since the solutions are  neither easy nor short-term, the Committee urges that adequate resources are committed on a  long-term basis. Done at Brussels, 22  February 1995. The Presidentof the Economic and Social CommitteeCarlos FERRER() Source:  Eurobarometer 37 - Drugs Prevention Week.