Seimas of the Republic of Lithuania,
Drug Addiction Prevention Commission, Chairperson
2005 09 27
Vilnius
Ladies and Gentlemen, Dear guests of the international forum,
Let me welcome you on behalf of the Seimas of the Republic of Lithuania and wish the Forum to be a success. I am particularly pleased to see the success of organisers of this topical and timely forum in assembling the drug control experts and prevention specialists from international organisations for two consecutive days, ready to share their experience in solving one of the most dire problems of modern society, the danger posed by drug abuse. It is most regrettable that children and adolescents tend to become its easy and increasingly popular target. Drug abuse leads to other social problems, gives rise to crime, the spread of drug abuse adds up to the spread of HIV/AIDS and, to a large extent, to the increased suicide rate.
Trying to encompass all the constituent elements of the fight against drug abuse and to focus on prevention, and not only on treatment and rehabilitation, the Seimas of the Republic of Lithuania approved a long-term National Drug Control and Drug Addiction Prevention Programme for 2004 - 2008 aimed at preventing drugs from entering the country, and confirmed the role of the Drug Addiction Prevention Commission of the Seimas in ensuring the consistent mechanism of continuous parliamentary control.
Fight with drug abuse needs to be consistent. Control of drug supply and reduction of drug abuse should remain its fundamental goals.
As for reduction of the demand for drugs, it is especially important to implement a consistent system for prevention, treatment, rehabilitation and reintegration, which is still non-existent in Lithuania.
In 2002 and 2003, the Seimas of the Republic of Lithuania passed resolutions on prevention and drug control in Lithuania, eloquently speaking out against any attempts to legalise drugs and any policies stimulating the spread of drug abuse. This was the position Lithuania presented to the EU within the framework of discussions on the draft EU Drug Action Plan for 2005-2008.
The Seimas of the Republic of Lithuania adheres to the opinion that none of the drug programmes can conflict with the UN conventions, other international agreements and the Constitution of our state.
I admit I am worried by the harm reduction method, and concerned that this framework may be used for weakening the opposition of the society to drug use and abuse. I fear abuse of goodwill and I dare say the harm reduction programme itself may be channelled in one direction, making it exclusively linked to the methadone programme.
The Lithuanian doctors have been using the methadone programme for 10 years now, with no research carried out in Lithuania on the subject. The criteria for the choice of the target regions for comparison studies are crucial, as is consideration of the state development level, culture, healthcare system development level, and population. What is most important is the basis for establishing credibility of the methadone programme. Will credibility only be based on the results of research carried out in 1979-1997, where most sources of data date back to 1990-1993? Will new research be carried out instead? Biomedicine, similarly to most other fast developing sciences, honours an agreement that data from research performed more than 5 years ago cannot be used as the main source. Moreover, in 2000-2005 the global international renowned science publications (ISI) have published over 190 articles analysing the methadone programmes. Most of these studies are longitudinal, encompassing five or more years of observation and not all of these studies are well boding to the administrators of the methadone programmes.
The drug doses are the most important for the purposes of research. The highest interval between methadone doses Lithuania (15 to 100 mg) can be compared to dose intervals in Indonesia (15 to 60 mg of methadone) and Thailand (5 to 95 mg). Lithuania accounts for a huge dose indeed… Are Europeans the most resilient race?
The main reason Lithuania states to be the basis for the shift to the free-of-charge methadone is queer, to say the least: “It often proves difficult to collect money from the clients for the methadone they use, therefore the programme with methadone free of charge was thought to be more efficient”.
Thus, the implementation of the methadone programme is not aimed to ensure better accessibility of service (which is the usual reason for healthcare services to become free of charge), but search for profit on the part of the institution administering the programme seams to be its driving force: someone is paying the programme, and the money is guaranteed.
This is why I am concerned about the distribution of methadone within various frameworks, whether by the Abuse Treatment Centres, or for experimental purposes in Roma communities, as was recently communicated to me in writing by three Ombudsmen of the Republic of Lithuania.
I am also alarmed by another element of the harm reduction framework, and I mean the needle exchange, which I would dare call syringe and needle distribution. This can have a negative impact on the HIV/AIDS prevention.
