A Restrictive and Humane Drug Policy - The Swedish Example
 

Mister Chairman,
Your Majesty,
Ladies and Gentlemen,
It is a great pleasure to address the 10th Anniversary ECAD Mayor's Conference. As National Drug Policy Co-ordinator I recognize that the most effective policy starts at the local level. As a former mayor I know that fighting the drug problem is a task that requires effort and perseverance. Having a forum to share experiences and getting support makes this task so much easier. I would like to congratulate the conference organizers, Tomas Hallberg and his colleagues, for giving us all these two days to exchange ideas and reflect on the challenges we are facing.
Thank you very much for giving me this opportunity to share with you some lessons learnt from the Swedish experience of implementing a restrictive and humane drug policy.
In April this year, the Swedish parliament endorsed the new National Action Plan on Drugs and I was appointed National Drug Policy Coordinator by the Government. I was tasked with coordinating all actions against drugs at national level and providing leadership for the implementation of the Action Plan.
The action plan focuses on prevention, treatment, and law enforcement as mutually reinforcing elements of a balanced counter narcotics strategy, guided by the vision of a drug-free society.
Before giving a few examples of activities in these three areas, I would like to say a few words about the basis of our National Action Plan.
The Swedish strategy rests on three equally strong pillars:
1. Prevention
2. Treatment
3. Control
This is a reflection of the conviction that the drug problem requires an integrated and balanced approach in conformity with the essence of the UN conventions on drugs: to limit the use of controlled substances to medical and scientific purposes.
There is political consensus, across all political parties in Sweden, that this requires the three pillars to be equally strong - supporting and not contradicting each other.
This means to avoid giving contradictory messages, for example by,
-on the one hand telling young people not to do drugs
and,
-on the other hand to openly tolerate, or even endorse in practice, the use and sale of controlled substances such as cannabis, at street level or in specially designated facilities.
In my country, there is also political consensus about a vision to guide our actions: the vision of a drug-free society.
This vision comes from the spirit of the UN Conventions as well from the belief that the abuse of drugs can be prevented. The Swedish history points in that direction. As an example, we were able to reduce drug abuse among youth from 14 % in the 1970s to 3 % in the late 1980s. In a situation where 97 young people out of 100 were not even trying drugs - and 99 were not using them on any regular basis - we had all the reasons to believe in the power of prevention.
Have we been able to keep this low figure?
Yes, we have still low figures - but - in Sweden like in most European countries drug abuse among youth increased in the 1990s, although in our case from a lower baseline than in many other countries.
In the late 1980s, relatively few young people experimented with drugs, and many of those who did were socially marginalized young people. What we saw in the 1990s was a tendency towards the abuse of drugs increasingly also taking place among mainstream youth. This was - and still is - particularly true for cannabis and to a lesser degree for amphetamine-type stimulants, such as Ecstasy.
This tendency created a great deal of political worries in my country.
Why this worry in a country with so few young drug users? In some European countries one third or more of school students in the age group 15-16 years have tried illicit drugs. In Sweden the portion is much lower, around 8 %!

So why worry?
We worry because we think that any increase in drug abuse among youth, no matter how small, is an indication that the drug situation may develop in the wrong direction.
We worry because we see that young people are exposed to messages that give the impression that drug abuse - if it takes place mainly during weekends and in recreational settings - is not dangerous but glamorous and quite safe.
We worry because we see a change in attitude among large groups of European youth, becoming more tolerant towards or even favoring the recreational use of illicit drugs.
We worry because we know from experience that the greater the social acceptance of a psychoactive substance, the more difficult it is to influence its use.
-alcohol and tobacco provide ample examples of this.

It may sound drastic, but when confronted with the reversed trend in drug use by young people - against the backdrop of significant increases in drug abuse by young people in many countries across the world - we concluded that Swedish drug policy had come to a crossroads.
1. Either we accept experimental drug abuse as an inevitable part of mainstream youth culture, or
2. We continue to view it as an exception and do our utmost to prevent it from becoming a socially accepted part of mainstream youth behavior.
We took the second road!
We decided to invest politically and economically in a balanced National Action Plan on Drugs.
We concluded that one reason for the increase in drug abuse among youth was that we had failed to understand that the drug problem needs constant attention - and investment.
The establishment of my post as National Drug Policy Coordinator should be seen as
-a manifestation
-a renewed political commitment and
-a clear signal to the local level to take the drug problem seriously.
1. Political commitment at the highest possible level was thus identified as a critical factor for success.
We have the commitment through the endorsement by the Parliament of the National Action Plan. The drug problem also figured as a vital political issue in the Declaration of Government after the September elections in Sweden.
2. Appropriate resources, financial, human and institutional resources. consistency and coordination are also crucial.
This is not a question of money only. It is also critically important to bring together the expertise and to mobilize all sectors of society - including civil society. Consistency across the programs of community organizations, professional groups and government agencies is equally important.
Finally,
3. It takes action at all levels for any drug action plan to be realized.
My country has a long and strong tradition of citizens getting together in voluntary organizations to create change. The non-governmental sector and the local communities are key actors in the implementation of the national action plan.
-No matter what we do at the national level, if we do not support the grassroots efforts to prevent drug abuse in our communities, we cannot truly empower young people to resist drugs. A vital component of our national action plan is therefore to mobilize the communities.
Now, let me return to the title of my intervention "A restrictive and humane drug policy"
What does it mean that our policy is restrictive?
It means that in line with UN Conventions, the use, possession, manufacture, trade, etc. of narcotic drugs are strictly limited to medical and scientific purposes. This is not a formality but a basic guiding principle, which influences the way we deal with the drug problem. It is also the origin of the vision of a drug free society - to always strive towards a society without illicit drug use.
Now, you may ask yourselves: Is it possible to be restrictive without being repressive?
My answer is "Yes". In order for a restrictive policy to be successful, it must be humane. It should be difficult to find drugs and there should be a lot of barriers against the abuses of drugs.
-But it should also be easy to get help, if you have a drug abuse problem.

