Proposal for a Council Recommendation on the prevention and reduction of risks associated with drug dependence
Date: 2002-05-08
Institutions: European Commission
Subjects: action programme, cooperation policy, data collection, drug addiction, exchange of information, health policy, health risk, public awareness campaign, public health, toxicology

COMMISSION OF THE EUROPEAN COMMUNITIES

Brussels, 08.05.2002
COM(2002) 201 final

2002/0098 (CNS)

Proposal for a

COUNCIL RECOMMENDATION

on the prevention and reduction of risks associated with drug dependence

(presented by the Commission)

PROPOSAL FOR A COUNCIL RECOMMENDATION ON THE PREVENTION AND
THE REDUCTION OF RISKS ASSOCIATED WITH DRUG DEPENDENCE

MEMORANDUM FROM MR BYRNE TO THE COMMISSION

This draft proposal for a Council Recommendation is based on Article 152, which refers
explicitly to the obligation of the Community to complement the Member States’ action in
reducing drugs-related health damage.

This proposal specifically addresses the second public health target defined by the European
Union Strategy on Drugs (2000-2004), that is to say, to reduce substantially over five years
the incidence of drug related health damage and, using risk reduction measures which have
been shown to be successful in achieving that aim.

The present proposal includes information and counselling, outreach-work, peer involvement,
emergency services, networking between agencies, integration between health and social care
and training and accreditation of professionals. There is special emphasis on prevention of
drug related infections.

Secondly the Member states are recommended to increase the effectiveness and efficiency of
their efforts in drugs prevention and prevention of drug related health risks. These measures
include use of scientific evidence and appropriate data collection, needs assessment, quality
criteria, innovative measures and evaluation training programmes for different levels and
audiences, and appropriate exchange of information within the European Union.

2

EXPLANATORY MEMORANDUM

The Commission, in its Communication to the Council and the European Parliament on the
implementation of the EU Action Plan on Drugs (2000-2004), announced the preparation of a
Council recommendation proposal on the prevention and reduction of risks associated with
drug dependence1.

The EU Drugs Strategy (2000-2004), endorsed by the European Council in December 1999,
has three main public health targets:

• to reduce significantly over five years the prevalence of illicit drug use, as well as new

recruitment to it, particularly among young people under 18 years of age;

• to reduce substantially over five years the incidence of drug-related health damage (HIV,

hepatitis B and C, tuberculosis, etc) and the number of drug-related deaths;

• to increase substantially the number of successfully treated addicts.

The main goal of this Council recommendation, based on Article 152 of the Treaty, is to
facilitate the achievement of the second public health target by Member States.

The situation and trends of drug use and drug-related health damage have been described in
the annual reports of the European Monitoring Centre for Drugs and Drug Addiction
(EMCDDA)2. Illegal drug use is more concentrated among young adults, with rates up to
double or more those of the whole population. Cannabis is the most widely used illegal drug,
followed by amphetamines and ecstasy in second position, cocaine in an increasing third
position and heroin at a broadly stable low level. Prevalence of HIV, hepatitis B and C among
injecting drug users appears relatively stable, although prevalence of hepatitis C infection is
high3.

Risk reduction measures have been successful in decreasing drug-related deaths and serious
health problems4. Risk reduction includes needle exchange and other hygienic measures
involved in drug injecting, substitution treatment5, low threshold services, information and
counselling on safer use and safer sex, and outreach work6.

The intensity of the risk reduction responses of the Member States appears to differ
considerably between countries. Member States with lower availability of risk reduction
measures may be at risk for new increases in HIV, hepatitis B and C transmission7.

1

2

3

4

5

6

7

COM (2001) 301 final.
According to the information provided by the EMCDDA
According to the information provided by the EMCDDA.
According to the information provided by the EMCDDA .
EMCDDA (2000), Reviewing Current Practice in Drug-substitution Treatment in the European Union,
Insight Series n°3, Luxembourg: Office for Official Publications of the European Communities.
EMCDDA (1999), Outreach Work among Drug Users in Europe: Concepts, Practice and Terminology,
Insights Series n°2, Luxembourg: Office for Official Publications of the European Communities.
EMCDDA (2001), Estimating Coverage of Harm Reduction Measures for Injection Drug Users in the
European Union (draft final report), Lisbon: EMCDDA.

3

Evaluation is a key tool for improving drug prevention and the reduction of drug dependence
associated risks8. The EU Drugs Strategy includes a whole chapter on evaluation and
Community and national policies could foster significant advances in this area. This Council
recommendation will also support the development of evidence-based evaluation to increase
the efficacy of drug prevention and the reduction of drug related health risks.

