Mongan, Deirdre (2007) European drug policies - extending beyond illicit drugs? Drugnet Ireland, Issue 21, spring 2007, pp. 30-31.
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The inclusion of licit substances in European drug policies is discussed in the EMCDDA annual report selected issues 2006.1 This report analyses the current approach advocated by EU countries to their drugs strategies, the rationale behind extending the scope of drugs strategies and the potential repercussions an extended drugs strategy would have on drugs services and responsible bodies at operational level.
The EU Drugs Strategy 2005–2012 adopted in 2004 is directed at illicit drug use, although it does acknowledge the health-related and social problems caused by the use of illicit drugs in combination with legal psychoactive substances such as alcohol, tobacco and medicines. However, there is an increasing body of opinion which believes that the scope of drugs strategies should be broadened to encompass licit addictive substances such as alcohol, tobacco and medicines, as well as illicit drugs.
Of the 27 countries surveyed for this report, 24 reported the existence of a national drugs strategy but just eight countries reported that their strategies included both drugs and alcohol (Table 1). The basis for the inclusion of both substances within a single strategy differs across countries. In some countries the justification comes from a public health perspective which considers the distinction between licit and illicit substances to be irrelevant – licit substances can cause addiction and consequently pose a major health and social problem. It is difficult to differentiate between users of licit and illicit substances due to the increasing prevalence of polydrug use. Another reason for broadening national strategies is based upon a medico-scientific consensus that takes into account the causes and consequences of addictive behaviours, regardless of the legality of the substance. This approach places greater emphasis on common behaviours than on substances.
Table 1 Substances or behaviours targeted in national drugs strategies
|
Illicit drugs |
Alcohol |
Tobacco |
Medicines |
Other substances or addictions |
Belgium |
+ |
+ |
+ |
+ |
+ |
Czech Republic |
+ |
+ |
+ |
|
|
Germany |
+ |
+ |
+ |
+ |
+ |
Spain |
+ |
+ |
+ |
+ |
|
France |
+ |
+ |
+ |
+ |
+ |
Cyprus |
+ |
+ |
+ |
+ |
|
Romania |
+ |
+ |
+ |
+ |
|
Norway |
+ |
+ |
|
+ |
|
Sources: Reitox national focal points
Ireland is identified as one of 11 countries with a drugs strategy that addresses only illicit drugs but which includes links to licit substances in the context of prevention and treatment. While the Irish National Drugs Strategy Building on experience: National Drugs Strategy 2001–2008 refers mainly to illicit drugs there are links between it and the national alcohol policy in terms of prevention approach. These links aim ‘to ensure complementarity between the different measures being taken’2 in the field of prevention.
The possibility of developing a combined alcohol and drugs strategy in Ireland is being examined. One of the recommendations of the steering group responsible for overseeing the mid-term review of the National Drugs Strategy was that ‘a working group involving key stakeholders of both the alcohol and drugs areas should be established to explore the potential for better co-ordination between the two areas and how synergies could be improved. The working group should also examine and make recommendations on whether a combined strategy is the appropriate way forward’.3
The field of prevention is the area where extending the remit of national drugs policies is most often apparent. In practice, prevention programmes address licit and illicit substances together. Prevention of drug use is associated with prevention of addictive behaviours which involve both licit and illicit substances. The main objective of prevention programmes is to delay or prevent the introduction into the use of legal drugs as it is now recognised that the early use of licit substances is the most important risk factor for progression to illicit drug use. This is particularly evident among programmes targeting young people which focus first on alcohol and tobacco as the longer that initiation to tobacco and alcohol can be delayed, the greater the reduction in later substance abuse problems.
In most countries, the extension of treatment programmes to include both licit and illicit substances is due to the increasing prevalence of polydrug use. Polydrug use presents challenges to drug monitoring systems that traditionally have focused on the use of individual substances. In Ireland there are no official links between alcohol and drug treatment services, but in practice many drug services also treat clients with problem alcohol use. The reason for this is that one-fifth of those treated for problem alcohol use also misuse drugs. The trend towards integrating treatment centres or establishing joint treatment centres for licit and illicit substances is particularly common in countries which have extended their drugs strategies to include licit substances.
While the majority of countries have established drugs strategies, the scope of these can vary greatly. However, a number of trends appear to be developing which seem to support the integration of licit and illicit substances in some respects. These mainly include prevention programmes and, increasingly, treatment programmes which are now taking into account both licit and illicit substances.
1. EMCDDA (2006) Annual report 2006: selected issues. Luxembourg: Office for Official Publications of the European Communities.
2. Department of Community Rural and Gaeltacht Affairs (2001) Building on experience: National Drugs Strategy 2001–2008. Dublin: Department of Community, Rural and Gaeltacht Affairs.
3. Steering group for the mid-term review of the National Drugs Strategy (2005) Mid-term review of the National Drugs Strategy 2001–2008. Dublin: Department of Community, Rural and Gaeltacht Affairs.
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