Correlation Focal points and expert group meeting

The Correlation – European Harm Reduction Network held its Focal point and expert group meeting from 2 to 4 October 2019 in Helsinki. The meeting gathered 60 participants from 31 countries and territories. Among them, DPNSEE network members are focal points for Albania, Bosnia Herzegovina, Bulgaria (not present at the meeting), Greece, Montenegro, North Macedonia, Romania and Serbia.

The agenda included a wide range of interesting issues including New projects on European level, Results of the first round of monitoring harm reduction, Challenges in Harm Reduction and also Correlation state of affairs and Methadone shortage in Romania. Complementing this agenda, participants were given the opportunity to join a series of workshops on Advocacy, Peer Involvement and Intervention Planning, Monitoring and Evaluation. Building upon this pool of expertise, the event offered the possibility to present developments in the different EU countries in regard to drug policy and harm reduction and to disseminate relevant work and activities.

Since the launch of the monitoring tool for harm reduction organizations, Correlation Focal Points have been working on collecting the required data and information. The tool had more than 100 questions and 35 countries from Europe participated. Some results are strange. For instance, the only 3 countries in Europe which expressed civil society’s good cooperation with governments were Albania, Bosnia Herzegovina and Romania! During the meeting, participants shared their experiences and provided feedback on the tool and the process.

Ms Dagmar Hedrich, Head of the Health consequences and responses sector, Lead scientist for harm reduction at EMCDDA, presented the data collected by the agency. DPNSEE Vice President and Executive Director asked what can we do with outdated data coming from some EMCDDA focal points and how could they include data from candidate and non-EU countries? The reply we got was that EMCDDA’s institutional obligation is to report on 28 EU countries and 2 who pay for their services (Norway and Turkey) and that budget cuts and no funds prevent them to cover more. An interesting view Ms Hedrich proposed is that the civil society organisations can perform social autopsy of overdose deaths of people who were using their services. The implementation researches are one of important potentials of CSOs – qualitative information they can provide. A good model they use is that EMCDDA prepares short reports with key messages, tailored for policy makers, followed by webpages or web based portals which give a full information.

The presentation from the European Centre for Disease Prevention and Control (ECDC) was focused on monitoring in general and on Hepatitis in particular. It emphasized that there is a big problem with low number of those diagnosed for HEP, huge numbers in prisons and lack of accurate data.

On Friday 4, the seminar Wellbeing economy – A way to sustainability in the HIV and AIDS response? was held as an official side event during Finland’s Presidency of the Council of the EU in cooperation with HIV Finland.

New EMCDDA manual and training courses for professionalising drug prevention

Source: EMCDDA

The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) has launched European Prevention Curriculum (EUPC), the manual for decision – makers, opinion – makers and policy-makers in science based prevention on substance use, designed to train professionals who are involved in shaping prevention decisions, opinions and policies in Europe in the science-based prevention of substance use (1).

There has been much progress over the past 20 years, both in Europe and internationally, in developing responsible and evidence-based interventions in substance use prevention. Yet, prevention practices for which there is little, or no, evidence of effectiveness are still being implemented in school and community settings today. In the worst cases, poorly designed interventions may even cause harm.

The new handbook represents an important step towards achieving the agency’s goal, outlined in EMCDDA Strategy 2025, to support interventions to prevent drug use which are based on evidence. It provides practical overviews of a variety of topics (e.g. aetiology, epidemiology, monitoring and evaluation) as well as prevention in diverse settings (e.g. family, school, workplace, community, media and the broader environment).

emcdda

The aim of the EUPC initiative is to implement a standardised prevention training curriculum in Europe and improve the overall effectiveness of prevention. Adapted from the Universal Prevention Curriculum by the EU-funded UPC-Adapt group, the handbook is based on international standards but with a European slant (2).

EMCDDA Director Alexis Goosdeel said: ‘I believe that Europe will greatly benefit from a professional prevention workforce that values prevention science, has the support of public institutions and is trained in, and knowledgeable about, approaches that are empirically tested and likely to yield results. The EUPC manual and training series aim to reduce the health, social and economic problems associated with substance use by strengthening the expertise of those who influence the development of prevention systems, cultures and activities in their regions.

