In this presentation of the City Council’s Action Plan which has its main focus on the drug scene in the City centre, I will share with you some reflections on which social and cultural factors make drug abuse in this city somewhat different from what we experience in comparable cities throughout Europe.
In other words I would like to approach drug abuse as a phenomenon rather than giving you a meticulous introduction to the detailed elements in the action plan, and explain the City Council’s value approach to these challenges.
Finally I will present some of the main structures and elements in the Action Plan as such.

After all there is more to life than plain empirical facts – life, and politics for that matter, also consist of dreams and visions for the better for everyone in society, included the unprivileged, the poor and the unhappy and those who abuse and are addicted to drugs.

Background

Despite its apparent innocuous image, Oslo has a drug problem, like any other big European city. In a European context, however, Oslo is a relatively small big city, or should we say metropolis. Given the country’s limited number of inhabitants our drugs problem is less extensive than many other countries, but there are certain patterns embodying the social settings where the abuse takes place and the desperate way the individuals behave within these settings, that make Oslo different from many of the other European big cities.

Paradoxically then, although this country for a long time has had, and still has one of the most restrictive legislations in Europe on drug abuse and distribution of narcotics, Oslo has during the years gradually developed an open public drugs arena where a limited number of people, as well as using drugs openly in front of ordinary people and the authorities, are also exposed to a social and individual misery that altogether has become unacceptable.

These hard core abusers gathered in the area that encircles the Central Station and the lower part of Karl Johan’s gate and from there along an axis up to the Aker river which splits the central parts of Oslo in two. Because the city centre is geographically quite limited the transparency is high and the open abuse is visible. Here far too many of our drug abusers used to gather, buying and selling, thus forming a market for distribution of drugs.
This area consequently developed into a habitat for utterly miserable and sick people of all age groups, though most of them where quite experienced abusers and addicts normally using what was at hand, though the most frequently distributed drug was heroin.

At the same time the area functioned as a recruitment area for younger people who were in the process of individual and social marginalisation. Many of those had their origin in other communities just outside Oslo and elsewhere in the whole country.
Like many other big cities Oslo has always been a melting pot consisting of people from all over the country. This means, of course, that our city also becomes attractive to those who seek anonymity and freedom from local social contempt and isolation. But, once staying here, our legislation provides itinerates certain rights to maintenance of basic subsistence and means of support and they can not be expelled from the city.
The result is more often than not that they chose to stay. Paradoxically a miserable life in the capital seems to be more attractive to a large number of internal immigrants than a social and individual being as untouchables in the provinces. It is sad to observe that many are so outcast that the drugs arena seems to represent their only social setting – a place where their identity is constituted and confirmed.

Many of those people had serious mental disturbances and classic mental disorders or psychosis on top of the drug abuse, the so called double diagnoses. Many of those were temporarily or permanently incapable of controlling their behaviour and the consequences of this lack of control.
Most of them were malnourished with both acute and chronic health problems, often related to injection infections, bruises from violence and falls, and other medical problems which for many led to serious illness, that combined with irregular doses or overdoses of narcotics resulted in sudden death.
Many had a resigned attitude to their abuse, and a lack of consciousness of the fact that they were living on the border between life and death.

Once established as a drugs market these areas also became attractive to all kinds of criminal delinquents distributing all kinds of stolen goods. There were of course clear indications of criminal back-benchers and stay behind groups pushing drugs to quite helpless abusers, making them victims for brutality and reprisals from other organised criminals operating in the market place.
This floating social environment made a clandestine brotherhood that had just one thing in common; buying and selling of drugs and rapid profit. In many ways the city centre gradually became a stronghold for all kinds of obscure people with quite dubious origin.

The companionship and solidarity that once could be traced among those people had vanished over time and left was a harsh and raw environment with just rudimentary rules of human conduct and behaviour.
This, among other things resulted in increased violence under ghetto like circumstances that almost slipped out the authority’s control. The situation became threatening and dangerous in general but most particularly for those who frequented these places.

Even worse the area became a symbol of the conflict between society’s restrictive attitude and legislation against distribution and use of drugs and the authorities’ reluctance, and perhaps incompetence to use authority and execute law and order to put an end to it.

