The
International Scope of the Drug Problem
Hon. David Kilgour, P.C., M.P., Secretary
of State (Latin America & Africa)
Background Paper for The International Society
for the Reform of Criminal Law
12th International Conference "Drugs,
Criminal Justice and Social Policy: New
Alternatives for An Old Problem"
St. Michael, Bridgetown, Barbados August
9 - 12, 1998
International
Cooperation
After attempting for decades to combat drugs
essentially on a nation state basis, governments
have finally learned that co-ordinated international
efforts are the only way to reduce this
commerce. The size of the drug trade defines
the challenge; the timing of this conference
is thus critical. Entering the new millennium,
drug free societies remain an elusive ideal.
There are some who ask if certain communities
will even survive another decade of drug
devastation. Drug wars appear to some police
officers and social/health workers to be
futile, dangerous and expensive undertakings;
others say the problem is that effective
measures have yet to be implemented internationally.
In 1991 Canada
hosted the XIV World Conference of Therapeutic
Communities: "Drugs and Society to
the Year 2000". More than 2000 delegates
from 52 nations attended the Montreal conference,
which resulted from a widely-perceived need
for international co-operation and unity
in searching for solutions. Peter Vamos,
the conference chairman, in his opening
remarks expressed an opinion that I believe
has reverberated in one form or another
throughout the proceedings of this conference:
As long as
the wars on drugs are declared by politicians
and are fought only by bureaucrats, the
police and the professional communities,
the results are doomed. But if the whole
population of each nation is mobilized by
its leadership, by focusing attention on
the real issues and giving the problem its
due priority, then we collectively can shrug
off the terrible yoke of a drug-infested
society.
Like Vamos,
I believe that effective strategies that
work today against drugs lie not only with
those on the front lines, but with caring
individuals in each and every community
across the world.
In my opinion,
the success or failure of this conference
will be measured by the degree to which
we succeed in translating our commitment
to fight drugs into vigorous sustained effort,
specific actions and innovative prevention
programs that can make a real difference
in reducing drug related problems.
Drugs and
Security in the Caribbean Narco-trafficking
and money laundering are, of course, major
threats to this region, particularly to
the small-island states of the Eastern Caribbean.
They include related crimes such as arms
trafficking and corruption of officials,
and are linked to serious health problems
like HIV/AIDS and hepatitis C. The region
is now a key transhipment area for drugs
smuggled from South America to North America,
Europe and elsewhere.
According
to the United Nations Drug Control Program
(UNDCP) Caribbean office, about 248 tons
of cocaine alone flow to the United States
through the Caribbean each year. Another
100 tons find their way to Europe. Just
over 60 per cent of the cocaine produced
in Latin America flows through the Caribbean.
The UNDCP summarizes the local consequences
of this drug traffic: "Drug-related
crime is a growing concern in the Caribbean,
be it in impoverished villagers in Haiti
looting cocaine cargoes that have washed
ashore, or gun battles between traffickers
and police."
Canada is
already active to a degree in anti-drug
activities in these islands. We strongly
support the Barbados plan of action and
applaud the efforts of Caribbean governments
to implement its provisions, in particular,
strengthening regional enforcement institutions
such as the Regional Security System and
Caribbean Customs Law Enforcement Council.
Canadians will continue to support the Barbados
plan through contributions to the UNDCP,
the Inter-American Drug Abuse Control Commission
(known by its Spanish-language acronym CICAD),
and through the long-standing bilateral
assistance programs of National Defence,
the Royal Canadian Mounted Police (RCMP),
Canada Customs and other agencies.
Canada's
Deputy Solicitor General, Jean Fournier,
was recently named chair of the Working
Group of CICAD on the Multilateral Evaluation
Mechanism. The group will evaluate the performance
and progress by all nations of the hemisphere
against illicit drugs. Furthermore, leaders
at the recent Summit of the Americas endorsed
Canada's initiative to create a Foreign
Ministers' Dialogue Group to look at long-term
solutions to our hemispheric drug problem.
Drugs and
Security in the Caribbean, Sovereignty under
Siege, published last year by Ivelaw Lloyd
Griffith, argues compellingly how since
the mid 1980s narco-trafficking and its
associated crimes pose a major security
threat. The author acknowledges that winning
the drug fight is easier said than done.
Griffith concludes:
...Ending
the siege in the Caribbean is something
that people and governments both within
and outside the region can ill afford not
to pursue continuously. The 'war on drugs'
will be a long 'war.' And it has to be a
'total war' and a 'collective war.' The
words of Caribbean poet Martin Carter, first
written in 1954 in Poems of Resistance,
capture the exigency of the situation: Like
a jig Shakes the loom Like a web is spun
the pattern All are involved! All are consumed!
Canadian
Experience
It is impossible to measure accurately the
full extent of alcohol and drug abuse in
Canada. Although we live in a world of statistics,
none is completely accurate and all are
subject to interpretation. Available drug
and alcohol statistics do give a sense of
the scope of the problem and highlight emerging
trends. What the statistics fail to measure
is the personal and social costs of drug
abuse. The loss of human potential, the
destruction of physical and mental health,
the breakdown of marriages and families,
the disruption of communities and social
order - all directly or indirectly affect
us. Drug abuse is a problem of many dimensions
with unacceptable human and economic costs.
A comprehensive
study by the Canadian Centre on Substance
Abuse estimated that substance abuse cost
more than $18.45 billion in Canada in 1992.
This represents $649 per capita, or about
2.7% of our total GDP. Illicit drug abuse
alone had direct economic costs to Canadians
of about $48 per capita. These figures do
not take into account the enforcement costs
and losses created by all crime (thefts,
murders, domestic incidents, etc.) indirectly
associated with the use of illicit drugs.
The largest item - approximately $823 million
- was lost productivity due to illness and
premature death. A substantial portion of
the cost was for law enforcement ($400 million).