The present Council recommendation is in line with the Declaration on the guiding principles
of drug demand reduction adopted at the Special Session of the General Assembly of the
United Nations devoted to countering the world drug problem together, in June 1998, and the
Political Declaration adopted at the Ministerial Conference of the Pompidou Group of the
Council of Europe in October 2000.

8

EMCDDA (2000), Evaluation: a Key Tool for Improving Drug Prevention, Scientific Monograph
Series n°5, Luxembourg: Office for official publications of the European Communities.

4

2002/0098 (CNS)

Proposal for a

COUNCIL RECOMMENDATION

on the prevention and reduction of risks associated with drug dependence

THE COUNCIL OF THE EUROPEAN UNION,

Having regard to the Treaty establishing the European Community, and in particular the
second subparagraph of Article 152(4) thereof,

Having regard to the proposal from the Commission9,

Having regard to the opinion of the European Parliament10,

Having regard to the Opinion of the Economic and Social Committee11,

Having regard to the Opinion of the Committee of the Regions12,

Whereas:

In accordance with Article 3(1)(p) of the Treaty, Community action must include a
contribution towards the attainment of a high level of health protection; whereas the
third subparagraph of Article 152(1) of the Treaty also makes provision for action in
reducing drugs-related health damage, including information and prevention;

The European Council, meeting in Helsinki on 10 and 11 December 1999, endorsed
the European Union Drugs Strategy 2000–2004 that covers all European Union drug
related activities and sets main targets; these targets include a substantial reduction
over five years of the incidence of drug-related health damage (HIV, hepatitis B and
C, TBC, etc) and the number of drug-related deaths;

The European Council, meeting in Santa Maria da Feira on 19 and 20 June 2000,
endorsed the European Union Action Plan on Drugs 2000-200413 as a crucial
instrument for transposing the European Union Drugs Strategy 2000–2004 into
concrete actions which provide an effective integrated and multidisciplinary response
to the drug problem;

The Commission, in its Communication to the Council, the European Parliament, the
Economic and Social Committee and the Committee of the Regions on the European

9

10

11

12

13

COM (2000) XXX final.
OJ C […], […], p. […]
OJ C […], […], p. […]
OJ C […], […], p. […]
Doc. 9283/00 CORDROGUE 32 of the Council of the European Union.

5

Union Action Plan to Combat Drugs (2000-2004)14, considered a comprehensive
approach that should cover all areas of drug abuse prevention, from discouraging the
initial use to reducing the negative health and social consequences as the best
strategy;

The European Parliament,
in its resolution on the Communication from the
Commission to the Council, the European Parliament, the Economic and Social
Committee and the Committee of the Regions on a European Union Action Plan to
Combat Drugs (2000-2004)15, welcomed the objective of reducing the number of
deaths among addicts and called on the EU and its Member States to encourage and
develop damage limitation policies, without debarring individual Member States
from adopting measures and pilot schemes in this area;

The programme of Community action on the prevention of drug dependence within
the framework for action in the field of public health16 and the programme of
Community action on the prevention of AIDS and certain other communicable
diseases within the framework for action in the field of public health17 have
supported projects aimed at preventing and reducing the risks associated with drug
dependence, in particular by encouraging co-operation between the Member States,
supporting their action and promoting co-ordination between their policies and
programmes; both programmes have been contributing to improving information,
education and training aimed at preventing drug dependence and the associated risks,
in particular, for young people and particularly vulnerable groups;

The Commission proposal for a decision of the European Parliament and of the
Council adopting a programme of action in the field of public health (2001-2006)18
includes the development of strategies and measures on drug dependence, as one of
the important lifestyles-related health determinants;

Since according to research the morbidity and the mortality associated with drug
the health risks
dependence affects a sizeable number of European citizens,
associated with drug dependence constitute a major problem for public health19;

In accordance with the principle of subsidiarity, any new measure taken in an area
which does not fall within the exclusive competence of the Community, such as
prevention and reduction of risks associated with drug dependence, may be taken up
by the Community only if , by reason of the scale or effects of the proposed action,
the objectives proposed can be better achieved by the Community than by Member
States; prevention and reduction of risks associated with drug dependence cannot be
confined to a geographical region or Member State therefore action requires
coordination at Community level.

14

15

16

17

18

19

COM (99) 239 final.
Doc. No. A5-0063/1999 final.
Decision 102/97/EC of the European Parliament and of the Council of 16 December 1996 (OJ L 19,
22.1.1997, p. 25).
Decision 647/96/EC of the European Parliament and of the Council of 29 March 1996 (OJ L 95,
16.4.1996, p. 16).
COM (2000) 285 final.
EMCDDA (2000), Annual Report on the State of
Luxembourg: Office for Official Publications of the European Communities.

the Drugs Problem in the European Union,

6

Provisions should be made on reporting at national and Community level to monitor
the measures taken by the Member States in this area, and the results thereof, and the
way these recommendations have been implemented;

HEREBY RECOMMENDS :

1.