In many ways, though I do not like to admit it, it also symbolised the city’s own incapability to deal properly with these people even though most of them were in contact with the welfare system and the social authorities. The fact is that they had permanent places in our rehabilitation institutions or more temporary accommodation.
This is at least true for the hard core of abusers as they actually were relatively few in numbers. But the layers of people around them were more numerous and more peripheral to the authorities as they floated around in the city centre seeking for new contacts and drugs wherever it was offered.

In the public eye and conscience as well as consciousness this concentrated area became a mirror of social desperation and individual misfortune that was perceived in a dual way; it became an aesthetic problem and an ethical problem at the same time. On the one hand it disgusted and appalled people - on the other hand they felt a strange attraction to these people perhaps because they reminded them of their own prosperous position in life, a feeling of gratitude maybe of their own success and lack of deprivation, or perhaps the opposite; their very proximity to the edge of poverty and misfortune.

Anyway, this dualistic position created a conflict between peoples’ sense of social responsibility and consideration for their fellow beings on the one hand and their contempt and laissez-faire attitude on the other. The solution of this conflict was not unsurprisingly that the authorities were to blame, as always, which of course is a role we just have to accept.

All in all, this meant that in Oslo, unlike many other cities elsewhere in Europe, drug abuse and distribution of narcotics took place in the very centre of the city, whereas similar social and individual misery is more spread in comparable cities in other countries.
This made the drug abuse very transparent with us and the appalling and miserable situation for these individuals was exposed openly to everyone, even more so because Norway and Oslo in particular have developed an injection culture which makes the death and overdose rate very high.

This does not mean, however, that our city - let alone our country - has a larger amount of drug abusers than other European cities and countries. Comparative studies and research prove otherwise. In fact the dimension of this challenge is less extensive than in comparable cities, but as already mentioned outrageously transparent.

It must be an interesting challenge for a social anthropologist to analyse the cultural and social factors that are at work when we experience this tendency of abusers to cluster in dense environments that are so visible to everyone. We have seen it before throughout the history of abuse and social poverty. I am quite sure there are certain explicable cultural factors and patterns behind these tendencies but I shall refrain from going into that now.

Value basis

Anyway, as politicians in charge and as fellow beings we were confronted with a totally unacceptable situation. In many ways the situation gradually came out of hands, reaching its peak three years ago. I realised that we had to do something which was more innovative than the traditional chasing of people that we had tried earlier.

During the last thirty years the authorities numerous times have tried to split up and dissolve the hard core drug networks without any success over time. We could of course once again order police actions to be carried out in order to remove the drug abusers for a limited period of time. We knew too well, however, that this would not bring us an inch closer to a successful solution which by nature is individually and socially rooted.

If the authorities wanted an easy way out we could, as they have done in other European cities, chosen repressive and harsh actions in order to split the drug site.
The reason why we did not do so, is rooted in a profound acknowledgement of the fact that we are talking about individuals with heavy burdens of social and individual deprivation who need extensive aid rather than punishment and isolation.

To me personally it is exceedingly important to emphasise that people with drug problems have to be considered and aided as individuals. This is not primarily a collective phenomenon; they do not have more in common than their abuse. But the reasons why they abuse drugs are manifold and different and the variety and disparity among them is obvious. The city’s measures and actions rest upon this acknowledgement and our point of departure is a humanitarian approach more than a craving for social control.

Consequently it is my personal view that we should insist on the fact that every individual chooses between actions, and that they must be considered responsible for their choices despite the misery that characterises them and their social surroundings. No human being is a mere victim, they are also participants in their own lives.
If then we constitute a division between them on the one hand and us on the other we create and maintain a human distance which hits our society’s most outcast and isolated group very hard.
If you remove a human being’s right to chose you commit an existential crime, telling him directly that he is invalid as an individual, because freedom of choice characterises man himself.

Indirectly we then state that those who abuse drugs have lost all control and consequently also should be declared innocent of their actions and irresponsible for their own welfare and for their future. By doing so, we unintentionally exclude them rather than include them. And I am afraid that this is exactly what we have done for a long time. That is why we tried to swing the pendulum by designing a new approach when we launched our action plan a couple years ago.