Direct health case costs due to illicit
drug use were estimated at $88 million.
These estimates are widely regarded to have
been conservative and will have risen considerably
since 1992. To put things in perspective,
total policing expenditures for Canada for
1992 were estimated at $5.3 billion.
The pattern
of drug abuse in Canada mirrors changing
patterns elsewhere and is particularly worrying
with respect to youth. A recent Ontario
Student Drug Use Survey by the Addiction
Research Foundation recorded an important
change in the environment and context in
which drug use occurs. The authors of the
study note that more students today hold
a more benign view of drug use, especially
for marijuana, than did their predecessors.
Other countries
report similar trends in the number of youth
using marijuana, stimulants and hallucinogens.
In Canada, the average age of initiation
is falling almost yearly. The social stigma
associated with taking certain drugs has
diminished and the rates of drug use among
young Canadians has unfortunately increased,
not only for drugs like marijuana, but for
cocaine, heroin and LSD, as well as certain
stimulants. In Europe, the United States
and Japan, the abuse of synthetic drugs
is on the rise, creating very serious concerns.
The abuse of injected drugs contributes
to the spread of diseases, including HIV/AIDS.
Based on
estimates by the UNDCP, annual illicit drug
consumption is now likely to involve 3.3
to 4.1 percent of the world's population.
Although heroin consumption is still relatively
small - eight million people or 0.14 percent
of the world population, it is increasing.
Cocaine use is more widespread in the total
number of consumers - 13 million people
or 0.23 percent of the world's population
- though fewer countries are affected. Marijuana
is the most widely used drug, involving
more than 2.5 percent of the world's population
or about 40 million people. The amount of
amphetamine-type stimulants (ATS) consumed
each year is increasing by 16 percent on
average. Today an estimated 30 million people
consume ATS. There appears to be a common
perception, spread through some media and
directed specifically to young people, that
these substances are "fashionable"
and "safe."
A 1995 study
by our Addition Research Foundation on University
Student Drug Use and Lifestyle Behaviours
showed significant increases in the use
of certain drugs. The proportion of students
using LSD has more than doubled since 1988,
from 3.2 percent to 7 percent. Heroin use
increased from 0.3 percent in 1988 to 1.1
percent in 1993. The use of anabolic steroids,
which were almost unknown at the time of
the first survey, increased from 0.6 percent
in 1988 to 1.5 percent in 1993. The use
of crack cocaine and prescription stimulants
was also up.
In some countries,
certain drugs, for example MDMA (Ecstasy),
are considered 'normal' by some young people.
Law enforcement personnel and drug counsellors
across the world confirm that young people
especially view drugs as entertainment,
not a means of escape from deprivation and
poverty. Police in the U.K. warn that on
the basis of current trends there, by the
year 2005 up to 80% of children could be
involved with drugs by the age of 10.
Trafficking
In a number of countries, the profits derived
from the production, distribution and consumption
of illegal drugs have rendered sections
of local economies dependant on the trade,
thus creating militant constituencies advocating
its continuance. In some jurisdictions,
administrative and judicial structures have
been undermined to the extent of endangering
political stability, and even destabilizing
governments. The sheer volume of "drug
money" affects money and exchange markets.
A United Nations survey revealed that the
worldwide dollar value of illegal drugs
is second only to the amount spent on the
arms trade. Drug trafficking constitutes
a primary source of revenue for organized
crime groups in Canada. The 1997 Annual
Report on Organized Crime in Canada by the
Criminal Intelligence Service of Canada
offers a grim picture of the illicit drug
trade in my country.
Most organized
crime groups in Canada are involved in drug
trafficking at some level. Police in Vancouver,
for example, report that street level heroin
trafficking has increased over the 1995/1996
period, to amounts of up to 3 or even 4
kilograms from the previous 1 kilogram average.
Commercial shipping lines are being used
increasingly to import large quantities
of heroin. Earlier this year, U.S. police
agencies identified Vancouver as the gateway
for the Southeast Asian heroin now hitting
North Americans. RCMP investigators confirm
that Vancouver is the key to seriously disrupting
the heroin trade as the city is the narrow
part of the funnel before the drugs are
dispersed throughout North America. According
to one RCMP drug intelligence analyst, "We're
perceived as a lot softer mark." Drug
importers and traffickers prefer to set
up shop in Canada and avoid the severe penalties
in the U.S.
A cheaper,
more potent form of heroin has also been
linked to an increase in overdose deaths
in British Columbia: 201 people across B.C.
died from overdose in the past six months
alone, versus 147 overdose deaths during
the corresponding period last year. There
are parts of Vancouver where HIV infection
are at some of the highest levels in the
so-called developed world. In the words
of one top official of the United Nations
International Drug Control Program, Christian
Kornevall, some of the most troubling developments
in the narcotic trade result from an over
abundance of drugs. The glut of drugs on
the world market is leading to more aggressive
marketing and product development to provide
drugs that are more refined and user-friendly.
One frustrated
B.C. chief health officer believes, "It's
time to admit that we lost the war on drugs".
"Police", he says, "haven't
a hope of stemming the supply into what
is already a saturated market." The
RCMP's provincial drug awareness co-ordinator,
Chuck Doucette, admits that police can't
easily fight billion dollar drug cartels.
He stresses that while enforcement cannot
be abandoned "we have to move to prevention
programs in schools, businesses and the
community. It's our only hope".
Chemicals
The illicit chemical drug trade in Canada
is also thriving according to The Criminal
Intelligence Service Canada. It includes
the clandestine manufacture and importation
of chemical drugs and trafficking in precursor
and essential chemicals. LSD continues to
be available across Canada; PCP is limited
mainly to our Western provinces. Some motorcycle
gangs continue to be the major organized
crime group involved in large scale
methamphetamine,
PCP and LSD trafficking. It is expected
that with the forecast increase in methamphetamine
demand in the United States, more U.S. groups
will travel to Canada to purchase precursors
and even set up illicit laboratories for
the manufacture of this drug. A number of
organized crime groups in Mexico already
specialize in the manufacture and distribution
of methamphetamine for the U.S. market.