European Master Trainers – cascading knowledge on evidence-based prevention

This week, the EMCDDA joins forces with the EU-funded project ASAP training for quality in prevention to deliver the first EUPC ‘training of trainers’ course in Lisbon (3). Following two three-day training courses of this kind and a final exam, successful participants will gain the status of European Master Trainers.

The qualification will allow the trainers to cascade evidence-based prevention knowledge through courses in their own country and language. The new handbook forms the main reference material for EUPC training courses, which can be delivered in three forms: online introductory training; training for local or regional decision-, opinion- and policymakers (DOPs); and training in academic settings (future DOPs).

This week 29 participants from 11 countries will take part in the training, including two participants from Georgia and the Lebanon funded through the EU4Monitoring Drugs (EU4MD) project, launched by the EMCDDA earlier this year.

It is hoped that the EUPC manual and training courses will boost the application and spread of effective modern prevention approaches at local and regional level in Europe and facilitate well-informed choices about funding and implementation priorities.


Czech drug policy model preserved

A week ago, we posted a news with an urgent call to support the Open letter to the Prime Minister of the Czech Republic to preserve its successful drug policy model, as our colleagues from the Czech Republic informed the international community that the Prime Minister is intending to move the Secretariat of the Council for Drug Coordination and its monitoring centre from the Office of the Government to the Ministry of Health.

DPNSEE was among 407 signatures to support the Open letter. And it worked!!!

As a result of expert pressure, the Czech government decided to desist from the intended move which we all feared would threaten the interdisciplinary model of Czech drug policy and endanger the funding of harm reduction and social services.

The support from international as well as domestic experts and professionals has been overwhelming and, apparently, has (once again) helped to preserve the Czech drug policy model.

For more details, please see a press release of the Czech government announcing that they desist from the move. The English translation is below:

THE OFFICE OF GOVERNMENT DESISTS FROM MOVING THE DRUG AGENDA UNDER THE MINISTRY OF HEALTH
4. 7. 2019 16:43

Regarding the fact that according to the Competence Act, the Office of Government should perform tasks related to the expert, organisational and technical aspects of the work done by the Government of the Czech Republic and its bodies, it has been considered that as a part of making the Office of Government more effective, the Secretariat of the Government Council for Drug Policy Coordination would be moved under the Ministry of Health with the prime minister continuing to preside the Council.

This wasn’t an isolated step. During the last year, the Governmental Council for Coordination of the Fight Against Corruption was moved under the Ministry of Justice and the agenda of social inclusion will move under the Ministry of Regional Development. In line with this, moving the drug agenda was being considered.

Due to the expert opinion that the move could diminish the importance of the drug agenda and that the discussion about moving was still undergoing, the Office of Government has decided to desist from this step. Secretariat of the Government Council for Drug Policy Coordination, currently lead by the National Drug Coordinator, will stay under the Office of Government.

Join an open letter to the Czech Prime Minister to preserve its drug policy

Our colleagues from the Czech Republic informed the international community that the Prime Minister is intending to move the Secretariat of the Council for Drug Coordination and its monitoring centre from the Office of the Government to the Ministry of Health.

As explained in the Open letter to the Prime Minister of the Czech Republic to preserve its successful drug policy model, this would have a negative effect on the interdisciplinary nature of drug policy in the Czech Republic and lead to restricted funding for social and harm reduction programmes in the future.

We have had a good communication with the Czech Secretariat and its National Monitoring Centre and learned a lot from their successful drug policy model. For this reason, DPNSEE supported the petition.

If you want to read and supported the petition follow this link>>>

European Drug Report 2019

The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) issued today their regular annual European Drug Report. The Report provides a comprehensive analysis of recent drug use and market trends across the European Union (EU), Norway and Turkey.

The 2019 report highlights in particular an increase in cocaine availability with seizures at a record high, amounting to 140.4 tonnes, double the quantity seized in 2016 (70.9 tonnes). Although the retail price of cocaine remained stable, its purity at street level reached its highest level in a decade in 2017.

The report notes the “Uberization” of the cocaine trade, where users and dealers use smartphones, messaging apps and satellite navigation to obtain the drug. Enterprising criminals have set up “cocaine call centres” across Europe to provide fast and flexible delivery services.