The Board of the Seimas of the Republic of Lithuania approved the creation of two work groups initiated by the Drug Addiction Prevention Commission of the Seimas: “On reducing the harm of drug abuse inflicted on health and on implementing the harm reduction programmes in Lithuania” and “On the creation of short and medium-term supervision system for adolescents prone to crime and juvenile delinquents, and on the preparation of relevant draft legislation”.
In addition, the Drug Addiction Prevention Commission of the Seimas is examining the possibility of introducing the alternative punishment scheme, i.e. medical treatment of drug abusers who commit crimes, following the practice established in the USA.
At the request of the Commission, the National Courts Administration examined criminal cases investigated in 2003-2004 and informed the Commission that in the said years, 1218 of the cases involved possession of narcotic or psychotropic substances. 1398 persons were convicted for those crimes; their average age being 32 years. 579 persons were sentenced to imprisonment, 85 persons - to community service and 78 persons were given the sentence of restriction of freedom. Fines were imposed on 324 persons, while 345 persons were placed under arrest. The amount of drugs seized in these criminal cases amounted to, approximately, 1090 kilograms and 65 litres.
We do not know, however, what number of persons committed crimes while under the influence of narcotic, psychotropic or other substances having impact on the mental state.
A database of drug abusers is non-existent, there is no follow-up on the drug addicts after they leave treatment institutions and there is no uniform procedure of financing. What makes the treatment of drug addicts more difficult is that the necessary medications for persons under 18 are not reimbursed. A large part of the people with addictive disorders are not covered by the mandatory health insurance.
If we are going to move ahead in this area, we need to have a comprehensive system of health, rehabilitation and reintegration in place without delay. Otherwise we will continue fighting the consequences and financing the same centres for addictive disorders which, in their turn, will distribute needles, syringes and … methadone.
I am fully convinced that to protect children and young people against addictions, prevention must commence as soon as they show an interest in drugs or "in an innocent manner" drink beer or wine to celebrate the start of the school year on September 1.
We must raise the awareness of individuals and their family members, communities and the general public, in educational as well as professional settings, in state and national organisations.
We must allocate adequate funding and target the support and interventions towards risk-group persons during various stages of their life, especially for the purposes of education of children and young people and to prevent possible cases of suicide.
It is important to establish partnership, co-ordination and management between regions, institutions and individuals as well as their family members, groups and communities.
It should be noted that we need the following programmes to be designed:
- More programmes aimed at the improvement of children's education, the development of tolerance, the solution to the problems of alcohol abuse and other addictions, violence and crime;
- Without delay, training programmes for teachers, social workers and other professionals, even policemen, to ensure sufficient labour force that is competent across the necessary disciplines.
And what is most important, the state must initiate research that would enable a comparison of the results at the national and international level, especially among the Baltic States.
The state must also allocate adequate financial resources to address the problem of drug addiction. Without that, the money of supporters or philanthropists will not produce good results and will not encourage the public to monitor either the use of funds or the drug prevention effort.
According to the Drug Control Department under the Government of the Republic of Lithuania, in the year 2004, 15.6 per cent of inmates in places of imprisonment used narcotic and psychotropic substances. (According to the data available to me, this year the figure stands at over 16.2 per cent.) The director of the Department indicated that a survey conducted by the Prisons' Department under the Ministry of Justice demonstrated that nearly half of the inmates who are using drugs start taking them after their imprisonment (46.9 per cent).
Consequently, if in 2003-2005 the Prisons' Department were allocated funding for the control of the entry of drugs into prisons and for alternative treatment, the above-mentioned figure of 46.9 per cent would be different and the 1398 newly convicted persons would already be prescribed treatment as an alternative to imprisonment, so the above-mentioned 16 per cent would be much lower.
Current situation in Lithuania could be called a calm before the storm. Without sufficient financing of the police, prisons, border protection and customs services, we cannot expect any improvement in the near future. If drugs are available for purchase easily and freely, buyers will never be in shortage.
The implementation of measures must be in line with each country's constitutional structures and policies, national and sub-national needs, situation and resources.
Human rights, human dignity and health, prevention of suicide and eradication of causes of stress, violence, depression, anxiety and dependency on alcohol or other substances are a matter of security of the entire society and of national security which must outweigh any expenses and financial resources. I truly believe that this is exactly what is going to happen.
May I wish the participants of the Forum good Partnership, Sharing of Information and Hope that having shared your professional experience you will contribute to the effort our country is making in the fight against the dire phenomenon of drug addiction.
May I wish you all every success.