Canadian motorcycle gangs will most likely
step up the supply of this drug to U.S.
The smuggling
of steroids into Canada remains a serious
problem. Various techniques are used to
move steroids into the country, although
the postal system is the most popular. The
importation of steroids into Canada from
various points around the world, mostly
Europe and former Soviet Bloc countries,
does not appear to involve organized crime
groups so far. According to U.S. authorities,
however, Russian-based organized crime elements
are major importers of steroids into the
United States.
Police in
Montreal make regular seizures of Ecstasy
(MDMA); the drug is known to be in demand
in large cities across B.C. and is popular
among European teenagers. It is believed
that this appeal could spread in Canada,
particularly now that its manufacture has
been documented in B.C. and in Quebec. The
Netherlands remains its single most important
source in the world; large Ecstasy seizures,
even in Asia, can be traced back to Holland.
Money Laundering
"Why does Mob love Canada?" Adrien
Humphreys asked in a recent article. The
journalist's answer includes: weakened banking
regulations, close proximity to the United
States, a generous parole system, the presence
of large casinos, a diverse ethnic population,
stable economy, absence of laws banning
organized associations, and lack of reporting
rules for money crossing our borders. The
largest difficulty in fighting drug traffickers
is often the colossal pay-off that awaits
them if they are not caught. The U.S. State
Department estimates the annual worldwide
value of laundered funds at between $300
billion and $500 billion. The Canadian content,
according to our RCMP, is now somewhere
between $3 and $10 billion.
A number
of years ago, The New York Times described
Canada as "one of the world's leading
havens for concealing illegal narcotics
profits." The word has unfortunately
spread to organized crime groups that my
country provides a hospitable environment
for money laundering. Law enforcement agencies
worldwide have yet to obtain really effective
legislation to combat money laundering.
Currency
smuggling allows criminals to move the proceeds
of crime into Canada. In the summer of 1996,
Canadian police seized approximately $1.5
million in suspected drug money smuggled
into the Vancouver area from the United
States. Canada is also used as a transit
point for proceeds of crime.
Our government
has responded with new instruments to combat
money laundering, to give police the tools
they need to stop money laundering, and
to take the profit out of crime. For example,
ten new Integrated Proceeds of Crime (IPOC)
Units were created in 1996. They combine
the resources of federal and local police,
Canada Customs, federal Crowns and forensic
accountants to investigate and prosecute
proceeds of crime cases. The units are now
located in most of our major cities. Anti-gang
legislation proclaimed last year gave new
power for police, prosecutors and the courts
to deal with criminal organizations. Comprehensive
training programs are now being provided
to assist police in enforcing this law.
"Organized
crime affects all Canadians: it's a national
problem that threatens public safety. I
have called this meeting to set a course
for a unified, national strategy to fight
it. We must act on many fronts simultaneously
to win the fight against organized crime,"
stated our Solicitor General, Andy Scott,
at a recent national workshop on organized
crime. A four-part action plan focusing
on the following was presented:
- Renewing
National Police Services to ensure they
meet the needs of law enforcement to fight
organized crime in all its forms;
-
Strengthening criminal intelligence so that
coordination and information-sharing across
police jurisdictions is improved;
-
Targeting both the drugs and the organized
criminals who cause the most harm in our
communities, and refining strategies to
reduce demand as well as supply;
-
Launching an offensive against economic
crime to keep pace with technological advances
made by criminal organizations, and hit
them where it hurts most - in their wallets.
Last May, our Solicitor General released
a consultation document on proposed anti-money
laundering measures. It contained a number
of proposals to improve detection, presentation,
and deterrence of money laundering in Canada,
including measures for reporting suspicious
financial transactions and the cross-border
movement of currency. It represents a first
step in meeting the current needs of police
on this issue. It also addresses Canada's
international commitments to the Financial
Action Task Force and other international
partners.
Demand Reduction
The Economist magazine put one feature of
the problem well: "the iron law of
the market is that demand breeds supply."
Others say that, although significant reduction
in consumer demand for drugs cannot be achieved
in view of virtually unlimited supply and
that supply can never be significantly reduced
in the face of increasing demands, both
must be addressed at the same time. South
American and Asian cartels meet the demands
of millions of North American drug users.
Yet, as Pino Arlacchi, Executive Director
of the UNDCP remarked during last June's
U.N. General Assembly Special Session on
the World Drug Problem: "Success of
demand reduction is crucial if we want to
ensure permanent success in the fight against
drugs." Barry R. McCaffrey, Director
of the office of the U.S. National Drug
Control Policy, said himself that reducing
drug use will not be won through military
interventions; progress for him can best
be achieved through carefully targeted demand
reduction programs at home and productive
alternative development programs in producer
countries.
The 1998
National Drug Control Strategy (U.S.) outlines
a comprehensive ten-year plan to reduce
drug use. It concentrates on shrinking American
demand for drugs through treatment and prevention,
and attacking the supply of drugs through
law enforcement and international co-operation.
The above-mentioned U N General Assembly
on drugs adopted the Political Declaration
on the Guiding Principles of Drug Demand
Reduction. The declaration - the first international
agreement with the sole objective of examining
individual and collective problems that
arise from individual drug abuse - indicates
the priority strategies required to reduce
drug demand worldwide in a major way by
the year 2008.