Heroin is still the most common illicit opioid on the drug market in Europe and is a major contributor to drug-related health and social costs. The quantity of heroin seized in the EU increased by over a tonne in 2017 to 5.4 tonnes, with an additional 17.4 tonnes seized by Turkey (some of which would have been destined for the EU market). Laboratories producing heroin from morphine using this precursor have been discovered in recent years in EU countries (Bulgaria, Czech Republic, Spain and the Netherlands). Heroin purity remains high and the retail price relatively low.

Belgium has overtaken Spain as the hub of the fast-growing European drug market. Belgium is playing an enlarged role in both the distribution and production markets of cocaine, methamphetamines and other illicit drugs, such as ketamine and GBL. The report also shows that Belgium, together with the Netherlands, is one of the main production centres for MDMA.

The Report also explores the challenges associated with new synthetic opioids, the latest developments in the cannabis market and synthetic drug production in Europe. Production of synthetic drugs appears to be ‘growing, diversifying an The purity of methamphetamine and amphetamine is higher than a decade ago, with 0.7 tonnes of methamphetamine and 6.4 tonnes of amphetamine seized in the EU in 2017. d becoming more innovative’ with methamphetamine posing the “greatest challenge”.

Legal recreational cannabis markets in some countries outside the EU were leading to “innovative” new products that presented difficulties for detection and control when entering the continent. The report points to fentanyl as a problem drug in Estonia, buprenorphine in Finland and the Czech Republic and methadone in Germany and Denmark. 11 new synthetic opioids were detected in 2018, including six new fentanyl derivatives. Since 2009, there have been 34 fentanyl derivatives detected in Europe, the EU agency says.

One in five people entering drug treatment facilities for an opioid-related problem “now reports a synthetic opioid, rather than heroin, as their main problem drug; and these drugs are becoming more commonly detected in drug overdose cases”. Around 8.200 people died of an overdose in Europe in 2018, according to the Report, around 300 more than in 2017. Most of the overdoses were not due to cocaine or other drugs, but rather opioids (heroin-induced), which made up 78% of all deaths. Researchers say the number of deaths could be 20% to 30% higher due to potential underreporting by member states. The spread of HIV has decreased by 40% over the past decade.

Providing people who inject heroin, or other drugs, with greater access to prevention, testing and treatment for HBV and HCV is central to combating viral hepatitis as a public health threat in line with the global 2030 Agenda for Sustainable Development, as they are the people with the highest burden of disease and at highest risk of transmission.

Mobile health applications are increasingly used in prevention, treatment and harm reduction.

To read full report in 24 languages follow this link>>>

Press releases with highlights in all EU languages are available following this link>>>

You can get the highlights of the report from the video bellow.

EU drugs agency and the Republic of Albania strengthen their cooperation

The Director of the The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) Alexis Goosdeel and Albanian Deputy Minister of the Interior Besfort Lamallari and Deputy Minister of Health and Social Protection Mira Rakacolli signed the document of the agreement to cooperate more actively on monitoring the drug phenomenon in future. The signing ceremony took place at the Delegation of the European Union to the International Organisations in Vienna, hosted by EU Ambassador Didier Lenoir, and in the presence of Dimitris Avramopoulos, European Commissioner responsible for Migration, Home Affairs and Citizenship.

The Working Arrangement originates in a request from the Albanian Ministry of the Interior to the EMCDDA Director in 2017 and follows the seal of approval of the European Commission and EMCDDA Management Board. While the agency has signed similar agreements with other third countries, this is the first request of its kind from the Western Balkans. The new agreement provides for the exchange of expertise between the entities concerned and will contribute to developing drug data-collection and reporting capacity in the country.

Dimitris Avramopoulos, Commissioner for Migration, Home Affairs and Citizenship in the European Commission, emphasised that “the Agreement will strengthen the cooperation to develop the right common policies to address drug trafficking in our regions and will pave the way for similar arrangements in the Western Balkans.”

emcdda

The EMCDDA began its cooperation with Albania in 2007 in the framework of EU-funded technical assistance projects designed to prepare Western Balkan countries for accession to the EU (and for participation in the work of the EMCDDA and its Reitox network. The EMCDDA and Albania are currently working together to consolidate Albania’s capacity to monitor the drug phenomenon through the use of evidence-based tools and knowledge built and promoted within the EU. They also exchange data on new psychoactive substances as well as expertise on establishing a national early-warning system.

