Let me first thank ECAD for having invited the INTER-AMERICAN DRUG ABUSE CONTROL COMMISSION (CICAD) of the ORGANIZATION of AMERICAN STATES to participate in this important forum.
I’m particularly grateful to Mr. JIM CORR, CHAIRMAN OF ECAD, and to LORD MAYOR JORGEN LINDER of GÖTEBORG for their hospitality. CICAD has been working with the city of GÖTEBORG for the last couple of years, and it is therefore a real pleasure for me to be here in person today.
Thank you, MAYOR GÓMEZ, for your presentation. It is an honour fior us to have you so actively involved in CICAD’s EU-LAC city partnership initiative.
Let me say a few words Wabout the INTER-AMERICAN DRUG ABUSE CONTROL COMMISSION, known as CICAD for its acronymin Spanish.
CICAD was created in 1986 as the Western hemisphere’s policy forum on all aspects of the drug issue. It also has an essential role in providing technical assistance to developing countries in the Americas to enhance their capacities to address the drug problem. CICAD’s technicak staff work closely with our 34 member governments to develop and support appropriate policies and practices in the areas of substance abuse prevention and treatment, drug production and trafficking, and money laundering control.
One of our goals is to encourage cooperation among countries and among regions - a subject to which I shall return later in my remarks.
For most of its 23-year-history, CICAD has focused its work on the central governments, helping them to develop national drug control strategies and laws, and providing significant amounts of training for staff of central government departments.
CICAD has helped set standards of quality in the treatment of drug dependence, for example, and has developed model legislationand on money laundering control,and the control of chemicals used in the manufacture of illicit drugs. In many cases, these standards or model laws have been incorporated into the national legislation.
The world is changing, and CICAD is changing with it. We are seeing around the world great concentrations of people living in mega-cities, with all the attendant opportunities and problems that that urban life presents. In Latin America and the Caribbean, almost 80 per cento of the population lives in urban areas.
Both Mexico city and Sao Paulo have more than 20 million people. THE UNITED NATIONS estimates that by 2030, nealry two thirds of the world`s population will live in urban areas.
It is therefore no surprise that cities like yours have a crucial, and increasingly important, role to play in the development of public policies and programmes on all types of issues -- and drug trafficking and drug use are no exception.
WHAT IS THE DRUG USE SITUATION IN THE WESTERN HEMISPHERE?
The data on drug use are skewed by statistics from the United States, wher extimates are that drug use in general has fallen over the last few years.
However, if we discount the U.S. data, CICAD research shows that the demand for illicit drugs ahs increased in most other western hemisphere countires for which we have information.
This increase in drug use, coupled with the high use of alcohol, has serious consequences for developing countries, whose budgets adn health services are already strained by the diseases of underdevelopment – infant diarrhea, dengue fever, yellow fever, river blindness, high infant mortality and poor nutrition, as well as the normal childhood illnesses.
Living conditions in the slums of large Latin American and Caribbean cities are very unhealthy: clear drinking water is rare in inte slums and in the Andean Highlands.
I could go on in much more detail, but you understand the scenario of massive urban concentration of social and health ills, with government responses constrained by low budgets and lower public expectations.
Although there are some notable exceptions, treatment and rehabilitation of drug- and alcohol-dependent persons is too often given a low priority by our member governments in the western hemisphere, given all those other demands on their services.
CICAD is here to say that drug and alcohol treatment is, and must be, an important part of any government`s health and social welfare program. Left untreated, addiction to drugs and alcohol produces long-term effects beyond the health of the addicteed person.
Untreated addiction impacts negatively on, among other things, crime rates, social exclusion, traffci accidents, unemployment, loss of productivity and disordered communities.
We all know that drug treatment is not easy and not always successful. But it behoves us to try to address addiction as one of many debilitating diseases that adversely affect our communities.
It is in this context that we in CICAD undertook our city partnerships program, which the Mayor of SAN RAMÓN has just described. Financed by the European Commission, this program is designed to improve drug treatment through exchanges and pooling of knowledge among 40 or so European, Latin American, and Caribbean cities that are participating.
This program has challenged CICAD to take what we have learned over the last 20 years at the national government level and apply our knowledge to the municipal level. CICAD has some advantages here:
- FIRST: CICAD IS A BROKER OF KNOWLEDGE AND EXPERIENCE. WE BRING TO THE TABLE THE EXPERIENCES AND STRATEGIES DEVELOPED AND TRIED OUT THROUGHOUT THE AMERICAS. WE ALSO BRING KNOWLEDGE OF WHAT NOT TO DO, AND WE THINK WE UNDERSTAND WHY SOME APPROACHES HAVE FAILED. I’M NOT SAYING THAT WE HAVE ALL THE ANSWERS – BUT I AM CONFIDENT WE ARE MOVING IN THE RIGHT DIRECTION.