In addition
to reducing supply and demand, the Political
Declaration calls on member states to take
a number of actions. By the year 2003, governments
are asked to establish new or enhanced drug
reduction strategies and programs; establish
or strengthen national legislation and programs
to combat the illicit manufacturing, trafficking
and abuse of ATS and their precursors; adopt
national money-laundering legislation and
programs; and strengthen multilateral, regional
and bilateral co-operation among judicial
and law enforcement authorities to deal
with criminal organizations involved in
drug-related crimes.
The member
states committed themselves by the year
2008 to eliminate or significantly reduce
the manufacture, marketing and trafficking
of psychotropic substances and the diversion
of precursors; also to achieve measurable
results in demand reduction and to achieve
significant benchmarks in the reduction
of illicit cultivation of the coca bush,
cannabis plant and the opium poppy.
Canada's
Role
My country was instrumental in the decision
to hold the Special Session of the UNGA
originally proposed by Mexico, and has played
a constructive role in working to ensure
its success. A recognized leader in demand
reduction, Canada provided the first draft
and funded the first meetings of the working
group that developed the Declaration on
the Guiding Principles of Drug Demand Reduction.
Another Canadian
contribution to preparation for the United
Nations General Assembly Special Session
(UNGASS) was the youth and substance abuse
event hosted by Canada in Banff, Alberta
in April 1998 (Youth Vision Jeunesse). Youth
(aged 12 to 25 years) who work in substance
abuse prevention programs around the world
participated in identifying successful strategies
to address drug abuse by youth and developed
recommendations, which were presented to
the Special Session.
Successfully
combatting positive drug imaging in the
media is challenging at best. Nearly one
out of every three advertising messages
on radio or television and in magazines
and newspapers promotes drugs and drug use
in some form, a pill for this or that or
a beer to be sociable. The attitudes these
ads foster towards the use of legal drugs
can affect the way people think about drugs
generally.
Canadian
Drug Policy
Canada takes a "balanced approach"
to the drug issue, based on the belief that
the most effective way to address the problem
is to deal with both supply and demand.
Our policy sets out to reduce the harmful
effects of the problem on individuals, families
and communities. Our law enforcement agencies
put an emphasis on going after traffickers
and confiscating the proceeds of their crimes
as an effective way to reduce the resources
available to continue their activities.
It is our
view that multilateral participation enables
us to have the broadest influence on the
anti-drug agenda and the biggest impact
on the drug problem. The UNDCP and the OAS'
CICAD enable primarily producer, transit
and consumer nations to dialogue and participate
in activities to our mutual benefit.
Canada takes
the same balanced approach in its dealings
with other countries and with the multilateral
institutions of the United Nations and the
OAS. The key organizations are the UNDCP
and its governing body, the Commission on
Narcotic Drugs (CND), and CICAD. Our acknowledgement
of a shared responsibility - it is in part
demand that drives the production and trafficking
of illicit drugs - has enhanced Canada's
reputation in international forums and in
bilateral co-operation.
Substance
Abuse in Alberta
Substance abuse has a pervasive effect on
the health and well-being of residents of
my own province of Alberta and a substantial
economic impact on all levels of society.
One third of Albertans report having experienced
an addiction problem either personally or
through a family member or friend. The costs
in Alberta are estimated in excess of $1.6
billion annually; an amount equal to $613
for each person in the province. The use
of illicit drugs in Alberta totalled $135
million in 1992. Most of these costs come
from productivity losses due to death and
disability ($88 million), followed by law
enforcement costs for police services, courts,
corrections, customs and excise ($30 million).
Growing research
evidence suggests that substance abuse treatment
is an effective strategy to reduce associated
costs. It has been demonstrated that by
effective intervention, treatment and prevention
programs the social and economic costs of
addictions can be reduced, workplace productivity
improved, health care utilization decreased,
social stability and personal well-being
enhanced. Studies suggest that a return
on investment is in the range of $2.00 to
$7.00 per dollar invested in treatment for
drug and alcohol abuse. The Alberta Alcohol
and Drug Abuse Commission (AADAC), an agency
of the Government of Alberta, demonstrates
how modest investments in addiction services
make a difference in Albertans' lives. AADAC
provides a holistic alternative to higher
cost hospital and medical services by delivering
services and working closely with other
community based agencies at 42 locations
throughout the province. The AADAC's 1995-96
Annual Performance Report indicates that
in that year 52% to 75% of the Commission
treatment clients report improved health
following treatment. Similarly clients report
improved employment or school involvement.
Criminal activity is also reduced following
treatment. With a budget of $28.5 million,
AADAC proves that addiction treatment is
a relatively small up-front cost for a large
rate of return over an extended time period.
New Alternatives
for an old Problem
The late U.S. President John F. Kennedy
quipped "Today's problems are the result
of yesterday's solutions." The theme
of this conference, "New alternatives
for an old problem," suggests new approaches
and alternative solutions to drug problems.
It is clear that we need to reach beyond
current criminal justice strategies, especially
incarceration, in reducing drug consumption.
We need truly effective education and prevention
programs. They will not win the war on drugs,
but will at least reduce the resulting harm.
As substance
abuse among youth increased and the public
alarm about it has grown, so has our understanding
of how to speak more effectively to the
issue. Currently, across North America,
including my own country, various groups
are designing strategies aimed at preventing
alcohol and other drug use among teenagers.
A 1997 study
by the Addiction Research Foundation (ARF)
found that because many high school students
think it's acceptable to use marijuana socially,
they simply don't listen to anti-cannabis
messages from adults. The implications of
these findings suggest that educators refocus
their drug prevention messages. The study
was set up to examine why cannabis use has
risen over the past few years among teenagers.
Surveys across North America confirmed these
increases. In Ontario, a 1993 survey found
that almost one in four students from Grades
7 to 12 had tried marijuana in the past
year, nearly double the number from a 1991
survey.