2.

Member States should, in order to provide for a high level of health protection, set as
a public health objective the prevention of drug dependence and the reduction of
related risks.

Member States should, in order to reduce substantially the incidence of drug-related
health damage (HIV, hepatitis B and C, tuberculosis, etc) and the number of drug-
related deaths, make available, as an integral part of their overall drug prevention and
treatment policies, a range of different services and facilities, particularly aiming at
risk reduction; to this end, Member States should:

(1)

(2)

(3)

(4)

(5)

(6)

(7)

(8)

(9)

provide information and counselling to drug users to promote risk reduction
and to facilitate their access to appropriate services;

inform communities and families and enable their
prevention and reduction of risks associated with drug dependence;

involvement

in the

include outreach work methodologies within the national drug policies, and
support appropriate outreach work training and the development of working
standards and methods, outreach work being defined as a community-oriented
activity undertaken in order to contact individuals or groups from particular
target populations, who are not effectively contacted or reached by existing
services or through traditional health education channels;

encourage the involvement of peers and volunteers in outreach work,
including drug-related emergency situations;

promote networking and co-operation between agencies involved in outreach
work, to enable continuity of services and better users accessibility;

provide comprehensive substitution treatment, supported by adequate psycho-
social care; taking into account that a wide variety of different treatment
options, including drug-free treatment, should be made available according to
the drug user’s needs;

establish measures to prevent diversion of substitution substances while
ensuring appropriate access to treatment;

promote adequate hepatitis B vaccination coverage among injection drug
users;

provide appropriate access to condoms, needles and syringes distribution,
exchange programmes and points;

(10) make available emergency services to deal with overdoses;

(11)

organise appropriate integration between health and social primary-care, and
specialised approaches in risk reduction;

7

(12)

support
reduction;

training and accreditation for professionals responsible for risk

3.

Member States should, in order to develop appropriate evaluation to increase the
effectiveness and the efficiency of drug prevention and the reduction of drug related
health risks:

(1)

(2)

(3)

(4)

(5)

(6)

(7)

(8)

(9)

use scientific evidence of effectiveness as a main basis to select
appropriate intervention;

the

develop and implement adequate evaluation protocols for all drug prevention
and risk reduction programmes, and include the planning and implementation
of appropriate evaluation among the conditions to be complied with by
beneficiaries for receiving public funding;

support
programme;

the inclusion of needs assessments at

the initial stage of any

establish and implement evaluation quality criteria, taking into account the
European Monitoring Centre for Drugs and Drug Addiction (EMCDDA)’s
guidelines for the evaluation of drug prevention20 and for the evaluation of
outreach work21, as well as the questionnaire on the exchange on drug
demand-reduction action (EDDRA)22;

organise standardised data-collection and information dissemination of
outreach activities, substitution treatments, needle exchange schemes, and
information and counselling services targeted to the reduction of the risks
this information to the
associated with drug dependence, and transmit
EMCDDA, according to its guidelines and recommendations, in particular
through the REITOX National Focal Points;

make effective use of evaluation results for the refining and development of
drug prevention policies;

set up evaluation training programmes for different levels and audiences;

integrate innovative methods that enable the involvement of all actors and
stakeholders in evaluation, in order to increase acceptance of evaluation;

in collaboration with the Commission,

encourage,
the exchange of
programme results, skills and experience within the EU and with the
applicant countries, in particular supporting the participation of national and
European projects in the EDDRA and other databases of the EMCDDA;

Member States should report to the Commission on the implementation of this
Recommendation within two years of the adoption of this Recommendation and
subsequently on request by the Commission with a view to contributing to the

EMCDDA (1998), Guidelines for the Evaluation of Drug Prevention: a Manual for Programme-
planners and evaluators, Manual Series n°1, Luxembourg: Office for official publications of the
European Communities.
http://www.emcdda.org/multimedia/project_reports/responses/guidelines_outreach.pdf
http://www.emcdda.org

8

4.

20

21

22

follow-up of this Recommendation at Community level and acting as appropriate in
the context of the European Union Action Plan on Drugs (2000-2004).

HEREBY INVITES THE COMMISSION:

the World Health
to cooperate with the Pompidou Group of the Council of Europe,
Organisation, the United Nations International Drug Control Programme and other relevant
international organisations active in the field;

to prepare a report, in accordance with the European Union Action Plan on Drugs (2000-
2004) and with the technical support of the EMCDDA, with a view to the revision and
updating of this recommendation, on the basis of the information submitted by the Member
States to the Commission and the EMCDDA, and the latest scientific data and advice.

Done at Brussels,

For the Council
The President

9