Research has clearly shown that drug abuse treatment can reduce,
-drug use,
-drug-related criminal behavior, and
-the health and social costs of drug abuse and addiction, including HIV infection.
Thus, investing in treatment is not only humane. It is also necessary, if we are to succeed.
However, one should not be unrealistic. Treatment is not chosen by everybody, especially not during the "honeymoon phase". Recovery is a long-term process. Relapses are not unusual. Therefore it is crucial to support low-threshold activities and out-reach activities to motivate and support drug-abusers who are not in treatment to change their behavior.
However, we should not leave it with that! Here comes - again - the vision of a drug-free society to guide us:
The out-reach and low threshold activities should not be an end in themselves but steps towards a life without illicit drugs!
The goal is to support a positive change by providing a continuum of care, treatment and rehabilitation. The various "harm reduction/ risk reduction" measures like outreach, peer support, etc should be integral parts of such a continuum. People should not die or get infected with HIV or Hepatitis on their long and cumbersome journey towards a life without illicit drugs.
Harm reduction programmes in these senses have a role to play in a comprehensive demand reduction strategy. But, they should not become substitutes for demand reduction programmes and should not be carried out at the expense of other important activities to reduce the demand for illicit drugs. They should be an element of a longer, more comprehensive strategy.
I would now like to share with you a few examples of activities, which aim at combining prevention, law enforcement and treatment.

So, what can be done at country level and at community level? I would like to share with you a few examples of activities that my office are involved in, as partnership activities or as sponsors.

Young people like to have fun. Partying and clubbing is part of life for many young people. If you search the Internet for the word clubbing, you realize very soon that it is a whole clubbers world out there, a global sub-culture. But clubbing has also been associated with drugs like Ecstasy. Is it possible to reach out to clubbers with an anti-drug message?

I would say "Yes", it is possible to reach out to clubbers and other young people, if you are prepared to tailor your message to the target group and if you use the right channels and messengers with high credibility.

Last summer, I was contacted by some young people, who are active in the Swedish club scene. Their idea was to organize a club tour with the message "Clubbing is about music, people and love - not about drugs". I decided to support the initiative. When we reach the finals in a month or so, twelve events will have taken place with some of the most prominent DJs giving the message that you can have a good time without narcotic drugs. We have had amazing media coverage, both within our country and outside, and a lot of chatting on the club web sites among the target group. The initiative is being followed-up closely and evaluated.

Another unusual arena for anti-drug messages is the night-club scene.
A recent study of guests and staff in some of the popular bars and nightclubs in Stockholm City indicated that there are high levels of drug abuse in nightlife settings as compared to the general population. The attitudes to so-called recreational drug use are also more liberal than among Swedes in general.
Based on the results of the study, eighteen owners of the largest and most popular bars and nightclubs in Stockholm have agreed a policy against drugs with the trade unions and the local government. The policy has all the three elements of a balanced strategy
-prevention
-treatment and
-control
Among the measures to be taken are
-refurbishment of rest rooms to make it more difficult to take drugs there
-voluntary drug tests of staff and management
-education of staff and
-offers of counseling and treatment in cases of identified drug abuse problems.

As one of the bar owners said: "Our industry is associated with glamour: we are trend-setters and we have a drug problem to deal with. It is important for us to give the message that it is not cool to do drugs".
In another initiative, my office has entered into a partnership with the three largest cities in Sweden. Through this partnership - which aims at creating a balance in the local policies between the three pillars of the national drug policy Prevention, treatment and law enforcement - we will support activities inter alia in schools, bars and in treatment/rehabilitation.

Local strategies and action plans will be developed by the participating schools, based on systematic information gathering and analysis of risk behaviors. Procedures will be agreed for cooperation between school, parents, social services and police with regard to problem identification and early interventions. Targeted programmes for support of parents will be implemented and evaluated, as well as developmentally targeted programmes for students. Finally, teachers and other staff at the schools will be trained.

New counseling and treatment alternatives will be developed for young people in close collaboration with the schools and the local governments.
We will also involve the private sector for social reintegration of former drug addicts, who have undergone treatment, either in prison or in treatment facilities.

There are also other ways and means to reach out to young people. Sweden is a sporting nation. There are some 22 000 sports clubs throughout Sweden, and half of all children and young people between 7 and 20 are active in various sports. By collaborating with the Swedish Sports Confederation we are able to reach these 900 000 young people and around half a million voluntary and professional leaders, who has a very important role in fostering the future generation.

We are also entering into partnership with the trade unions. Only through the two largest trade union federations we will be able to reach out to approximately one million young people under the age of 30.

These were only a few examples of targeted response, which are based on quantitative and qualitative assessments of the problem. Of course we want to see quick results, but I am very much aware that working to solve the drug problems requires patience and well thought out investments.

Therefore, we have decided to invest massively in research, with the parallel objectives of getting more relevant knowledge about patterns and trends, on which to build our actions
-and of stimulating more researchers to take an interest in this area.
I started by saying that we believe in prevention. I will conclude by saying that we also believe in treatment and law enforcement. These are the three - equally strong - pillars of the Swedish drug policy - with the key objectives
1. To prevent drug abuse in the first place
2. To make quality treatment and rehabilitation available for all
3. To reduce the availability of drug by targeting both street level dealers and organized crime.

Thank you very much for your attention

 
 
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