The ARF researchers
found that the teenagers' attitudes towards
marijuana were largely based on their own
or family members' experiences with the
drug. Since students did not see many negative
consequences from using occasionally, they
tend to disregard messages that contradict
their observations. Overall, there has been
a shift in the way the drug is perceived
compared to a generation ago points out
one ARF scientist. Marijuana has lost its
symbolic value as a sign of rebellion. Light
social use was considered the norm. When
adults delivered drug education messages,
students questioned not only the content
of the message, but also the experience
of the source.
Parents who
admitted to past use were considered hypocrites
when asking their children to abstain. Many
students also believed at least some of
their teachers currently smoked marijuana,
or had done so in the 1960s. Also, anti-drug
messages from adults who had not tried drugs
were not considered credible since such
adults were not seen to be competent authorities
on the effects of drug use.
Although
students essentially ignored abstinence-related
messages, they were receptive to factual,
non-judgemental information. As the ARF
points out, this suggests that since abstinence
messages were often ignored and many teenagers
experiment with marijuana, drug education
programs should be focused toward students
who are at risk of developing more serious
drug problems.
Research
on effective drug prevention shows that
efforts are most effective when they involve
communities, families, schools, community
organizations and churches jointly. The
strategies which appear to work most effectively
address the problem by promoting students'
values, knowledge and skills, and by creating
a positive school climate, encouraging parents
and mobilizing communities. A recent book,
Preventing Substance Abuse, Interventions
that Work, describes specific solutions
that have produced desired changes. The
authors present "substance abuse"
as a constellation of problems that cannot
be resolved through a single set of prevention
solutions. They discuss successful prevention
programs, identifying their origin, implementation
and outcomes. General "dos" and
"don'ts" of prevention are provided,
including knowledge from vigorous evaluations
of programs that don't work. We all, of
course, need to move to programs that are
the most effective
DARE's effectiveness
In the United States, DARE (Drug Abuse Resistance
Education) is the most widely disseminated
school-based prevention program during the
last year of elementary education. It is
currently being offered to about 5 million
students in all 50 states at a total cost
of about $50 million and in a number of
other countries. A recent article in Preventive
Medicine reported the results of a 5-year,
longitudinal evaluation of the effectiveness
of DARE. The long term effectiveness of
DARE unfortunately showed no significant
differences between intervention and comparison
schools with respect to cigarettes, alcohol
or marijuana use during the 7th grade, approximately
one year after completion of the program,
or over the full 5-year measurement interval.
The article concludes that the results of
the 5-year study are largely consistent
with the conclusions obtained from prior
evaluations of the short-term effects of
the DARE curriculum on adolescent drug use
and drug related attitudes. They have reported
limited effects of the program on drug use,
greater efficacy with respect to attitudes,
social skills and knowledge, but a general
tendency for the program effects to decay
over time. The authors draw a number of
implications for DARE and other school-based
prevention programs in general, especially
the need for more robust programming targeted
specifically at the primary risk factors
for adolescent drug use. There is also a
need for the inclusion of booster sessions
to sustain positive effects of the program.
Another research
team examined the evaluations of DARE and
concluded that the average reduction in
substance use was small. DARE has important
strengths, including favourable reactions
among students who have participated, widespread
political support, and considerable funding.
However, these strengths have not guaranteed
that the program is always effective or
a drug abuse preventive. A scientific advisory
group has been established to review the
research and evaluations of the DARE program
and to consider changes in the curriculum.
Programs
That Work
There is a wealth of data that programs
already exist in many countries to make
a reality of the knowledge of "what
works." Programs that were demonstrated
to be effective in bringing about the desired
effects can be identified and put together
to form a good range of programs: "The
Anti-Drug Programs that Work World Bank,"
so to speak, could be accessed by any community
looking for new approaches to local circumstances.
Any new initiative that proved successful
could be added, thereby becoming a catalyst
for the development of other successful
programs. Consider the following programs
and initiatives that if put into practice
on a large scale could reduce harm and abusive
behaviour.
Life Skills
Training Program
The Life Skills Training (LST) universal
classroom program addresses a wide range
of factors by teaching self-management skills
in combination with drug resistance skills
and normative education. The LST program
teaches children social resistance and refusal
skills, but it goes well beyond "Just
say no." LST teaches skills to avoid
high-risk situations. Along with age-appropriate
drug information, students learn how popular
culture and the media influence drug use
in society. Studies have shown that simple
information techniques of the past are not
effective in preventing teen drug use, as
they offered only a grocery list of the
negative effects of drugs.
In the LST
program, students learn techniques for coping
with stress and anxiety, how to resist advertising
appeals and how to formulate counter-arguments
when offered drugs. The New York junior
high students who received three-year LST
programs used 45% less alcohol, tobacco
and marijuana than students who received
no classroom instruction, according to findings
by the American Psychological Association.
Young people also developed improved decision-making,
communication and general assertiveness
skills.
School Environments
A report by the Carnegie Council on Adolescent
Development concluded that providing and
focusing on knowledge alone in prevention
programs is rarely effective and can even
be counter-productive. It can even have
the paradoxical result in some youths to
sample the substance. Information alone
was not sufficient to change either attitudes
or behaviour. Programs that focus entirely
on problem solving, self-esteem, and communication
have little positive impact on drug use.
These two approaches, according to the Carnegie
report, placed too little emphasis on the
kind of real-life skills students need to
cope with various internal and external
pressures to use drugs.
The programs
that address a variety of skills, knowledge
and values are more effective. For example,
the Arkansas "Teens are Concerned"
program is an exemplary comprehensive program.
It involves training, statewide presentation
by the program members, alcohol and drug
free alternative activities, and media campaigns
with local television, radio and newspapers.