- SECOND: ONE OF OUR BEST TOOLS TO DEAL WITH THE CHALLENGE OF ADDICTION IS USEFUL INFORMATION. CICAD HAS HELPED CREATE NATIONAL OBSERVATORIES ON DRUGS AROUND LATIN AMERICA AND THE CARIBBEAN, MOST OF WHICH PROVIDE TIMELY AND RELIABLE DATA ON DRUG USE, DRUG SEIZURES, AND SO ON. THESE “OBSERVATORIES” CONDUCT SURVEYS OF DRUG USE USING CICAD’S STANDARDIZED METHODOLOGIES.
WE MUST KNOW WHAT THE SITUATION IS BEFORE DEVELOPING POLICIES AND PLANS, AND NOT AFTERWARDS. IF WE DON’T HAVE DATA, WE CAN’T CONVINCE THOSE WHO HOLD THE PURSE-STRINGS THAT WE NEED THE MONEY FOR DRUG TREATMENT – OR INDEED FOR ANY OTHER POLICY OR PROGRAM.
I AM A PRAGMATIST, AND WANT TO SEE CONCRETE PLANS THAT WORK BEST. I HAVE THREE BASIC PRINCIPLES TO OFFER YOU.
- POLICIES NEED TO BE BASED ON SOLID EVIDENCE
- INTER-AGENCY COOPERATION IS NEEDED TO ADDRESS THE DRUG PROBLEM, AND
- WE NEED CONTINUITY IN DRUG POLICIES AND PLANS
1. POLICIES NEED TO BE BASED ON SOLID EVIDENCE
Everyone talks these days about “EVIDENCE-BASED POLICIES”. But in my own experience working in the Americas, it’s hard to get elected authorities and other senior officials to focus on research as the basis for their policy pronouncements.
But even though it’s hard to get them to focus on research, it is vital to do so.
WE MUST HAVE ANSWERS TO QUESTIONS SUCH AS:
- WHICH DRUGS ARE MOST COMMONLY USED IN MY CITY?
- WHAT TYPES OF PEOPLE ARE USING DRUGS AND ALCOHOL? – ARE THEY TEENAGERS, YOUNG ADULTS, CRIMINAL OFFENDERS, WOMEN?
- DO THE DRUG AND ALCOHOL PREVENTION PROGRAMS IN MY CITY ACTUALLY WORK? HOW DO I KNOW THAT? HOW DOES MY CITY COUNCIL KNOW THAT?
- HOW MANY OF THOSE ARRESTED FOR DRUG DEALING ARE THEMSELVES ADDICTED TO DRUGS AND/OR ALCOHOL?
- HOW MANY DRUG AND ALCOHOL TREATMENT FACILITIES ARE THERE IN MY CITY? WHAT SERVICES DO THEY PROVIDE?
- ARE THE DRUG AND ALCOHOL TREATMENT PERSONNEL PROPERLY QUALIFIED?
- DOES ALCOHOL OR DRUG USE BY WORKERS CONTRIBUTE TO TRAFFIC ACCIDENTS?
- HOW MANY CRIMINAL OFFENSES COMMITTED IN MY CITY ARE DRUG-RELATED?
- AND SO ON….
WITHOUT PROPER ANSWERS TO THESE QUESTIONS, IT WILL BE HARD TO JUSTIFY EXPENDITURES OF PUBLIC FUNDS ON DRUG ABUSE PREVENTION PROGRAMS, OR ON OPENING A NEW DRUG TREATMENT FACILITY. WITHOUT DATA, IT WILL BE EVEN HARDER TO CONVINCE YOUR CENTRAL GOVERNMENT TO GIVE YOUR CITY THE FUNDS OR THE POWERS THAT YOU NEED TO TACKLE YOUR LOCAL PROBLEM.
Through our CITY PARTNERSHIP PROJECT, CICAD is developing a series of tools to help cities collect information on their drug and alcohol problems. The next PARTNERSHIP EVENT on the subject of developing local needs assessments and developing local drug information systems will take place in MONTEGO BAY, JAMAICA, in the first week of March. This is the second meeting of cities that we have organized on this topic: the first was held in Montevideo, Uruguay last December. The tools will provide the city authorities – in some cases for the first time – with information specific to their own city, which will enable them to plan their own local responses.
2. MY SECOND PRINCIPLE IS:
WE NEED SOLID INTER-AGENCY COOPERATION TO SOLVE PROBLEMS IN THE DRUG FIELD.