It is my firm conviction that all measures aiming at treatment, humane harm reduction or rehabilitation must have a common goal building on deliberate ideas and outspoken will to constitute and facilitate the individuals’ ability of reconstructing their emotional and social lives by re-conquering control and predictability.

The City Council’s action plan’s value foundation accentuates every individual’s right to keep his identity, integrity and to be heard and listened to. The main reason we are insisting on this is rooted in the fact that this group is conceived as a pariah cast in our society and peoples’ moral contempt is obvious, as already mentioned.

Rather than harsh police actions alone we are trying to offer alternatives to the drug scenes in the city centre by strengthening the already existing welfare measures and by designing and establishing new services funded on humanitarian approaches.

At the same time we recognise that drug abuse concerns not only the individual but also his surroundings. Drug abuse must be conceived as a phenomenon that is developed in a precarious balance between the individual, his family and society. Parents, children and relatives are of course particularly exposed and are inflicted pain and sorrow by the abuser’s behaviour and actions, let alone the constant feeling of bad conscience and the permanent anxiety of losing the abuser in overdoses or other dramatic lethal events.

Consequently it is pertinent to maintain that the individual’s problem also becomes a collective and public matter. Both parties must be considered and taken care of. We must develop a reciprocal responsibility between the individual abuser and his intimate surrounding and society. In order to achieve this we must claim responsible participation from all parties including the abuser himself. As mentioned earlier; no-one is a mere victim and everyone is responsible to be a present the central person in his own life.

More than ever it is important to seek for holistic approaches and models for cooperation between the individual abuser, his family and society. In this first stage the action plan is directed towards harm reduction, humane care provisions and rehabilitation. It builds above all on humanitarian rescue intervention in order to relieve individual pain.
The next step will hopefully achieve stronger integration of the abusers, alternative identities, participatory representation in ordinary social settings, activation of the abusers to enable them to be a fighting part of the right to visibility, and dignity and through that, create an atmosphere that makes it imaginable to abolish or reduce public contempt.

I conceive drug abuse as a mirror of deep emotional and spiritual deprivation, a desperate behaviour that above all calls for humanitarian actions and human and humane care.
In addition to that, drug abuse represents a particular challenge because it transcends society’s legal and moral norms and limits. And through that, it touches society’s right to protect her self. In my mind we must be able to live with these apparent paradoxes through a demonstration of civil and political courage, with execution of authority combined with humane actions.
That is why I feel very strongly that when the legislation forbids the use and distribution of narcotics we cannot allow it in the streets or wherever it takes place just because the abusers are miserable and socially isolated. We must be able to execute the law and show empathy and humane approaches at the same time. Normally we define people as responsible for their choices and actions. The drug abuser is granted identical rights. But we must remember that even if the abuser has identical rights it does not mean that he has got equal rights. Equality is achieved only if we stop making a schism between him and ourselves. If we exempt him from responsibility we unintentionally add inequality to his life.

The City Council’s Action Plan

I have so far given you the background for the Action Plan. You will surely understand that with these values underlying our actions, our point of departure was not as easy as if we had chosen rougher methods.
In other words the City Council did not choose the easiest way out. But obviously, the empirical facts forced us to reconsider our strategies for preventive actions, and this called for alternative solutions to mere police actions and other repressive measures.

Some of you may have noticed that I have presented the challenges in the City centre in the imperfect, as if the problems have vanished, just like that. Of course they have not.
But last summer the police forces according to the law launched a clearing action in the city prohibiting people to use and distribute narcotics. This was a part of the action plan’s mandate. And the action has so far been successful because it smashed the concentrated drug scene in the city centre and forced the abusers to use wider areas of the city to their activities, and to a certain extent also made them visit the alternative places that were described and established as a result of the Action plan.

Two years ago the City Council launched the action plan in co-operation with The Ministry of Justice, The Ministry of Health, The Ministry of Social Affairs, The Ministry of Family and Children Affairs and The Ministry of Regional Affairs and The Department for Police in Oslo District.