A school
climate where drugs are unacceptable and
where students feel they are cared for makes
a tremendous difference in preventing teen
drug use. Research shows students in such
schools are less likely than others to use
drugs. A school can start with establishing
clear policies about alcohol, tobacco and
other drugs and developing an anti-drug
curriculum and peer leadership training
programs. Students' involvement in these
efforts and positive extra-curricular activities
help create an atmosphere where drugs are
the wrong thing to do. "Schools remain
our best shot at intervention," commented
one director of the Institute for Prevention
Research at Cornell University Medical College,
referring to establishing prevention programs
at schools. "If this program (Life
Skills Training) were implemented across
the U.S., we could save 100,000 lives a
year."
Teen Challenge
This program, which started 40 years ago
in New York slums, claims to be the most
successful program of its kind in the world
with a documented 86% success rate for participants
who complete the one year residential training
program. Teen Challenge of Barbados was
formed two years ago to help those with
substance abuse problems to retake control
of their lives by embracing Christian values
and applying Biblical principles to every
area of life. The success of the program
underscores the need for similar initiatives
guided by the inspiration of religious convictions
to allow people devastated by substance
abuse to recover their ethical and spiritual
compasses.
Culturally
Sensitive Programs
First Nations peoples in Canada are increasingly
reaching to the wealth of their own traditions
to deal with their drug problem. In the
words of Art Solomon, an Ojibway Elder:
"To heal a nation, we must first heal
the individuals, the families and the communities."
Waseskun House in Québec is a unique
community healing centre which offers services
to Aboriginal offenders throughout Eastern
Canada. Started by a group of volunteers
in 1988, Waseskun House has become one of
the most effective resources in North America.
The healing camp focuses on helping male
offenders (recently female offenders were
included) to regain balance in their lives.
It is a holistic residential program rooted
in an inclusive approach to Native cultural
traditions, a here-and-now awareness of
current realities and a proactive view of
responsible re-integration of individuals
into societal harmony. Most of the ex-offenders
who participate are dealing with drug and
alcohol abuse problems. The men participate
in a regular community healing circle, during
which they are free to resolve whatever
issues they choose, during a time frame
they decide upon.
Other activities
include traditional ceremonies, meditation,
addictions and sexuality information groups,
AA meetings, Talking Circles and individual
sessions. The words of one of the residents
of Waseskun Camp '97, when talking about
his experiences there, underline the need
for such programs rooted in cultural tradition:
"I came to this treatment centre for
my alcohol and drug addiction thus having
begun my healing journey at the House in
downtown Montréal.... The programs
I did there were helpful to my healing journey
since they were connected to my Native traditional
culture. For me, the highlight of my story
at Waseskun Camp was when I went into the
sweat lodge (my first time). This is one
experience that will stay forever in my
memory."
Under Toronto's
African-Canadian Youth Substance Abuse Program,
lessons in African history and philosophy
combine with harm reduction principles.
The program gives African-Canadian youth
a chance to learn and discuss topics such
as the ethics of slavery, the historic liaison
between Africans and Native Americans and
ancient African history. In the opinion
of it's counsellors, this improves self-esteem;
and, as that improves, many are able to
reduce the use of harmful substances and
eventually eliminate them altogether.
The Nia Centre
in Halifax offers prevention and education
programs designed specifically for Black
youth. Nia, Swahili for 'purpose', is one
of the seven values celebrated as part of
Kwanza, an African-American celebration.
The Centre, a program of the Halifax Task
Force on Drugs, was founded by community
members and has been funded by Canada's
Drug Strategy. Its goal is to increase awareness
of health, social, cultural and educational
issues in relation to drug abuse and to
address prevention approaches.
Representatives
from a variety of Toronto cultural communities
came together for the first time to address
addiction issues and to lobby for language-specific,
culturally-sensitive addiction services.
The group, called the Ethnocultural Coalition
- Access to Addiction Services, consists
of representatives from Somali, Iranian,
Spanish, Tamil, Caribbean, Chinese, Serbian
and Polish communities. Canada accepts more
than 200,000 new immigrants every year.
A majority of them settle in Ontario; almost
42% of those who end up in Toronto evidently
speak neither English nor French. Immigrants
have until now been all-but-invisible to
mainstream addiction service providers because
of their lack of English or French language
skills or other cultural considerations.
Certainly, this area of need for cultural-specific
addiction services should be the target
of specific programs and interventions.
RCMP Role
Earlier this year, the RCMP Drug Awareness
Co-ordinator, Bob Kennedy, demonstrated
how innovative, direct and culturally sensitive
response by government agencies to a drug
problem in a community can also make a difference
in situations where traditional responses
fail. Canada Customs were seizing 50kg a
month of the Somali drug Khat at the Ottawa
airport. About 200kg a week would arrive
at Toronto's Pearson airport. Dealing with
this problem consumed a great deal of RCMP
time and manpower. The judiciary did not
view Khat as serious, sentencing offenders
to one day in jail per kilo they imported.
Kennedy decided to contact the Somali community
to learn more about its culture and meet
its leaders. He found out that there was
general awareness of the damage Khat was
causing in the community but there was little
understanding of the legal implications
of its use. Further, there was a traditional
fear of police ingrained in the community
inherited from experiences in Somali.
As a result
of Officer Kennedy's intervention, a meeting
was set up with Somali leaders, community
members and media and the representatives
of federal departments of Transportation,
Customs and Excise, and RCMP, to explain
a broad range of issues associated with
importation of the drug. As a result of
the meeting, Kennedy was asked to sit on
a community advisory committee on Khat;
a booklet targeted at the Somali community
explaining all laws and regulations associated
with drugs was prepared, and the RCMP provides
assistance to the community regarding translations
and interpretations of the Canadian laws.
There have been no significant seizures
since at the Ottawa airport. The RCMP in
Toronto, where some 200kg of Khat still
arrive weekly, are planning a similar strategy.
Racing Against
Drugs
Another alternative drug and alcohol abuse
program, "Racing Against Drugs"
(RAD), was developed by the province of
Saskatchewan RCMP Drug Awareness Division
in partnership with various organizations.