While no formal national drug observatory has yet been established in Albania, along the lines of a Reitox national focal point, the EMCDDA has developed close working relations with the Ministry of the Interior and with the Institute of Public Health of the Ministry of Health and Social Protection. This cooperation led to the financing of the first national general population survey on drugs in Albania in 2014 as well as the production of a Country Drug Report for Albania in 2017 following EMCDDA guidelines.

Albania is one of six candidate and potential candidate countries to the EU currently receiving assistance under the EMCDDA IPA 6 project, which kicked off in July 2017 and will run until June 2019.

EMCDDA added 16 new programmes to online registry

The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) has added 16 new programmes to online registry of evidence-based prevention programmes. Xchange, EMCDDA’s project, is an online registry of evidence based prevention programmes. At the moment, it contains 38 programmes, even if it is in pilot phase.

In addition to providing information on the effectiveness of programmes, the registry, available on the EMCDDA Best practice portal, also offers information on the experiences of professionals who have implemented these programmes in individual European countries. This enables decision-makers to assess the ease with which programmes can be implemented in different social, cultural and organisational contexts. It also helps prevention professionals to learn and interact with each other about their experiences with these programmes.

Five of the new programmes focus on substance use prevention and 11 on crime and delinquency prevention.

emcdda

The registry is the centre piece of a growing network of national registries. Through Xchange, an interested visitor can access additional details on a specific programme in the national language within a local registry, or access through a national registry the European implementation experiences of a given programme. A unique feature of Xchange is that it allows national high-ranking programmes to be promoted in this European registry and, inversely, allows international visitors to find more details about local adaptations in national languages.

The Council of the European Union’s Minimum quality standards in drug demand reduction in the EU demands that prevention professionals have access to knowledge on effective prevention programmes. A growing number of programmes are considered effective at reducing substance use and related problems under carefully controlled conditions. However, access to evidence‐based prevention programmes is still limited and they remain under‐utilised compared to prevention strategies with no empirical evidence for effectiveness. Xchange aims to address this challenge by providing access to such programmes.

To explore the new programmes follow this link>>>>

 

 

The right to privacy of using cannabis

At the beginning of the year, The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) published the news about the right to privacy of using cannabis. The news indicate that in 2018 the highest courts in countries across three continents have asserted that state intervention in the private life of their citizens who wish to (grow and) use cannabis is not always justified. EMCDDA reports about three countries: Georgia, South Africa and Mexico.

Georgia

In Georgia, on 30 July, the Constitutional Court decided that punishment of use of cannabis in private without a doctor’s prescription was in breach of Article 12 of the Constitution, which states ‘Everyone has the right to the free development of their personality’. The court found that the aims of protecting public health or public security could not justify state punishment of cannabis use in private. Penalising cultivation and possession for personal use were not contested in this case and therefore not considered.

South Africa

In South Africa, on 18 September, 10 judges of the Constitutional Court ruled that it was not reasonable to penalise an adult who cultivates, or uses, or possesses cannabis for personal consumption in private. The laws were incompatible with Article 14 of the Constitution, which states that ‘Everyone has the right to privacy which includes the right not to have […] their possessions seized’.

Mexico

In Mexico, on 31 October, the Supreme Court gave its fifth judgement since 2015 stating that penalising private cultivation, possession and use of cannabis (and tetrahydrocannabinol) was unconstitutional, against the principle of free development of the personality. Other courts are obliged to follow Supreme Court judgments once five similar rulings have been delivered.

All three courts emphasised that any private use of cannabis should not be in the presence of children.

The courts also commented on trends in international developments in cannabis policy and use. The Georgian court noted the increasing application of human rights law in modern legal standards, and the South African court ruled that such state interference is not justified ‘in open and democratic societies’.

In the 1988 UN Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances, Article 3(2) states that a country should criminalise possession and cultivation for personal use ‘subject to its constitutional principles’. The court in Mexico stated that it upheld the constitutional principle of free development of personality and considered it was still in line with the Convention.

