Council Recommendation of 18 June 2003 on the prevention and reduction of health-related harm associated with drug dependence
Date: 2003-06-18
Institutions: Council of the European Union
Subjects: disease prevention, drug addiction, health policy, public health

3.7.2003

EN

Official Journal of the European Union

L 165/31

COUNCIL RECOMMENDATION

of 18 June 2003

on the prevention and reduction of health-related harm associated with drug dependence

(2003/488/EC)

THE COUNCIL OF THE EUROPEAN UNION,

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

Having regard to the proposal from the Commission (1),

Having regard to the opinion of the European Parliament (2),

Having regard to the opinion of the European Economic and
Social Committee (3),

Having regard to the opinion of
Regions (4),

the Committee of

the

Whereas:

(1)

(2)

(3)

(4)

(5)

In accordance with Article 3(1)(p) of
the Treaty,
Community action is to include a contribution towards
the attainment of a high level of health protection. 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 (such as
HIV, hepatitis B and C and tuberculosis) 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 — 2004 as a crucial instru-
ment
transposing the European Union Drugs
Strategy 2000 — 2004 into concrete actions which
provide an effective integrated and multi-disciplinary
response to the drug problem.

for

The Commission, in its Communication to the European
Parliament and the Council on the European Union
Action Plan to Combat Drugs (2000 — 2004), consid-
ered 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
abovementioned Communication welcomed the objec-
tive of reducing the number of deaths among addicts
and called on the European Union and its Member States

(1) Proposal of 17 May 2002 (not yet published in the Official Journal).
(2) Opinion delivered on 13 February 2003 (not yet published in the

Official Journal).

(3) OJ C 61, 13.2.2003, p. 189.
(4) OJ C 73, 26.3.2003, p. 5.

(6)

(7)

(8)

(9)

to encourage and develop damage limitation policies,
from
without debarring individual Member States
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 health and the programme of
Community action on the prevention of AIDS and
certain other communicable diseases within the frame-
work for action in the field of public health have
supported projects aimed at preventing and reducing the
risks associated with drug dependence, in particular by
encouraging cooperation between the Member States,
supporting their action and promoting coordination
Both
between
programmes have been contributing to improving infor-
mation, education and training aimed at preventing drug
dependence and the associated risks,
in particular, for
young people and particularly vulnerable groups.

programmes.

policies

their

and

The decision of the European Parliament and of the
Council adopting a programme of action in the field of
public health (2003 — 2008) includes the development
of strategies and measures on drug dependence, as one
of the important lifestyle-related health determinants.

the morbidity and the
Since, according to research,
mortality associated with drug dependence affects a size-
able number of European citizens,
the health-related
harm associated with drug dependence constitutes a
major problem for public health.

the Community,

In accordance with the principle of subsidiarity, any new
measure taken in an area which does not fall within the
such as
exclusive competence of
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 and action therefore requires coordination at
Community level.

(10)

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 imple-
mented.

(11)

The most important measure to reduce the risk asso-
ciated with drug abuse is to prevent the abuse itself,

L 165/32

EN

Official Journal of the European Union

3.7.2003

HEREBY RECOMMENDS THAT:

1. 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, and develop and implement comprehensive strategies
accordingly.

2. Member States should, in order to reduce substantially the
incidence of drug-related health damage (such as HIV, hepa-
titis B and C and tuberculosis) 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, bearing in mind the general objective,
in the first place, to prevent drug abuse, Member States
should:

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

2.

3.

inform communities and families and enable them to
be involved in the prevention and reduction of health
risks associated with drug dependence;

include outreach work methodologies within the
national health and social drug policies, and support
appropriate outreach work training and the develop-
ment of working standards and methods; outreach
work is defined as a community-oriented activity under-
taken 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;

4. encourage, when appropriate, the involvement of, and
promote training for, peers and volunteers in outreach
work, including measures to reduce drug-related deaths,
first aid and early involvement of
the emergency
services;

5. promote networking and cooperation between agencies
to permit continuity of

involved in outreach work,
services and better users' accessibility;

6. provide, in accordance with the individual needs of the
drug abuser, drug-free treatment as well as appropriate
substitution treatment supported by adequate psycho-
social care and rehabilitation taking into account the
fact that a wide variety of different treatment options
should be provided for the drug-abuser;

7. establish measures to prevent diversion of substitution
substances while ensuring appropriate access to treat-
ment;

8. consider making available to drug abusers in prison
access to services similar to those provided to drug
abusers not in prison, in a way that does not compro-
mise the continuous and overall efforts of keeping
drugs out of prison;

9. promote adequate hepatitis B vaccination coverage and
prophylactic measures against HIV, hepatitis B and C,
tuberculosis and sexually transmitted diseases, as well as
screening for all the aforementioned diseases among
injection drug users
social
networks, and take the appropriate medical actions;

and their

immediate

10. provide where appropriate, access to distribution of
to

condoms
programmes and points for their exchange;

injection materials,

also

and

and

11. ensure

that

emergency

services

are

trained and

equipped to deal with overdoses;

12. promote

appropriate

integration between health,
including mental health, and social care, and specialised
approaches in risk reduction;

13. support training leading to a recognised qualification
for professionals responsible for the prevention and
reduction of health-related risks associated with drug
dependence.

3. Member States should consider, in order to develop appro-
priate evaluation to increase the effectiveness and efficiency
of drug prevention and the reduction of drug-related health
risks:

1. using scientific evidence of effectiveness as a main basis

to select the appropriate intervention;

2. supporting the inclusion of needs assessments at the

initial stage of any programme;

3. developing and implementing adequate evaluation proto-
all drug prevention and risk reduction

cols
for
programmes;

4. establishing and implementing evaluation quality criteria,
taking into account
the
European Monitoring Centre for Drugs and Drug Addic-
tion (EMCDDA);

the Recommendations of

5. organising standardised data-collection and information
dissemination according to the EMCDDA recommenda-
tions through the REITOX national focal points;

6. making effective use of evaluation results for the refining

and development of drug prevention policies;

7. setting up evaluation training programmes for different

levels and audiences;

8.

integrating innovative methods that enable all actors and
stakeholders to be involved in evaluation,
in order to
increase acceptance of evaluation;

9. encouraging, in collaboration with the Commission, the
exchange of programme results, skills and experience
within the European Union and with third countries,
especially the applicant countries.

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Official Journal of the European Union

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4. Member States should report to the Commission on the implementation of this Recommendation
within two years of its adoption and subsequently on request by the Commission with a view to contri-
buting to the follow-up of this recommendation at Community level and acting as appropriate in the
context of the European Union Action Plan on Drugs.

HEREBY INVITES the Commission to:

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

— prepare a report, in accordance with the European Union Action Plan on Drugs 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 Luxembourg, 18 June 2003.

For the Council

The President

G. DRYS