Taking advantage of the fact that auto racing
is one of the world's largest spectator
sport and a growing family attraction in
Saskatchewan and Canada, RAD targets all
ages from pre-school to senior citizens.
It offers people of all ages the opportunity
to experience the world of auto racing while
at the same time providing an alternative
to drug and alcohol abuse. Community response
to the program has reportedly been overwhelming.
"RAD" has been showcased at events
such as the Draggins Car Show in Saskatoon,
the Majestics Car Show in Regina, the Moose
Jaw Art Show and other events. Numerous
school displays and presentations have also
been done.
Problem-Solving
Policing in Montréal
An innovative pilot project launched by
the Montréal police in 1992 to assist
a neighbourhood overrun by drug related
crime is a good example of a balance between
reducing both supply and demand. In essence,
it employs a get-tough approach with people
caught selling drugs while offering treatment
instead of jail to those found in simple
possession. A team of officers trained in
"problem-solving policing" was
put in place full time to stop the neighbourhood's
crime from getting worse and to give residents
a greater sense of personal safety. On the
street, police offered drug users support
and assistance as an alternative to arrest
for possession. Agreements were made with
detox and treatment centres in the area
to allow those needing help to be referred
there by police. Evaluations carried out
during the year-long pilot project indicated
such a high level of success that the program
has been renewed and extended to other neighbourhoods.
The Importance
of Family
The role of families in the start and maintenance
of drug misuse and dependence is now getting
more attention from the therapeutic community.
While the epidemiological trends in drug
abuse are also important, these should not
be considered without recognition of the
importance of the family as the most primary
influence in the development and growth
of individuals. A recent study by the Toronto-based
Addiction Research Foundation indicates
that the quality of family life and parent-child
communication plays an important role in
preventing substance use among adolescents.
It examined the links between aspects of
family life and smoking, heavy drinking,
marijuana use, other illicit drug use, delinquency
and drinking and driving.
Young people
who lived with both natural parents had
the lowest incidence for all six behaviours,
while those living with neither natural
parent were at the greatest risk. The data
indicated a strong link between students'
family lives and delinquency, heavy drinking
and the use of marijuana and other illicit
drugs. Factors in family life that influenced
young people included the amount of time
parents spend with their children and parental
efforts to keep track of where their children
are and what they are doing. Students who
regularly talked over problems with their
parents had the lowest rate of delinquency,
and those who never talked with parents
about problems were at greatest risk for
heavy drinking, illicit drug use and delinquency.
A number
of successful programs involving families
demonstrates an important truth: parents
can make a vital difference in teenage alcohol
and other drug use. Young people who feel
support from their families, who communicate
well with their parents, and who live with
standards and discipline are less likely
to become involved in alcohol or other drugs.
"Parents can be the greatest change
in the world" commented one expert
with the U.S. National Federation of Parents
for Drug-Free Youth.
Some experts
on youth crime say that while children from
troubled, or low-income families tend to
be more at risk of running into trouble
with the law, there is a new category of
young offender of middle class background
showing up more frequently. Doug McNally,
an ex-police chief and a member of Canada's
National Crime Prevention Council, comments:
"Although there is no statistical evidence,
I worry that it's caused by the same problem
- parental neglect."
The upheavals
the family has experienced in recent decades
serve to emphasize the need to strengthen
it as an institution and to ensure that
it is given adequate support to maintain
its vital role as a societal pillar.
Project Family
A variety of anti-drug programs that involve
parents have been implemented successfully
in both Canada and other countries. The
"Families Program" in the U.S.
provides prevention programming for 6 to
10-year old children of substance abusers.
Their intervention approach involves both
generations in learning and practising new
behaviours. Training sessions improve parenting
skills and reduce substance abuse by parents;
children's skills training decreases children's
negative behaviours and increases their
socially acceptable behaviour through work
with a therapist.
This intervention
approach has been evaluated in a variety
of settings with several cultural groups.
The results include reductions in family
conflict, improvement in family communication
and organization, and less youth behavioural
disorders, aggressiveness and substance
abuse.
A Seattle
program, "Focus on Families",
is designed for parents receiving methadone
treatment and their children. Its goal is
to reduce parents' use of illegal drugs
by teaching them skills for relapse prevention
and coping. Parents are also taught how
to manage their families better; topics
include family goal-setting, family communication,
family management, creating family expectations
about alcohol and other drugs, teaching
children skills (problem solving and resisting
drug offers) and helping children succeed
in school. Booster sessions and care management
services are also provided. Early results
indicate that parents' drug use is dramatically
lower and parenting skills significantly
better than in control groups.
Street Kids
Street kids are thought to be a group of
particularly heavy drug users. They are
also a better prey for abuse because of
the environment. Some have lost their link
with their families and have no friends,
but striving to be part of a group is important
to most adolescents. There are no reliable
estimates of the size of the street youth
population for Canada as a whole because
of the transitory nature of this community.
As many as 150,000 street youths probably
move through Canadian cities every year;
an estimated two-thirds of them use drugs
or alcohol weekly or daily.
The 'squeegee
kids', considered a nuisance by some in
Canadian cities, are evidently heavy drug
users. Just a few weeks ago, a former 'squeegee'
young woman shared her experience on a local
radio talk show of what life was like on
streets where drugs and alcohol abuse are
the norm. She says that for every dollar
motorists pay to a 'squeegee' person wiping
their car window directly supports a drug
cartel. She pleaded passionately for more
counselling that helped her recover her
life, but pointed out that the street kids
have to be forced off the streets because
they will not go voluntarily. She herself
was arrested and took advantage of available
programs that helped her reconstruct her
behaviour and develop a healthy attitude
towards life.