The European Convention on Human Rights, Article 8(1), states that “Everyone has the right to respect for his private and family life, his home and his correspondence’, with limits, and the ‘private life’ has been interpreted to include the right to develop one’s own personality.”

Potency and price of cannabis in Europe doubled in last 11 years

The first study to investigate changes in cannabis across Europe showed that cannabis resin and herbal cannabis have significantly increased in potency and in price. The study was published on 30 December 2018 in the journal Addiction by researchers from the University of Bath and King’s College London. It draws on data collected from across 28 EU Member states, as well as Norway and Turkey by the European Monitoring Centre for Drugs and Drug Addiction.

The findings show that for herbal cannabis, concentrations of Δ9-tetrahydrocannabinol (‘THC’ – the main psychoactive constituent of cannabis) increased by a similar amount each year, from 5% in 2006 to 10% in 2016.

For cannabis resin, THC concentrations were relatively stable from 2006 to 2011 (from 8% to 10%) but then increased rapidly from 2011 to 2016 (from 10% to 17%). The price of cannabis resin also increased, but to a lesser extent than for herbal cannabis.

Cannabis resin typically contains cannabidiol (CBD) in addition to THC. CBD has recently attracted considerable interest due to its potential to treat several medical conditions including childhood epilepsy syndromes, psychosis and anxiety. But, when present in cannabis, CBD may offset some of the harmful effects of THC such as paranoia and memory impairment.

Cannabis-containing higher levels of THC and/or lower levels of CBD has been linked to greater long-term harms such as the development of cannabis dependence, and an increased risk of psychotic illness. New resin production techniques in Morocco and Europe have increased levels of THC, but not CBD.

Leader of the research team Dr Tom Freeman indicates that “CBD has the potential to make cannabis safer, without limiting the positive effects users seek. What we are seeing in Europe is an increase in THC and either stable or decreasing levels of CBD, potentially making cannabis more harmful. These changes in the illicit market are largely hidden from scientific investigation and are difficult to target by policy-makers. An alternative option could be to attempt to control THC and CBD content through regulation.”

The research is available following this link>>>>

EU drugs agency publishes its first report on the medical use of cannabis

What is the evidence base for the medical use of cannabis and cannabinoids? What is the difference between cannabis preparations and medicinal products and why is this important? How is this issue regulated in the EU? These and other questions are explored in a new report published today by the EU drugs agency (EMCDDA): Medical use of cannabis and cannabinoids: questions and answers for policymaking. The report responds to growing interest in this topic as more European countries develop policies and practice in this area.

ʻMany EU countries now allow, or are considering allowing, the medical use of cannabis or cannabinoids in some formʼ, states the report. But approaches vary widely between countries, both in terms of the products permitted and the regulatory frameworks governing their provision. Understanding this variety of national approaches is important for an informed policy debate in this area in the EU.

The report aims to explore current practice in the EU regarding the provision of these substances for medical purposes and clarify some of the complex issues in this area in order to support science, policy and practice. The report notes that the terms ʻmedical use of cannabis and cannabinoidsʼ can refer to a wide variety of products and preparations that may contain different active ingredients and use different routes of administration.

The publication provides a state-of-the-art overview of evidence for the medical use of cannabis and cannabinoids. It concludes that more research and clinical studies are needed to fill ʻimportant gaps in the evidenceʼ.

The report highlights the challenges of decision-making in this area and summarises the multiple issues that governments may consider when deciding whether to make cannabis or cannabinoids available for medical use. These include: the types of product that patients will be allowed to use; the medical conditions for which such products can be used; and the type of medical and regulatory supervision under which patients are allowed to use them.

EMCDDA Director Alexis Goosdeel says: ‘In most countries, the provision of cannabis and cannabinoid products and preparations for medical purposes has evolved over time, often in response to patient demand or product development. This report seeks to provide an objective look at current evidence, practice and experience in this very fast-moving field and describe the complex patchwork of approaches adopted in the EU and beyond. Lastly, it points to the importance of developing a common language on this issue to help build a base for evaluation and assessmentʼ.

To read the report, follow this link>>>>