Drug use and misuse has many causes, rooted in individual psychology, the social and economic environment, family and community disfunction, and others. The response to drug misuse must therefore be multi-disciplinary, and must involve health departments, social welfare and employment agencies, the police, the courts, the prison system, urban planners and community leaders to plan and address different aspects of the problem. Also, central government departments need to meet on a regualr basis with their counterparts in the states, provinces and cities, in order to coordinate and not duplicate their programs.
Let me give you an EXAMPLE of why this must be the case:
WHEN A DRUG-DEPENDENT INDIVIDUAL GOES INTO DRUG TREATMENT AND REHABILITATION, CERTAIN ARRANGEMENTS NEED TO BE MADE AND COORDINATED:
- CAN THE PERSON GET TO THE DRUG TREATMENT CENTER BY PUBLIC TRANSPORTATION? IF NOT, HOW DOES SHE OR HE GET THERE?
- IF SHE’S A WOMAN WITH CHILDREN, WHERE WILL HER CHILDREN GO WHILE SHE IS IN DRUG TREATMENT? WHO WILL LOOK AFTER THEM?
- IF THE PATIENT IS AN ADOLESCENT, HOW WILL HE KEEP UP WITH HIS SCHOOL WORK?
- WILL THE LOCAL EMPLOYMENT OFFICE HELP HIM OR HER TO FIND A JOB ONCE HE COMPLETES DRUG TREATMENT?
- DOES THE PRISON EMPLOY COUNSELORS TO TREAT DRUG-DEPENDENT PRISONERS?
THESE ARE JUST A FEW EXAMPLES OF PROBLEMS THAT REQUIRE MUNICIPAL AGENCIES TO WORK TOGETHER. I’M SURE YOU CAN THINK OF MANY MORE WHERE YOUR LEADERSHIP IS NEEDED.
3. MY THIRD PRINCIPLE IS:
CONTINUITY OF DRUG POLICIES AND PLANS IS ESSENTIAL.
In the Western hemisphere, and probably in your countries and cities also, it is often the case that when the government changes, policies and plans change too.
However, the principles and good practices of substance abuse prevention and treatment do not change. Substance abuse prevention programs, as we all know, must be long term and sustained over time if they are to have a chance of success. The same continuity of policy is also needed in drug treatment and rehabilitation. For a MAYOR and a CITY COUNCIL, therefore, the questions are:
- HOW DO WE ENSURE THAT OUR DRUG TREATMENT SERVICES WILL REMAIN IN PLACE OVER TIME?
- DO I HAVE A TASK FORCE IN MY CITY TO COORDINATE ACTION ON DRUGS AND ALCOHOL? ARE THE RIGHT PEOPLE ON THIS TASK FORCE?
- DO I HAVE AN AGREED-ON PLAN OF ACTION IN MY CITY? HOW DOES MY PLAN OF ACTION FIT IN WITH THE CENTRAL GOVERNMENT’S PLANS AND POLICIES?
- DOES THE PLAN ENJOY THE SUPPORT OF THE OPPOSITION?
- IF NOT, HOW DO I WIN THAT SUPPORT.
I’ve asked a number of challenging questions, and hope that during the course of the conference, we can all come up with some answers.
Now I’d like to turn to TWO ISSUES that are relatively new to us in CICAD and that also may be of interest to your cities.
The first deals with NEW DRUGS OF ABUSE
YOUR city councils, health officers and police may need to focus on new drugs that may be making their way into your community – an early warning system, if you will.
Up to now, most people have been worried about plant-based drugs -- cocaine, crack, heroin and marijuana. But what we are seeing in the western hemisphere, and in some European countries, is an increase in the use of synthetic drugs such as ecstasy, amphetamines and methamphetamines.
The chain of production, shipment and wholesale and retail sales of plant-based drugs is a long one, spanning many countries and continents. Coca leaf is grown in only three or four countries in Latin America, and is typically processed in those countires into cocaine hydrochloride. The cocaine powder is shipped through other countries to its market, whether in Europe, North America or elsewhere. And the illicit profits are laundered in yet other countries.
Synthetic drugs are another story. They can be produced in any city, in any garage, in any neighbourhood, using chemicals that are relatively easy to find. There are a number of wasy in which synthetic drugs are a challenge for any city:
- OF COURSE, THEY ARE SUBSTANCES VERY HARMFUL TO THE HEALTH OF THE USER.
- THE MANUFACTURING PROCESS ITSELF IS HAZARDOUS – THE CHEMICALS ARE VERY VOLATILE, AND IN INCOMPETENT HANDS, COULD RESULT IN AN EXPLOSION. THAT EXPLOSION COULD TAKE PLACE IN YOUR CITY, NEXT TO THE TOWN HALL OR NEAR A SCHOOL.
- THE MANUFACTURE OF METHAMPHETAMINES PRODUCES TOXIC WASTE -- NORMALLY, FOR EVERY POUND OF METHAMPHETAMINE MANUFACTURED, 5 TO 6 POUNDS OF TOXIC WASTE IS PRODUCED.