The downtown
Toronto 'Ambassador Program', operating
as a "retrieval program" for street
youth, is an example of young people helping
each other. It goes beyond just finding
kids who have dropped out of school and
lived through drug abuse; it gives them
an active role in dissuading others from
making the same mistakes. The Ambassador
Program, delivered by a coalition of eight
youth services agencies under the auspices
of Frontier College, has three priorities:
to get street youths back onto an educational
path; to give them practical experience
in the workplace; and to offer them a chance
to put a troubled life experience to work
for the betterment of others. The payoff
for the rest of the community is not only
the reality that a number of kids find alternatives
to drugs and crime, but that so many other
'high risk' youth are steered away from
similar lifestyles.
The youth
enrolled in the program are trained to visit
senior elementary schools in 'high risk'
neighbourhoods and make presentations to
Grade 7 and 8 students about life on the
street and on drugs, based on their own
experiences. Educators have long identified
twelve to fourteen-year olds as the best
age group to target for risk reduction.
The program director says the feedback from
the youth enrolled in the Ambassador Program
has been 'phenomenal' and that the overwhelming
demand from the schools for these types
of presentations shows their values and
underscores the need for more peer education
projects.
Harm Reduction
Harm reduction is still a controversial
approach to addressing drug problems, but
it has advanced in recent years, especially
in Britain and the Netherlands. The first
objective of harm reduction is to decrease
the negative consequences of drug use, whereas
drug policies elsewhere aim at reducing
drug consumption. Harm reduction sets up
a hierarchy of goals, with the more immediate
and realistic ones to be achieved as first
steps towards risk-free use or, if possible
abstinence.
Diane Riley
of the Canadian Centre on Substance Abuse
in her recent article, "The Harm Reduction
Model: Pragmatic Approaches to Drug Use
from the Area between Intolerance and Neglect",
outlines the arguments in favour of this
model. "Harm reduction," she states,
"acknowledges that policy makers, educators
and health promoters can tell drug users
how and why they should prevent harm and
provide them with the means to do it, but
only the users themselves can actually prevent
the harm. Research has clearly shown that
users will change their behaviour in response
to information about safer use, and that
this change is greater if skills training
as well as the means to ensure safety are
provided." Dr. Riley identifies the
basic principals of harm reduction education:
that the drug use is normal; it incurs benefits
as well as risks; it cannot be completely
eliminated but the harms can be reduced;
many young people grow out of drug use;
education should be non-judgmental; it requires
an open dialogue with the young and respect
for people's right to make their own decisions;
it emphasizes positive peer support not
decisiveness.
The British
Advisory Council on the Misuse of Drugs
declared that the spread of HIV is greater
danger to health than drug misuse. The World
Health Organization expressed a similar
opinion, stressing that attempts to reduce
drug use must not compromise measures against
the spread of AIDS. The Canadian government
adopted harm reduction as the framework
for Canada's National Drug Strategy in 1987.
It defined harm as "sickness, death,
social misery, crime, violence and economic
costs to all levels of government."
The only
comprehensive harm reduction programs today
are in Merseyside, England, developed in
the early 1980s in response to an epidemic
spread of drug use, particularly heroin.
The Merseyside clinics, pharmacists and
police force worked together to establish
an unique model of harm reduction, one involving
the prescription of drugs, syringe exchange
and helping rather than punishing drug users.
The service also offers counselling, the
provision of drugs including heroin, and
employment and housing services.
The police
role in Merseyside was to deal with drug
traffickers while operating a cautioning
policy toward drug users: taking an offender
to a police station, confiscating the drug,
and formally warning the offender that any
further unlawful possession of drugs would
result in prosecution. Users are given information
about local treatment services, including
syringe exchanges. The first time offenders
are warned and not given a criminal record.
On the second and third occasions, they
go to court and are fined upon conviction
for possession of small quantities or sentenced
for large amounts. If an addict becomes
registered by getting in touch with service
agencies, they are legally entitled to carry
drugs for personal use. The overall effect
is to steer users away from crime and possible
imprisonment.
At the end
of June 1991, Mersey Region had the second
lowest rate of HIV positive injection drug
use (IDU) of all 14 English regions: eight
per million population compared with an
English national rate of 34, and a top rate
of 136 per million in North-West Thames;
the rate for the UK as a whole was 51, with
Scotland's 183 HIV positive IDU per million
population. The Merseyside programs have
also been successful in reducing crime.
In 1990 and 1991, the Merseyside police
were the only force in the U.K. to register
a decrease in crime rates.
As Riley
points out, harm reduction does not provide
clear-cut answers and quick solutions, but
it has potential, if properly applied, to
address serious problems while not compromising
the quality and integrity of human life.
That is why it is essential that we more
clearly define harm reduction approaches
and carefully evaluate the impacts and effectiveness.
Youth Vision
The Banff "Youth Vision Jeunesse"
Drug Abuse Forum of young people from 24
countries, mentioned earlier in this paper,
was intended as a showcase for innovative
drug prevention ideas was proof that young
people want to take an active stand in the
world's anti-drug efforts and be a part
of the solution and not the problem. Secretary
General Kofi Annan commented at the presentation
of the "Vision from Banff" - document
adopted at the forum on drug abuse: "But
if this battle is to be won, our youth must
join in it, for it is their future which
is in the balance. Helping young people
say "no" to drugs is one of our
most important goals. All too often in this
process, the voice of young people is not
heard loud or clear enough. That is why
the United Nations is proud to have organized
the meetings in Banff and Paris, which you
attended. That is why we are pleased to
give you the opportunity to make your view
even more widely known during this special
session."
The youth
vision crafted in Alberta echoed through
the UN Special Session of the General Assembly
on World Drug Problems with clearly identified
recommendations to counter the drug problem.
Hopefully
all the participants at this conference
will make every effort to translate this
youth-inspired vision into a reality.
|