The goal was to analyse and describe the main challenges connected to the growing problem of social decline and individual misery in the city centre in order to spread the problems by building up alternative places by a wide range of different welfare measures. The responsibility was divided and manifold, but put in a simplified form the social and welfare authorities were supposed to design and run social and health based measures whereas the police would be responsible for the execution of law and order. Both parties were supposed to initiate and keep up an intimate cooperation.

At the same time this problem was recognised as a national challenge because the abuse that we observed in the city centre symbolised and reflected equivalent problems in the other regions of this country, and the representation of five ministries in the select steering group that was established as the upper authority for the project accentuated this. The action plan had a short time limit, within six months the department for Welfare and social affairs should present the plan which would be implemented immediately.
The plan was publicly launched in February 2003 and is now in the last year of its first stage. The results so far have been beyond expectations in most senses but there are of course a lot of challenges to be dealt with, even more so because there seems to be a tendency that new ways and new approaches widen our consciousness in the sense that the more one reveals the more there is to be revealed and dealt with.

This plan implements a wide range of social welfare measures in order to redeem the individual and social misery in the city centre, and particularly concentrated in the vicinity of the Central Station. The action plan is genuinely built on an expressed humanitarian foundation as we firmly believe that a gentle approach to these problems is more successful over time.

The plan is neither particularly spectacular nor exceptionally innovative or radical – rather it presents a wide range of social welfare activities which serve as a life rescue scheme to the abusers. Many of the activities are based on an institutional level – some of these institutions represent places where the abusers live for longer periods of time, others serve as places for immediate help and short time accommodation.

The content of this plan is thus far too extensive to be presented fully in this context, but I will give you some keywords to give you an impression of its intention:

Most of the social institutions where the drug abusers stay and live for longer periods of time offer several meals per day, as we know too well that the abusers’ health are badly affected by malnutrition and even starvation. These measures have been very successful and resulted in better contact and communication between social workers and clients – the latter reporting that this offer gives them a feeling of dignity and serves as a conflict reducing measure.
Separate places to stay – you may call them “dwelling places” – or open cafes - which are facilities the users can get to without discriminating or humiliating control measures – places to meet people of the same kind – where they are served food, getting warm, offered to wash their clothes – have a shower – and of course meet social workers to talk to – if they want to.
Some of these places have low threshold medical services attached to them – where professional nurses assess their general health problems which often are serious, characterised by malnutrition, infections, bruises, and so forth…..

In addition we have established a number of other low threshold medical offers – detached from social institutions
Most of these places distribute condoms, distribute and redistribute syringes to the abusers to prevent general infections, hepatitis, HIV and Aids.
For those who more or less are permanently intoxicated we have detoxification clinics which in addition to sobering people up also do social work in order to offer more permanent treatment in therapeutic institutions.

A growing number is also offered pharmacological treatment and substitution or maintenance treatment. This year we have opened a place where addicts are allowed to use syringes under supervision of professionals under very restrictive circumstances. I refrain from commenting this further, I can only inform you that there has been a very heated debate prior to its establishment, and that the discussion seems to get on.

We have initiated co-operation with the neighbouring municipalities in the vicinity of Oslo and municipalities all over the country in order to get migrant people back to where they come from. This is mainly a co-operation between the social agencies in the respective towns, cities and smaller communities but is developed as a result of communication between political authorities as well.

These measures are of special importance for the youngest, those who are about to start a career as abusers by testing out narcotics from curiosity and other reasons. The city’s out reach agency plays an important role in this work, because they are working on the streets and are more or less detached from the more permanent administrative “mother institutions”.

In addition to this there are numerous projects aiming at competence enhancement, cooperation between professions and institutions and experimental approaches built on new ideas, innovative measures and creative experiments.

Included in the action plan for alternatives to public drug abuse is also Oslo city’s action plan against drugs which is inspired by ECAD’s principles for preventing drug abuse among adolescents in particular. This action plan has a ten point programme describing recommended measures of preventive nature.

Final words

By this presentation I hope to have given you some ideas of the ideals behind the action plan and a simplified version of the framework that it builds on.
Personally, I believe that the best part of this plan is that we have placed misfortunate people on the agenda in a new way, in the sense that the humanitarian aspect has become much clearer – and maybe that is our biggest achievement.

Thank you very much for your kind attention!

 
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