THE CLANDESTINE PRODUCERS OF METHAMPHETAMINE HAVE TO GET RID OF THIS WASTE --SOMEHOW AND SOMEWHERE. SOMETIMES THEY DUMP IT INTO THE SEWER AND THIS CAN CAUSE A BLOCKAGE. THE CITY WORKERS THAT GO TO FIX THE BLOCKAGE ARE EXPOSED TO THE TOXIC WASTE. FIREMEN AND POLICE ENTERING A HOUSE WITH A METHAMPHETAMINE LAB ARE ALSO VULNERABLE. A HOUSE WITH A LAB CAN EXPLODE. WHEN POLICE FIND A LAB IN AN URBAN SETTING THEY HAVE TO CLEAR AN AREA AROUND THE HOUSE. THE SIZE OF THE AREA CAN BE UP TO SEVERAL HUNDRED METERS IN DIAMETER, DEPENDING ON THE THREAT.
All of this means that local law enforcement will need to be stepped up and take a different approach and new precautions. It also means that health care personnel must be trained to recognize signs of methamphetamine abuse. The geography of illicit drugs has changed, and the threat of methamphetamine production puts cities at the center of the drug trade.
Synthetic drugs may not yet be a problem in your community – but this brings me right back to my first point, which is the vital need for good information about what is going on in your cities.
ALTERNATIVES TO INCARCERATION FOR DRUG-DEPENDENT OFFENDERS
The second issue I’d like to raise here is one, which will allow me to conclude on a more positive note.
It concerns the shift that is occuring in some countries and cities with respect to the disposition by the courts of drug-dependent offenders.
Through CICAD’s CITY PARTNERSHIP EU-LAC PROJECT, some cities have shown interest in developing alternatives to incarceration for drug-dependent offenders. These alternatives to incarceration are sometimes called “DRUG COURTS”, or “DRUG TREATMENT COURTS”, or “drug treatment under court supervision”. They allow the judge to suspend the sentense while the offender follows a course of treatment and therapy for his addiction. Offenders who take part in a drug treatment court program have to report to the judge, once a week, and must submit to random urine testing to verify that he is not continuing to use drugs. The judge has wide discretion in deciding what to do about a "dirty" urine test: he may order the offender to jail for a weekend to ponder his relapse into drug use, or he may order more intensive therapy.
And while the program is directed by the judge, or in some cases, the prosecutor, the jugde is supported by a tean that often includes a nurse, a therapist, a social worker and a parole officer.
Most drug treatment courts were established very recently. But in Canada and the United States, where some drug treatment courts have been operating for over twenty years, the research on outcomes has been quite encouraging. Offenders who complete the treatment program are less likely to commit another crime, and less likely to relapse into drug use than those who do not go through the program.
DRUG TREATMENT COURTS are not a panacea for all drug and crime problems. But they can break the cycle of drugs, violence and crime into which some drug-dependent offenders get caught.
CICAD and the government of Chile are organizing A CITY PARTNERSHIP EVENT in Santiago, Chile, in the third week of March, at which some EU-LAC PROJECT PARTNERS will have a chance to observe a drug treatment court in action, and hear from a team of Chilean authorities how they established their drug treatment courts, and whether they feel they are working well.
AMONG OTHER SCHEDULED ACTIVITIES AND EVENTS, THE CITY OF GÖTEBORG WILL ALSO HOST ANOTHER IMPORTANT EVENT IN MAY OF THIS YEAR. All EU-LAC city Mayors will be invited, together with those professionals responsible for providing treatment services at the municipal, regionaland national level.
Let me end my remarks with AN INVITATION TO THE EUROPEAN, LATIN AMERICAN AND CARIBBEAN CITIES present today. CICAD WOULD WELCOME YOUR PARTICIPATION IN OUR CITY PARTNERSHIPS PROGRAM, If you are not already participating.
On the screen you can see the link to the project web site, which I invite you all to look at www.EULACDRUGS.org
I have tried to pique your interest in some of the ways, in which drug abuse can affect – is affecting – YOUR cities, and to suggest a few ways of tackling the problems. There is much more to talk about, and I hope we can continue the discussion informally.
It remains for me to thank once again the THE CITY OF GÖTEBORG, and particularly people such as the deputy mayors, DARIO ESPIGA and CARINA LILJESAND; BENGT DELANG, director of administration for allocation of social welfare; OVE LUNDGREN, project leader and contact person for EU-LAC in GÖTEBORG, and the rest of their team for their constant support.
Thank you ECAD again for this invitation. I look forward to meeting you all and hearing your own views about this serious health and social problem, and about YOUR own cities’ responses to the drug problem.